title: Paracoccidioides brasiliensis PS2: First Autochthonous Paracoccidioidomycosis Case Report in Rio de Janeiro, Brazil, and Literature Review.
abstract: Paracoccidioidomycosis (PCM) is a systemic mycosis caused by pathogenic dimorphic fungi of the Paracoccidioides brasiliensis complex. It is the most important systemic mycosis in Latin America, mainly in Brazil. Despite its severity and high mortality rates, it is considered a neglected disease. Species within the genus Paracoccidioides present genetics and morphological variations with probable clinical, diagnostic and therapeutic consequences. In fact, there are a very small number of detailed case reports with molecular identification of these fungal agents. Here, it is reported a case of PCM due to Paracoccidioides brasiliensis PS2. Molecular identification of the isolate was performed by amplification and sequencing of the arf and gp43 genes. Clinical cases and strain reports with molecular identification in the literature are also reviewed. The case herein presented is the first autochthonous report of PCM due to Paracoccidioides brasiliensis PS2 species in the state of Rio de Janeiro, Brazil, an important endemic area. The patient presented a chronic pulmonary form of PCM and had a satisfactory response to sulfamethoxazole/trimethoprim although sequelae such as adrenal insufficiency and dysphonia were observed. This study may contribute to improve the knowledge about this severe disease, its causative cryptic species and their consequences to patients.
authors.affiliation: Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 21045-900, Brazil. priscila.marques@ini.fiocruz.br.
authors.forename: Priscila Marques
authors.initials: PM
authors.lastname: de Macedo
authors.affiliation: Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Almeida-Paes
authors.affiliation: Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Mauro
authors.initials: M
authors.lastname: de Medeiros Muniz
authors.affiliation: Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Manoel Marques Evangelista
authors.initials: MM
authors.lastname: Oliveira
authors.affiliation: Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Rosely Maria
authors.initials: RM
authors.lastname: Zancopé-Oliveira
authors.affiliation: Coordenação de Pesquisa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: Regina Lana Braga
authors.initials: RL
authors.lastname: Costa
authors.affiliation: Laboratório de Pesquisa Clínica em Dermatologia Infecciosa, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 21045-900, Brazil.
authors.forename: Antonio Carlos Francesconi
authors.initials: AC
authors.lastname: do Valle
mesh_terms: D020727:ADP-Ribosylation Factors / Q000235:genetics; D000328:Adult; D000946:Antigens, Fungal / Q000235:genetics; D001938:Brazil; D016000:Cluster Analysis; D005656:Fungal Proteins / Q000235:genetics; D006023:Glycoproteins / Q000235:genetics; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology*; D008297:Male; D010228:Paracoccidioides / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D010229:Paracoccidioidomycosis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology*; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D017385:Sequence Homology
chemical_list: C103180:43 kDa protein, Paracoccidioides; D000946:Antigens, Fungal; D005656:Fungal Proteins; D006023:Glycoproteins; D020727:ADP-Ribosylation Factors
keywords: Molecular identification; Paracoccidioides brasiliensis PS2; Paracoccidioidomycosis; Pulmonary chronic disease