Paracoccidioidomycosis: Current Perspectives from Brazil



Rinaldo Poncio Mendes1, *, Ricardo de Souza Cavalcante1, Sílvio Alencar Marques2, Mariângela Esther Alencar Marques3, James Venturini4, Tatiane Fernanda Sylvestre1, Anamaria Mello Miranda Paniago5, Ana Carla Pereira6, Julhiany de Fátima da Silva1, Alexandre Todorovic Fabro7, Sandra de Moraes Gimenes Bosco8, Eduardo Bagagli8, Rosane Christine Hahn9, Adriele Dandara Levorato1
1 Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
2 Department of Dermatology, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
3 Department of Pathology, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
4 Laboratory of Experimental Immunology, Department of Biological Science, Faculty of Science, São Paulo State University – UNESP, São Paulo, Brazil
5 Department of Infectious and Parasitic Diseases, Faculdade de Medicina – Federal University of Mato Grosso do Sul – UFMS, Brazil
6 Instituto Lauro de Souza Lima, São Paulo State, Bauru, Brazil
7 Unit of Experimental Research, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
8 Department of Microbiology and Immunology – Instituto de Biociências de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil
9 Laboratory of Investigation and Mycology, Federal University of Mato Grosso, Faculty of Medicine Cuiabá, Mato Grosso, Brazil


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© 2017 Mendes et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Tropical Diseases, Faculdade de Medicina de Botucatu – São Paulo State University – UNESP, São Paulo, Brazil; Tel: (+55)143880-1742; E-mail: tietemendes@terra.com.br


Abstract

Background:

This review article summarizes and updates the knowledge on paracoccidioidomycosis. P lutzii and the cryptic species of P. brasiliensis and their geographical distribution in Latin America, explaining the difficulties observed in the serological diagnosis.

Objectives:

Emphasis has been placed on some genetic factors as predisposing condition for paracoccidioidomycosis. Veterinary aspects were focused, showing the wide distribution of infection among animals. The cell-mediated immunity was better characterized, incorporating the recent findings.

Methods:

Serological methods for diagnosis were also compared for their parameters of accuracy, including the analysis of relapse.

Results:

Clinical forms have been better classified in order to include the pictures less frequently observesiod.

Conclusion:

Itraconazole and the trimethoprim-sulfamethoxazole combination was compared regarding efficacy, effectiveness and safety, demonstrating that azole should be the first choice in the treatment of paracoccidioidomycosis.

Keywords: Paracoccidioidmycosis, Paracoccidioides brasiliensis, Paracoccidioides lutzii, Endemic mycosis, Systemic mycosis, Antifungal compounds.