Intestinal paracoccidioidomycosis resembling Crohn’s disease in a teenager: a case report
| Autor: | Raquel Franco Leal, Pedro Vitor Veiga Silva Magalhães, Raquel Togni, Nielce Maria de Paiva, Antonio Fernando Ribeiro, Elizete Aparecida Lomazi, Leandro Minatel Vidal de Negreiros |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Crohn’s disease medicine.medical_specialty Abdominal pain Adolescent Intestinal paracoccidioidomycosis 030106 microbiology lcsh:Medicine Colonoscopy Drug intolerance Case Report Inflammatory bowel disease Gastroenterology Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Crohn Disease Gastrointestinal Agents Internal medicine medicine Humans Crohn's disease medicine.diagnostic_test Paracoccidioidomycosis business.industry lcsh:R Paracoccidioides General Medicine medicine.disease Infliximab Diarrhea 030211 gastroenterology & hepatology Differential diagnosis medicine.symptom business medicine.drug |
| Zdroj: | Journal of Medical Case Reports Journal of Medical Case Reports, Vol 12, Iss 1, Pp 1-4 (2018) |
| ISSN: | 1752-1947 |
| Popis: | Background Differential diagnosis of inflammatory bowel disease is often very challenging. Paracoccidioidomycosis is a fungal disease that can mimic manifestations of Crohn’s disease. Case presentation We report a case of a 13-year-old Caucasian boy with abdominal pain for 1.5 years associated with nausea, diarrhea, and weight loss of 10 kg. He presented increased C-reactive protein and an increased erythrocyte sedimentation rate. A colonoscopy showed deep serpiginous ulcers throughout his entire colon and rectum, which suggested Crohn’s disease. He received one dose of infliximab, which is an anti-tumor necrosis factor-α, and showed no improvement. After the second dose, he got worse and started to have bloody diarrhea. A new colonoscopy was performed and pathological examination revealed ulcerative chronic inflammation with non-caseating granulomas and fungal structures (budding forms) compatible with Paracoccidioides brasiliensis. He underwent intravenously administered and then orally administered trimethoprim-sulfamethoxazole treatment. Due to drug intolerance, he was treated with amphotericin B and itraconazole, then he showed clinical improvement and mucosal healing with good outcome. Conclusion Paracoccidioidomycosis must be part of the differential diagnosis of inflammatory bowel diseases in endemic areas and must be excluded before starting immunosuppressive therapy. |
| Databáze: | OpenAIRE |
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