Coccidioidomycosis in Brazil. A case report

Autor: MARTINS Marilena dos Anjos, ARAÚJO Evangelina da Motta Pacheco Alves de, KUWAKINO Marcelo Hisato, HEINS-VACCARI Elisabeth Maria, DEL NEGRO Gilda Maria Bárbaro, VOZZA JÚNIOR João Antonio, LACAZ Carlos da Silva
Jazyk: angličtina
Rok vydání: 1997
Předmět:
Zdroj: Revista do Instituto de Medicina Tropical de São Paulo, Vol 39, Iss 5, Pp 299-304 (1997)
Druh dokumentu: article
ISSN: 0036-4665
1678-9946
Popis: Coccidioidomycosis is an endemic infection with a relatively limited geographic distribution: Mexico, Guatemala, Honduras, Colombia, Venezuela, Bolivia, Paraguai, Argentina and the southwest of the United States. In these countries, the endemic area is restricted to the semiarid desert like regions which are similar to the northeast of Brazil. Case report: The patient is a 32 year-old male, born in the state of Bahia (Northeast of Brazil) and has been living in São Paulo (Southeast) for 6 years. He was admitted at Hospital das Clínicas, at the Department of Pneumology in October 1996, with a 6 month history of progressive and productive cough, fever, malaise, chills, loss of weight, weakness and arthralgia in the small joints. Chest x-rays and computerized tomography disclosed an interstitial reticulonodular infiltrate with a cavity in the right upper lobe. The standard potassium hydroxide preparation of sputum and broncoalveolar lavage demonstrated the characteristic thickened wall spherules in various stages of development. Sabouraud dextrose agar, at 25° C and 30° C showed growth of white and cottony aerial micelium. The microscopic morphology disclosed branched hyphae characterized by thick walled, barrel shaped arthroconidia alternated with empty cells. The sorological studies with positive double immunodiffusion test, and also positive complement fixation test in 1/128 dilution confirmed the diagnosis. The patient has been treated with ketoconazole and presents a favorable clinical and radiological evolution
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