Central Nervous System Paracoccidioidomycosis in an AIDS Patient: Case Report |
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Authors: | Mario León Silva-Vergara Ivonete Helena Rocha Rakel Rocha Vasconcelos André Luiz Maltos Fernando de Freitas Neves Luciana de Almeida Silva Teixeira Delio José Mora |
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Institution: | 1. Infectious Diseases Unit, Triangulo Mineiro Federal University, Avenida Frei Paulino, 30, Uberaba, Minas Gerais, CEP 38025-180, Brazil
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Abstract: | Up to now, over 200 patients with paracoccidioidomycosis (PCM) associated to HIV infection have already been reported; however, the central nervous system involvement in this coinfection was rarely reported. This paper presents a 35-year-old Brazilian male AIDS patient who developed pulmonary PCM successfully treated with itraconazole. At the antiretroviral therapy starting, he had 32 CD4+ T cells baseline count and high viral load levels. After 9 months, he presented severe fungal meningoencephalitis diagnosed by sublenticular enhanced nodular lesion at computerized tomography and magnetic resonance brain imaging and a positive Paracoccidiodes brasiliensis smear and culture from cerebrospinal fluid. At the time, a sixfold increase in CD4+ T cell count and undetectable viral load level were evidenced. The patient received amphotericin B during 1 year presenting slow but progressive clinical improvement, and he is currently asymptomatic and without neurological disabilities. To our knowledge, this is the second case report of a patient with neuroparacoccidioidomycosis associated to HIV infection. |
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