Document 0991
 DOCN  M9650991
 TI    Paracoccidioidomycosis and AIDS: an overview.
 DT    9505
 AU    Goldani LZ; Sugar AM; Evans Memorial Department of Clinical Research,
       Boston University; Medical Center Hospital, Massachusetts 02118, USA.
 SO    Clin Infect Dis. 1995 Nov;21(5):1275-81. Unique Identifier : AIDSLINE
       MED/96126015
 AB    The scarcity of reported cases of paracoccidioidomycosis and AIDS
       remains unexplained. We review the details of the 27 cases reported in
       the medical literature. Paracoccidioidomycosis occurs in patients with
       advanced AIDS who are not receiving prophylaxis for Pneumocystis carinii
       pneumonia with trimethoprim-sulfamethoxazole, which is also effective
       against Paracoccidioides brasiliensis. Clinical manifestations include
       prolonged fever, weight loss, generalized lymphadenopathy, splenomegaly,
       hepatomegaly, and skin rash. Diagnosis can often be made by direct
       microscopic examination and culture of the fungus from skin and lymph
       node specimens and occasionally from sputum, blood, spinal fluid, and
       bone marrow specimens. Since antibodies to P. brasiliensis are
       occasionally detected, the diagnosis should not be ruled out for
       patients whose serology is negative. Despite specific therapy with
       different regimens, the overall mortality of paracoccidioidomycosis
       among patients with AIDS is high (30%). The prognosis can be improved by
       earlier diagnosis and aggressive therapy with amphotericin B, followed
       by lifelong immunosuppressive therapy with
       trimethoprim-sulfamethoxazole. Health care providers caring for human
       immunodeficiency virus-infected patients who live or have resided in
       areas in which paracoccidioidomycosis is endemic must be aware of the
       possibility that this systemic mycosis may occur and have potentially
       severe consequences.
 DE    Antifungal Agents/THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/*COMPLICATIONS/DIAGNOSIS/  DRUG THERAPY  Human
       Paracoccidioidomycosis/*COMPLICATIONS/DIAGNOSIS/DRUG THERAPY  JOURNAL
       ARTICLE  REVIEW  REVIEW OF REPORTED CASES

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).