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1996-03-30
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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).