Brazilian guidelines for the clinical management of paracoccidioidomycosis
Maria Aparecida Shikanai-Yasuda,Rinaldo Poncio Mendes,Arnaldo Lopes Colombo,Flavio Queiroz-Telles,Adriana Kono,Anamaria Mello Miranda Paniago,André Nathan,Antonio Carlos Francisconido do Valle,Eduardo Bagagli,Gil Benard,Marcelo Simão Ferreira,Marcus de Melo Teixeira,Mario León Silva-Vergara,Ricardo Mendes Pereira,Ricardo de Souza Cavalcante,Rosane Christine Hahn,Rui Rafael Durlacher,Zarifa Khoury,Zoilo Pires de Camargo,Maria Luiza Moretti,Roberto Martinez +20 more
TLDR
The present guidelines aims to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management and emphasis on clinical, microbiological, and serological diagnosis and management of clinical forms and sequelae, as well as in patients with comorbidities and immunosuppression.Abstract:
Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America that is associated with rural environments and agricultural activities. However, the incidence and prevalence of paracoccidiodomycosis is underestimated because of the lack of compulsory notification. If paracoccidiodomycosis is not diagnosed and treated early and adequately, the endemic fungal infection could result in serious sequelae. While the Paracoccidioides brasiliensis ( P. brasiliensis ) complex has been known to be the causal agent of paracoccidiodomycosis, a new species, Paracoccidioides lutzii ( P. lutzii ), has been reported in Rondonia, where the disease has reached epidemic levels, and in the Central West and Para. Accurate diagnoses and availability of antigens that are reactive with the patients' sera remain significant challenges. Therefore, the present guidelines aims to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. This consensus summarizes etiological, ecoepidemiological, molecular epidemiological, and immunopathological data, with emphasis on clinical, microbiological, and serological diagnosis and management of clinical forms and sequelae, as well as in patients with comorbidities and immunosuppression. The consensus also includes discussion of outpatient treatments, severe disease forms, disease prevalence among special populations and resource-poor settings, a brief review of prevention and control measures, current challenges and recommendations.read more
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References
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Guideliness in paracoccidioidomycosis
Maria Aparecida Shikanai-Yasuda,Flávio de Queiroz Telles Filho,Rinaldo Poncio Mendes,Arnaldo Lopes Colombo,Maria Luiza Moretti +4 more
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Paracoccidioidomycosis: a recently proposed classification of its clinical forms
Marcello Franco,M. R. Montenegro,Rinaldo Poncio Mendes,Silvio Alencar Marques,Neusa Lima Dillon,N. G. S. Mota +5 more
TL;DR: A variety of criteria is an indication of the partial acceptance of many classifications of human paracoccidioidomycosis, since the authors still do not know where the fungus comes from and how it invades the human host, making difficult the evaluation of the early phases of the disease.