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ABSTRACT A 49-year-old patient with changes in the nails of the hallux for 10 years was diagnosed with onychomycosis. The identity of the causative agent was confirmed as Cladosporium halotolerans from the Cladosporium sphaerospermum species complex using molecular techniques. MALDI-TOF identified the agent as C. sphaerospermum complex species. Overall, species such as onychomycosis agents should attract special attention to avoid mistakes in the identification process while considering a probable contaminant as responsible for the disease. These species deserve attention since there are rare descriptions of them as causes of onychomycosis. It is important to recognize them as causes of disease and not just as a probable contaminant.

https://doi.org/10.31744/einstein_journal/2023rc0326

II Consenso Brasileiro em Paracoccidioidomicose - 2017
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Shikanai-Yasuda, Maria Aparecida

; Mendes, Rinaldo Pôncio

; Colombo, Arnaldo Lopes

; Telles, Flávio de Queiroz

; Kono, Adriana

; Paniago, Anamaria Mello Miranda

; Nathan, André

; Valle, Antonio Carlos Francisconi do

; Bagagli, Eduardo

; Benard, Gil

; Ferreira, Marcelo Simão

; Teixeira, Marcus de Melo

; Vergara, Mario Leon Silva

; Pereira, Ricardo Mendes

; Cavalcante, Ricardo de Souza

; Hahn, Rosane

; Durlacher, Rui Rafael

; Khoury, Zarifa

; Camargo, Zoilo Pires de

; Moretti, Maria Luiza

; Martinez, Roberto

Epidemiologia e Serviços de Saúde

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2018, Volume 27 Nº spe elocation e0500001

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo A paracoccidioidomicose (PCM) é uma micose sistêmica, relacionada às atividades agrícolas, com incidência e prevalência subestimadas, pela ausência de notificação em várias Unidades da Federação (UFs). A evolução insidiosa do quadro clínico pode ter como consequência sequelas graves se o diagnóstico e o tratamento não forem instituídos precoce e adequadamente. Ao lado do complexo Paracoccidioides brasiliensis (P. brasiliensis), a descrição de nova espécie, Paracoccidioides lutzii (P. lutzii), em Rondônia, onde a doença alcançou níveis epidêmicos, bem como na região Centro-Oeste e no Pará, constituem-se em desafios para a instituição do diagnóstico e a urgente disponibilização de antígenos que tenham reatividade com os soros dos pacientes. Este consenso visa atualizar o primeiro consenso brasileiro em PCM, estabelecendo recomendações para o manejo clínico do paciente, com base nas evidências conhecidas. São apresentados dados de etiologia, epidemiologia, imunopatogenia, diagnóstico, terapêutica e sequelas, enfatizando-se o diagnóstico e a terapêutica, bem como recomendações e desafios atuais nessa área do conhecimento.

Abstract Paracoccidioidomycosis is a systemic fungal disease associated with agricultural activities. Its incidence and prevalence are underestimated because of the lack of reporting in several Brazilian states. If paracoccidiodomycosis is not diagnosed and treated early and adequately, endemic fungal infection may result in serious sequelae. In addition to the Paracoccidioides brasiliensis (P. brasiliensis) complex, the appearance of a new species, Paracoccidioides lutzii (P. lutzii), in Rondônia state, where the disease has reached epidemic levels, and in the country’s Midwest region and Pará state, are challenges to diagnosis and to the urgent availability of antigens that are reactive with patients’ sera. These guidelines aim to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. The guidelines provide data on etiology, epidemiology, immunopathogenesis, diagnosis, treatment and sequelae, with emphasis on diagnosis and treatment, as well as current recommendations and challenges in this field of knowledge.

Resumen La paracoccidioidomicosis es una micosis sistémica, relacionada con las actividades agrícolas, con incidencia y prevalencia subestimadas por la ausencia de notificación en varios estados. La evolución insidiosa del cuadro clínico puede tener como consecuencia secuelas graves si el diagnóstico y el tratamiento no se establecen precoz y adecuadamente. Al lado del complejo Paracoccidioides brasiliensis (P. brasiliensis), la descripción de nueva especie, Paracoccidioides lutzii (P. lutzii) en Rondonia, donde la enfermedad alcanzó niveles epidémicos, y en la región Centro Oeste y en Pará, se constituyen en desafíos para la institución del diagnóstico y la urgente puesta a disposición de antígenos que tengan reactividad con los sueros de los pacientes. El presente consenso tiene por objeto actualizar el primer consenso brasileño en paracoccidioidomicosis, estableciendo recomendaciones para el manejo del paciente al borde del lecho, con base en las evidencias conocidas. Se presentan datos de etiología, epidemiología, inmunopatogenia, diagnóstico, terapéutica y secuelas, enfatizando el diagnóstico y terapéutica, así como recomendaciones desafíos y actuales en esta área del conocimiento.

https://doi.org/10.5123/s1679-49742018000500001 42486 downloads

II Consenso Brasileiro em Paracoccidioidomicose - 2017
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Shikanai-Yasuda, Maria Aparecida

; Mendes, Rinaldo Pôncio

; Colombo, Arnaldo Lopes

; Telles, Flávio de Queiroz

; Kono, Adriana

; Paniago, Anamaria Mello Miranda

; Nathan, André

; Valle, Antonio Carlos Francisconi do

; Bagagli, Eduardo

; Benard, Gil

; Ferreira, Marcelo Simão

; Teixeira, Marcus de Melo

; Vergara, Mario Leon Silva

; Pereira, Ricardo Mendes

; Cavalcante, Ricardo de Souza

; Hahn, Rosane

; Durlacher, Rui Rafael

; Khoury, Zarifa

; Camargo, Zoilo Pires de

; Moretti, Maria Luiza

; Martinez, Roberto

Epidemiologia e Serviços de Saúde

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2018, Volume 27 Nº spe elocation e0500001

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.5123/s1679-49742018000500001 29 downloads

Brazilian guidelines for the clinical management of paracoccidioidomycosis
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Shikanai-Yasuda, Maria Aparecida

; Mendes, Rinaldo Pôncio

; Colombo, Arnaldo Lopes

; Queiroz-Telles, Flávio de

; Kono, Adriana Satie Gonçalves

; Paniago, Anamaria M. M

; Nathan, André

; Valle, Antonio Carlos Francisconi do

; Bagagli, Eduardo

; Benard, Gil

; Ferreira, Marcelo Simão

; Teixeira, Marcus de Melo

; Silva-Vergara, Mario León

; Pereira, Ricardo Mendes

; Cavalcante, Ricardo de Souza

; Hahn, Rosane

; Durlacher, Rui Rafael

; Khoury, Zarifa

; Camargo, Zoilo Pires de

; Moretti, Maria Luiza

; Martinez, Roberto

Revista da Sociedade Brasileira de Medicina Tropical

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Set 2017, Volume 50 Nº 5 Páginas 715 - 740

Resumo: En | Texto: En | PDF: En

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 Rondônia, where the disease has reached epidemic levels, and in the Central West and Pará. 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.

https://doi.org/10.1590/0037-8682-0230-2017 10753 downloads

Terpinen-4-ol, tyrosol, and β-lapachone as potential antifungals against dimorphic fungi
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Brilhante, Raimunda Sâmia Nogueira

; Caetano, Érica Pacheco

; Lima, Rita Amanda Chaves de

; Marques, Francisca Jakelyne de Farias

; Castelo-Branco, Débora de Souza Collares Maia

; Melo, Charlline Vládia Silva de

; Guedes, Glaucia Morgana de Melo

; Oliveira, Jonathas Sales de

; Camargo, Zoilo Pires de

; Moreira, José Luciano Bezerra

; Monteiro, André Jalles

; Bandeira, Tereza de Jesus Pinheiro Gomes

; Cordeiro, Rossana de Aguiar

; Rocha, Marcos Fábio Gadelha

; Sidrim, José Júlio Costa

Brazilian Journal of Microbiology

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Dez 2016, Volume 47 Nº 4 Páginas 917 - 924

Resumo: En | Texto: En | PDF: En

Abstract This study aimed to evaluate the in vitro antifungal activity of terpinen-4-ol, tyrosol, and β-lapachone against strains of Coccidioides posadasii in filamentous phase (n = 22) and Histoplasma capsulatum in both filamentous (n = 40) and yeast phases (n = 13), using the broth dilution methods as described by the Clinical and Laboratory Standards Institute, to determine the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of these compounds. The mechanisms of action of these compounds were also investigated by analyzing their effect on cell membrane permeability and ergosterol synthesis. The MIC and MFCf these compounds against C. posadasii, mycelial H. capsulatum, and yeast-like H. capsulatum, were in the following ranges: 350-5720 µg/mL, 20-2860 µg/mL, and 40-1420 µg/mL, respectively for terpinen-4-ol; 250-4000 µg/mL, 30-2000 µg/mL, and 10-1000 µg/mL, respectively, for tyrosol; and 0.48-7.8 µg/mL, 0.25-16 µg/mL, and 0.125-4 µg/mL, respectively for β-lapachone. These compounds showed a decrease in MIC when the samples were subjected to osmotic stress, suggesting that the compounds acted on the fungal membrane. All the compounds were able to reduce the ergosterol content of the fungal strains. Finally, tyrosol was able to cause a leakage of intracellular molecules.

https://doi.org/10.1016/j.bjm.2016.07.015 1107 downloads

Antiretroviral drugs saquinavir and ritonavir reduce inhibitory concentration values of itraconazole against Histoplasma capsulatum strains in vitro
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Brilhante, Raimunda Sâmia Nogueira

; Caetano, Érica Pacheco

; Riello, Giovanna Barbosa

; Guedes, Glaucia Morgana de Melo

; Castelo-Branco, Débora de Souza Collares Maia

; Fechine, Maria Auxiliadora Bezerra

; Oliveira, Jonathas Sales de

; Camargo, Zoilo Pires de

; Mesquita, Jacó Ricarte Lima de

; Monteiro, André Jalles

; Cordeiro, Rossana de Aguiar

; Rocha, Marcos Fábio Gadelha

; Sidrim, José Júlio Costa

Brazilian Journal of Infectious Diseases

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Abr 2016, Volume 20 Nº 2 Páginas 155 - 159

Resumo: En | Texto: En | PDF: En

Abstract Recent studies have shown that some drugs that are not routinely used to treat fungal infections have antifungal activity, such as protease inhibitor antiretroviral drugs. This study investigated the in vitro susceptibility of Histoplasma capsulatum var. capsulatum to saquinavir and ritonavir, and its combination with the antifungal itraconazole. The susceptibility assay was performed according to Clinical and Laboratory Standards Institute guidelines. All strains were inhibited by the protease inhibitor antiretroviral drugs. Saquinavir showed minimum inhibitory concentrations ranging from 0.125 to 1 μg mL−1 for both phases, and ritonavir presented minimum inhibitory concentrations ranging from 0.0312 to 4 μg mL−1and from 0.0625 to 1 μg mL−1 for filamentous and yeast phase, respectively. Concerning the antifungal itraconazole, the minimum inhibitory concentration values ranged from 0.0019 to 0.125 μg mL−1 and from 0.0039 to 0.0312 μg mL−1 for the filamentous and yeast phase, respectively. The combination of saquinavir or ritonavir with itraconazole was synergistic against H. capsulatum, with a significant reduction in the minimum inhibitory concentrations of both drugs against the strains (p < 0.05). These data show an important in vitro synergy between protease inhibitors and itraconazole against the fungus H. capsulatum.

https://doi.org/10.1016/j.bjid.2015.11.003 937 downloads

PREVALENCE OF PARACOCCIDIOIDOMYCOSIS INFECTION BY INTRADERMAL REACTION IN RURAL AREAS IN ALFENAS, MINAS GERAIS, BRAZIL
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Magalhães, Evandro Monteiro de Sá

; Ribeiro, Carla de Fátima

; Dâmaso, Carla Silva

; Coelho, Luiz Felipe Leomil

; Silva, Roberta Ribeiro

; Ferreira, Eric Batista

; Rodrigues, Maria Rita

; Camargo, Zoilo Pires de

; Velloso, Tânia Regina Grão

; Malaquias, Luiz Cosme Cotta

Revista do Instituto de Medicina Tropical de São Paulo

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Jul 2014, Volume 56 Nº 4 Páginas 281 - 285

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Este estudo teve como objetivo estimar a prevalência de sensibilização da pele pelo Paracoccidioides brasiliensis em áreas rurais em Alfenas, MG, Brasil, e avaliar os fatores de risco associados à infecção. Foi realizado um estudo transversal de base populacional utilizando testes intradérmicos com paracoccidioidina em 542 indivíduos selecionados por demanda espontânea. Os participantes foram submetidos a uma entrevista através do preenchimento de um formulário de inscrição com os dados epidemiológicos e os testes com a administração intradérmica de 0,1 mL de paracoccidioidina no antebraço esquerdo. O teste foi lido 48 h após a injeção e foi considerado positivo se enduramento era maior ou igual a 5 mm. De 542, 46,67% participantes foram positivos ao teste de pele. Prevalência aumentou de acordo com o aumento da idade. Houve significância estatística apenas para o sexo masculino. Profissão, alcoolismo e tabagismo não foram significativamente associados com o risco de infecção paracoccidioidomicose. Há relevância da infecção paracoccidioidomicose em áreas rurais, o que sugere mais estudos epidemiológicos e clínicos sobre esta micose no sul do estado de Minas Gerais.

This study aimed to estimate the prevalence of paracoccidioidal infection by intradermal reaction (Delayed-Type Hypersensitivity, DTH) to Paracoccidioides brasiliensis in rural areas in Alfenas, Southern Minas Gerais (MG) State, Brazil, and to assess risk factors (gender, occupation, age, alcohol intake and smoking) associated with infection. We conducted a population-based cross-sectional study using intradermal tests with gp 43 paracoccidioidin in 542 participants, who were previously contacted by local health agents and so spontaneously attended the test. Participants underwent an interview by filling out a registration form with epidemiological data and were tested with an intradermal administration of 0.1 mL of paracoccidioidin in the left forearm. The test was read 48 hours after injection and was considered positive if induration was greater than or equal to 5 mm. Out of 542 participants, 46.67% were positive to the skin test. Prevalence increased in accordance with an increase of age. There was statistical significance only for males. Occupation, alcohol intake and smoking habits were not significantly associated with the risk of paracoccidioidomycosis infection. There is relevance of paracoccidioidomycosis infection in such rural areas, which suggests that further epidemiological and clinical studies on this mycosis should be done in the southern part of Minas Gerais State.

https://doi.org/10.1590/S0036-46652014000400002 2428 downloads

Coccidioidomycosis in armadillo hunters from the state of Ceará, Brazil
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Brillhante, Raimunda Sâmia Nogueira

; Moreira Filho, Renato Evando

; Rocha, Marcos Fábio Gadelha

; Castelo-Branco, Débora de Souza Collares Maia

; Fechine, Maria Auxiliadora Bezerra

; Lima, Rita Amanda Chaves de

; Picanço, Yuri Vieira Cunha

; Cordeiro, Rossana de Aguiar

; Camargo, Zoilo Pires de

; Queiroz, José Ajax Nogueira

; Araujo, Roberto Wagner Bezerra de

; Mesquita, Jacó Ricarte Lima de

; Sidrim, José Júlio Costa

Memórias do Instituto Oswaldo Cruz

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Set 2012, Volume 107 Nº 6 Páginas 813 - 815

Resumo: En | Texto: En | PDF: En

Coccidioidomycosis is a systemic mycosis with a variable clinical presentation. Misdiagnosis of coccidioidomycosis as bacterial pneumopathy leads to inappropriate prescription of antibiotics and delayed diagnosis. This report describes an outbreak among armadillo hunters in northeastern Brazil in which an initial diagnosis of bacterial pneumonia was later confirmed as coccidioidomycosis caused by Coccidioides posadasii. Thus, this mycosis should be considered as an alternative diagnosis in patients reporting symptoms of pneumonia, even if these symptoms are only presented for a short period, who are from areas considered endemic for this disease.

3256 downloads

Cotrimoxazole enhances the in vitro susceptibility of Coccidioides posadasii to antifungals
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Cordeiro, Rossana de Aguiar

; Astete-Medrano, Delia Jessica

; Marques, Francisca Jakelyne de Farias

; Andrade, Heuziwanne Tavares Leite

; Perdigão Neto, Lauro Vieira

; Tavares, Juliane Lira

; Lima, Rita Amanda Chaves de

; Patoilo, Kharla Kharolyni Nobre Rabelo

; Monteiro, Andre Jalles

; Brilhante, Raimunda Sâmia Nogueira

; Rocha, Marcos Fábio Gadelha

; Camargo, Zoilo Pires de

; Sidrim, José Júlio Costa

Memórias do Instituto Oswaldo Cruz

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Dez 2011, Volume 106 Nº 8 Páginas 1045 - 1048

Resumo: En | Texto: En | PDF: En

The aim of the present study was to evaluate the effect of cotrimoxazole on the in vitro susceptibility of Coccidioides posadasii strains to antifungals. A total of 18 strains of C. posadasii isolated in Brazil were evaluated in this study. The assays were performed in accordance with the Clinical and Laboratory Standards Institute guidelines and the combinations were tested using the checkerboard method. The minimum inhibitory concentrations were reduced by 11, 2.4, 4.3 and 3.5 times for amphotericin B, itraconazole, fluconazole and voriconazole, respectively. Moreover, it was seen that cotrimoxazole itself inhibited C. posadasii strains in vitro. The impairment of folic acid synthesis may be a potential antifungal target for C. posadasii.

2865 downloads

10.

Trichosporon species isolated from the perigenital region, urine and catheters of a Brazilian population
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Silvestre Junior, Agenor Messias

; Miranda, Mauricio Alexandre Bandeira Rampazzo

; Camargo, Zoilo Pires de

Brazilian Journal of Microbiology

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Out 2010, Volume 41 Nº 3 Páginas 628 - 634

Resumo: En | Texto: En | PDF: En

The present study aimed to 1) determine the colonization rates of medically important Trichosporon species on normal perigenital skin and 2) determine the isolation rates of Trichosporon spp. isolated from the urine and catheters of Brazilian patients hospitalized in the Intensive Care Unit (ICU). The overall colonization rate of Trichosporon spp. was 11.15% (112 isolates). The most common species isolated from normal perigenital skin was T. cutaneum (29.46%), followed by T. asteroides (20.53%), T. ovoides (15.17%), T. inkin (10.71%), T. mucoides (8.92%), and T. asahii (6.25%). From urine and catheters, T. asahii was the species most commonly isolated (76.5%; n =23), followed by T. inkin (16.6%; n = 5) and T. asteroides (6.6%; n = 2). In addition, the highest isolation rate occurred in subjects in the 71- to 80-year-old age range (36.7%; n= 11), followed by 61 to 70 (26.7%; n = 8), 51 to 60 (13.3%; n = 4), 31 to 40 (13.33%; n = 4), and 41 to 50 (10%; n =3). We concluded that 6 medically important species of the genus Trichosporon colonize the perigenital region in a normal population. The identification of these species is possible by means of classical methods but often requires repeated analyses repetitions due to difficulties in the assimilation process. In contrast, only 3 species of Trichosporon were isolated from urine and catheters.

3321 downloads

11.

Simultaneous infection of human host with genetically distinct isolates of Paracoccidioides brasiliensis
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Batista Júnior, João

; Berzaghi, Rodrigo

; Arnaud, Adelita Duanra Medeiros do Monte

; Fontes, Cor Jesus Fernandes

; Camargo, Zoilo Pires de

; Hahn, Rosane Christine

Memórias do Instituto Oswaldo Cruz

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Fev 2010, Volume 105 Nº 1 Páginas 62 - 65

Resumo: En | Texto: En | PDF: En

This study is the first report on genetic differences between isolates of Paracoccidioides brasiliensis from a single patient. We describe a simultaneous infection with genetically distinct isolates of P. brasiliensis in a patient with chronic paracoccidioidomycosis. The clinical isolates were obtained from lesions in different anatomical sites and were characterised by random amplified polymorphic DNA (RAPD) analysis. The RAPD technique can be helpful for distinguishing between clinical isolates. Different random primers were used to characterise these clinical isolates. The RAPD patterns allowed for differentiation between isolates and the construction of a phenetic tree, which showed more than 28% genetic variability in this fungal species, opening new possibilities for clinical studies of P. brasiliensis. Based on these results and preliminary clinical findings, we suggest that different genotypes of P. brasiliensis might infect the same patient, inducing the active form of the disease.

2508 downloads

12.

Natural antibodies in paracoccidioidomycosis
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Unterkircher, Carmelinda S.

; Leão, Mariella V.P.

; Blotta, Maria Heloisa S.L.

; Camargo, Zoilo Pires de

Brazilian Journal of Microbiology

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Jun 2004, Volume 35 Nº 1-2 Páginas 59 - 63

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Recente atenção tem sido dada aos anticorpos naturais como componentes da imunidade natural e como parte integrante da rede idiotípica. Todavia, seu papel funcional em diferentes infecções tem, raramente, sido estudado. O objetivo deste trabalho foi investigar a presença de anticorpos naturais na paracoccidioidomicose (PCM). Em adição, analisamos os anticorpos específicos anti-P. brasiliensis e sua distribuição em subclasses a fim de adquirir mais conhecimento sobre a resposta imune humoral nesta micose. Nossos achados mostram que a resposta de anticorpos naturais não é acentuada na PCM quando comparada com outras infecções por parasitas e, é restrita a poucas especificidades, sugerindo que o P. brasiliensis estimula moderadamente as células B CD5+. O anticorpo anti-actina foi a principal especificidade encontrada na PCM. Os anticorpos especificos para P. brasiliensis, nos pacientes crônicos, eram, principalmente, da subclasse IgG1.

Recent attention has been focused on the natural antibodies as a component of natural immunity and as integral part of the idiotypic network. However, their functional role in different infections has rarely been studied. This work was undertaken to investigate the presence of natural antibodies in paracoccidioidomycosis (PCM). In addition, we analyzed anti-P. brasiliensis antibodies and their distribution in IgG subclasses in order to acquire better knowledge about the humoral immune response in this mycosis. Our findings show that the natural antibody response is not very much increased in PCM when compared with other parasite infections and this response is restricted to a few specificities, suggesting that P. brasiliensis moderately triggers CD5+ B cells. The anti-actin antibody was the main antibody specificity found in PCM. Specific antibodies to P. brasiliensis were mainly found in the IgG1 subclass in chronic patients of PCM.

1782 downloads

13.

Paracoccidioidomicose em índios brasileiros da tribo Suruí: estudo clínico-laboratorial de 2 casos
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Forjaz, Marly H.H.

; Fischman, Olga

; Camargo, Zoilo Pires de

; Vieira Filho, João Paulo Botelho

; Colombo, Arnaldo Lopes

Revista da Sociedade Brasileira de Medicina Tropical

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Out 1999, Volume 32 Nº 5 Páginas 571 - 575

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Paracoccidioidomicose é considerada a micose sistêmica endêmica mais prevalente na América Latina. Apesar da maior parte da casuística de paracoccidioidomicose ocorrer entre trabalhadores rurais, há poucos casos documentados de ocorrência dessa micose entre índios brasileiros. São apresentados 2 casos de paracoccidioidomicose em índios Suruí, família linguística Tupi-Mondé, procedentes de Cacoal, Rondônia. Ambos apresentaram sorologia positiva à imunodifusão apenas com antígenos da fase miceliana do P. brasiliensis. Os autores apresentam revisão de literatura sobre a ocorrência dessa micose entre índios brasileiros e discutem a necessidade de futuras investigações buscando caracterizar as diferenças regionais de cepas de P. brasiliensis e seu impacto no diagnóstico sorológico dessa micose.

Paracoccidioidomycosis has been considered the most frequent endemic systemic mycosis in Latin America. Although most cases of paracoccidioidomycosis involve rural workers, this systemic fungal disease has been scarcely reported among Amerindian populations from Brazil. We report two cases of paracoccidioidomycosis in Tupi-Mondé Amerindians from Cacoal, state of Rondônia, Brazil. Both cases exhibited positive serological results by a specific immunodiffusion test only when the assay was performed with antigens obtained from the mycelial form of P. brasiliensis. The authors present a literature review of paracoccidioidomycosis in Brazilian Amerindians and discuss the need for further investigations about the impact of the antigenic diversity of P. brasiliensis from different geographic areas on the serological diagnosis of PCM.

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