Abstract
Paracoccidioidomycosis (PCM) is an endemic fungal infection in Latin America, which manifests as an acute or chronic form and is more frequent in adult males. It is caused by Paracoccidioides brasiliensis or Paracoccidioides lutzii, which are thermodimorphic fungi. The disease can present as a severe and disseminated form involving the lungs, skin, lymph nodes, spleen, liver, and lymphoid organs of the gastrointestinal tract. Most of the primary infections are subclinical, and the cell-mediated immune response contains the infection. It is rare in transplant patients, and there are few cases described in the literature. In solid organ transplant patients, it usually results from the reactivation of a latent infection, manifesting itself after a few years of transplantation with frequent pulmonary and skin involvement. PCM is an endemic infection in Brazil; however, as it is not classified as a notifiable disease, there is no accurate database on its incidence, and case reports are important sources of information. Clinical disease in kidney transplant patients is rare and has a high mortality rate. In this scope, the present clinical case reports the challenges of the clinical management of disseminated PCM caused by Paracoccidioides brasiliensis in a kidney transplant recipient who used immunosuppressive drugs and was treated with Itraconazole.
Highlights
Paracoccidioidomycosis (PCM) is a disease caused by dimorphic fungi such as Paracoccidioides brasiliensis and Paracoccidioides lutzii
We present a case that illustrates the challenges in clinically managing disseminated PMC infection in an immunosuppressed KTx recipient treated with itraconazole
We only identified a histological recurrence of immunoglobulin A (IgA) nephropathy with no signs of fungal structures or inflammation in the renal parenchyma
Summary
Paracoccidioidomycosis (PCM) is a disease caused by dimorphic fungi such as Paracoccidioides brasiliensis and Paracoccidioides lutzii It is common in Latin America, and almost 80% of cases occur in Brazil [1,2]. Examination on admission showed anemia (Hb: 8.8 g/dL; Hct: 29.2%), elevated C-reactive protein levels (46.3 mg/dL (reference range:
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