Fungus Paracoccidioides Brasiliensis Research Articles

PARACOCCIDIOIDOMICOSE NA ODONTOLOGIA

Paracoccidioidomycosis is a fungal disease caused by the fungus Paracoccidioides brasiliensis, which prefers humid and warm places. Male individuals between 30 and 60 years of age are generally the most affected by this disease, especially those who work in rural areas or gardening. The objective of this study was to conduct a literature review addressing the topic of paracoccidioidomycosis in dentistry, highlighting its oral clinical aspects, increasing the knowledge of dentists so that they can help in the early recognition and diagnosis of the lesion. Diagnosis can be made through fungal culture, incisional biopsy, serological tests, histopathological analysis of the skin and mucous membranes, and chest X-rays to check for possible lung involvement. The most frequent clinical signs appear in the alveolar mucosa, gums, palate, and tongue, but other areas of the body can also be affected by the condition. In most cases, the disease is identified through oral clinical characteristics, and the dentist is the first professional to treat these patients. Treatment for paracoccidioidomycosis is prolonged and varies according to the severity of the lesions, involving the use of various antifungals such as itraconazole and cotrimoxazole. To increase the patient's life expectancy and prevent the spread of the disease, it is essential that the dentist recognizes the oral clinical manifestations, performs tests, and correctly refers the patient for appropriate medical treatment.

Transcriptional profiling of a fungal granuloma reveals a low metabolic activity of Paracoccidioides brasiliensis yeasts and an actively regulated host immune response.

Granulomas are important immunological structures in the host defense against the fungus Paracoccidioides brasiliensis, the main etiologic agent of Paracoccidioidomycosis (PCM), a granulomatous systemic mycosis endemic in Latin America. We have performed transcriptional and proteomic studies of yeasts present in the pulmonary granulomas of PCM aiming to identify relevant genes and proteins that act under stressing conditions. C57BL/6 mice were infected with 1x106 yeasts and after 8- and 12-weeks of infection, granulomatous lesions were obtained for extraction of fungal and murine RNAs and fungal proteins. Dual transcriptional profiling was done comparing lung cells and P. brasiliensis yeasts from granulomas with uninfected lung cells and the original yeast suspension used in the infection, respectively. Mouse transcripts indicated a lung malfunction, with low expression of genes related to muscle contraction and organization. In addition, an increased expression of transcripts related to the activity of neutrophils, eosinophils, macrophages, lymphocytes as well as an elevated expression of IL-1β, TNF-α, IFN-γ, IL-17 transcripts were observed. The increased expression of transcripts for CTLA-4, PD-1 and arginase-1, provided evidence of immune regulatory mechanisms within the granulomatous lesions. Also, our results indicate iron as a key element for the granuloma to function, where a high number of transcripts related to fungal siderophores for iron uptake was observed, a mechanism of fungal virulence not previously described in granulomas. Furthermore, transcriptomics and proteomics analyzes indicated a low fungal activity within the granuloma, as demonstrated by the decreased expression of genes and proteins related to energy metabolism and cell cycle.

Epidemiological aspects and oral implications of Paracoccidioidomycosis infection

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by the dimorphic fungus Paracoccidioides brasiliensis. It represents a significant infection in South America, occurring mainly in tropical and subtropical countries such as Brazil. Oral mucosal lesions, which are the most important symptom in dentistry, may be the first visible physical manifestation of the disease, often preceding even pulmonary lesions. This study aims to carry out an integrative literature review to identify the main epidemiological aspects and oral implications of Paracoccidioidomycosis (PMC) infection. A search was carried out in the PubMed, LILACS and SciELO databases and, after applying the inclusion, exclusion, eligibility and thematic relevance criteria, 18 articles were selected for analysis in this study. Paracoccidioidomycosis (PCM) is endemic in Brazil and mainly affects middle-aged and elderly men and occurs in rural areas. It is a systemic disease where clinical manifestations are often added to oral lesions. Dentists play a key role in identifying these lesions, in the correct diagnosis and treatment of this disease. Making PCM notification compulsory in Brazil is essential.

P160 Paracoccidioidomycosis severe: Bizarre presentation in the face

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM IntroductionParacoccidioidomycosis is a systemic mycosis caused by the dimorphic fungus Paracoccidioides brasiliensis. The disease is restricted to Latin America. It is the principal systemic mycosis in Brazil, with higher incidences in the southern, southeastern and central regions.ObjectivesIt's to report a case of paracoccioidomycosis with a bizarre presentation on the face.Case ReportA 54-year-old male farmer from Açailândia, Maranhão, with a history of an extensive ulcerated lesion that started in the right wing of the nose. After 6 months of evolution, the lesion had already spread reaching the nasal and oral mucosa, evolving with acute respiratory failure, requiring tracheostomy (Fig.1). He was referred to the Cancer Hospital for a biopsy, which was referred for pathological examination, showing an intense inflammatory infiltrate consisting of lymphocytes, histiocytes, neutrophilis with giant, multinucleated cells that phagocytize refrigerant bodies, compatible with paracoccidioidomycosis. Material sent for direct examination and culture, showed positive for Paracoccidioides sp. After PCR amplification of the genetic material and sequencing, P. brasiliensis was identified. Chest tomography showed sparse ground-glass attenuation, but affecting both lungs and radiodense striations in the lower lobes bilaterally. Treatment was established with liposomal amphotericin B, with a good therapeutic response (Fig. 2). The patient was discharged from the hospital using itraconazole and still upper outpatient follow-up, with good healing of the lesions.ConclusionParacoccidioidomycosis can get a severe presentation, distancing the physician from the diagnosis, showing that in all these situations, simple tests, such as the direct examination of lesional material or sputum can elucidate the diagnosis. We need to think about it in endemic area.

Kombucha beverage from non-conventional edible plant infusion and green tea: Characterization, toxicity, antioxidant activities and antimicrobial properties

Kombucha is a beverage based on a sugared medium fermented by a symbiotic culture of bacteria and yeast. The aim of this study was to produce unfermented and kombucha beverages with Malvaviscus arboreus and Camellia sinensis as substrates, and assess their physico-chemical characteristics, in vivo toxicities, antioxidant activities and antimicrobial properties . The beverages were prepared from infusions (0.5%, w/v), with sucrose (5.0%, w/v), kombucha culture (2.5%, w/v), and 1.0% (v/v) of the previously fermented beverage, and incubated at 24 ± 2 °C for 14 days. The results showed that both produced kombuchas are within the physico-chemical and microbiological parameters recommended by the Food and Drug Administration. None of the tested samples showed toxicity from the in vivo model of Galleria mellonella larvae. A significant increase of 145% w/v was observed on the total phenolic content of the Malvaviscus arboreus kombucha when compared to its infusion. Green tea and green tea kombucha showed antifungal activity against the pathogenic fungus Paracoccidioides brasiliensis . Green tea was also the only beverage to present antimicrobial activity against all fungi cultures evaluated and against Staphylococcus aureus and Listeria monocytogenes . Thus, it is possible that the type of substrate used in the kombucha production interferes with its bioactive properties . This report shows the potential use of non-conventional edible plant , such as Malvaviscus arboreus, as substrate for kombucha fermentation and for the first time the use of Galleria mellonella larvae as in vivo model of toxicity in the analysis of kombucha. • Fermented beverage produced using non-conventional edible plant - M. arboreus . • An increase in the phenolic content of the malvavisco infusion with fermentation. • In vivo toxicity assessment of tea infusions and kombuchas using G. mellonella . • Fungicidal activity of green tea infusion and kombucha against P. brasilienses.

PARACOCCIDIOIDOMICOSIS WITH MANIFESTATIONS IN ORAL MUCOSA: 2 CASE REPORTS

Paracoccidioidomycosis is a systemic mycosis, mucocutaneous, caused by the dimorphic fungus Paracoccidioides brasiliensis. This study reports 2 cases of fungus involvement in alcoholic and smoker patients living on the same street in an urban area. In the first case, the female patient had multiple papulo-erosive, ulcerated, and hypertrophic oral lesions. Lesions in the facial skin region and respiratory tract were also observed. Despite treatment with injectable amphotericin B, the patient died due to malnutrition and late diagnosis. After 1 year, another case was diagnosed in the locality. The male patient had nodular lesions on the back of the tongue. The use of oral itraconazole was initiated and there was a favorable clinical evolution after 1-year follow-up. Histopathological diagnosis was made through incisional biopsy in both cases. Early diagnosis is essential, and in many cases the first clinical manifestations are oral lesions, and the dental surgeon plays an important role.

Virulence factors of Paracoccidioides brasiliensis as therapeutic targets: a review.

Paracoccidiodomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis and Paracoccidioides lutzii. The disease requires long and complicated treatment. The aim of this review is to address the fungal virulence factors that could be the target of the development of new drugs for PCM treatment. Virulence factors favoring the process of fungal infection and pathogenicity are considered as a microbial attribute associated with host susceptibility. P. brasiliensis has some known virulence factors which are 43kDa glycoprotein (gp 43) which is an important fungal antigen, 70kDa glycoprotein (gp 70), the carbohydrates constituting the fungal cell wall α-1,3, glucan and β-1,3-glucan, cell adhesion molecules and the presence of melanin pigments. The discovery and development of drugs that interact with these factors, such as inhibitors of β-1,3-glucan, reduced synthesis of gp 43, inhibitors of melanin production, is of great importance for the treatment of PCM. The study of virulence factors favors the understanding of pathogen-host relationships, aiming to evaluate the possibility of developing new therapeutic targets and mechanisms that these molecules play in the infectious process, favoring the design of a more specific treatment for this disease.

PARACOCCIDIOIDOMYCOSIS OF THE CHEEK: CASE REPORT

Paracoccidioidomycosis (PCM) is a disease caused by the fungus Paracoccidioides brasiliensis, which is common in Brazil and some other areas in Latin America. We report a case of a 50-year-old male patient, a farm worker and smoker, presenting an asymptomatic ulcerated lesion with moriform appearance in the left buccal mucosa and uncertain time of evolution. The presumptive diagnosis was PCM. The patient underwent incisional biopsy, and histopathologic analysis revealed pseudoepitheliomatous hyperplasia and granulomatous inflammatory reaction. Ovoid yeasts with birefringent membrane were also evidenced. Grocott-stained slices demonstrated the presence of microorganisms exhibiting multiple buddings (ship´s wheel appearances) and double buddings (Mickey Mouse ears). The diagnosis was PCM. The patient was referred to the infectious diseases specialist for treatment of the lesion. Although PCM affects lungs primarily, it is often diagnosed through oral manifestation. Thus, dentists play a fundamental role in the identification of these lesions and referral for appropriate treatment. Paracoccidioidomycosis (PCM) is a disease caused by the fungus Paracoccidioides brasiliensis, which is common in Brazil and some other areas in Latin America. We report a case of a 50-year-old male patient, a farm worker and smoker, presenting an asymptomatic ulcerated lesion with moriform appearance in the left buccal mucosa and uncertain time of evolution. The presumptive diagnosis was PCM. The patient underwent incisional biopsy, and histopathologic analysis revealed pseudoepitheliomatous hyperplasia and granulomatous inflammatory reaction. Ovoid yeasts with birefringent membrane were also evidenced. Grocott-stained slices demonstrated the presence of microorganisms exhibiting multiple buddings (ship´s wheel appearances) and double buddings (Mickey Mouse ears). The diagnosis was PCM. The patient was referred to the infectious diseases specialist for treatment of the lesion. Although PCM affects lungs primarily, it is often diagnosed through oral manifestation. Thus, dentists play a fundamental role in the identification of these lesions and referral for appropriate treatment.

PARACOCCIDIOIDOMYCOSIS IN A FEMALE PATIENT—A CASE REPORT

Paracoccidioidomycosis is a systemic disease caused by the dimorphic fungus Paracoccidioides brasiliensis and is most common in Latin America. It has a marked predilection for men. A 76-year-old woman looked for help complaining about "a mouth ulcer, which extended all the way from the tongue to the throat." The patient reported that the lesions had been hurting for 3 months. She also affirmed being a smoker for 30 years. In the extraoral physical exam, a cervical bilateral, sublingual, and submandibular lymphadenopathy was noted. In the intraoral exam ulcerated lesions on the dorsum and apex of the tongue were observed, as well as a nodule in the right pterygomandibular raphe. The diagnostic hypotheses were squamous cell carcinoma and paracoccidioidomycosis. An incisional biopsy was performed and a conclusion of paracoccidioidomycosis diagnostic was reached. The patient underwent treatment under the surveillance of an infectious diseases specialist and has been using systemic antifungal medication since then. Paracoccidioidomycosis is a systemic disease caused by the dimorphic fungus Paracoccidioides brasiliensis and is most common in Latin America. It has a marked predilection for men. A 76-year-old woman looked for help complaining about "a mouth ulcer, which extended all the way from the tongue to the throat." The patient reported that the lesions had been hurting for 3 months. She also affirmed being a smoker for 30 years. In the extraoral physical exam, a cervical bilateral, sublingual, and submandibular lymphadenopathy was noted. In the intraoral exam ulcerated lesions on the dorsum and apex of the tongue were observed, as well as a nodule in the right pterygomandibular raphe. The diagnostic hypotheses were squamous cell carcinoma and paracoccidioidomycosis. An incisional biopsy was performed and a conclusion of paracoccidioidomycosis diagnostic was reached. The patient underwent treatment under the surveillance of an infectious diseases specialist and has been using systemic antifungal medication since then.

EXTENSIVE PARACOCCIDIOIDOMYCOSIS ORAL MANIFESTATION ASSOCIATED WITH SYSTEMIC SYPHILIS: A CASE REPORT

Paracoccidioidomycosis is a disease caused by the dimorphic fungus Paracoccidioides brasiliensis. A 46-year-old male patient, chronic smoker, crack and cocaine user reported a history of completed syphilis treatment 5 years ago. The patient described a recent history of a mouth burn secondary to chlorine. Clinical examination revealed moriform ulcers with hemorrhagic dots on the surface on the lower labial mucosa, buccal mucosa, and hard palate. The histopathologic diagnosis of this incisional biopsy was paracoccidioidomycosis. Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS) were considered reactant in both serologic investigations. The patient was referred for treatment of both infections. After 7 months of drug therapy, the oral lesions regressed, and the patient did not report more symptoms. The present case emphasizes the importance of the detailed clinical examination and complementary tests. The presence of coinfections is highlighted, because the patient's habits could favor these contaminations. The oral surgeon knowledge about these diseases allows for prompt diagnosis and minimizes morbidity.

First report of Paracoccidioides brasiliensis infection in fish.

The thermodimorphic fungus Paracoccidioides brasiliensis is the etiological agent of paracoccidioidomycosis (PCM), a deep mycosis endemic in Latin American countries that affects mainly male rural workers. Infection by P. brasiliensis has also been reported in several species of terrestrial animals; however, the capacity of the fungus to infect aquatic organisms is poorly known. The aim of this study was to detect P. brasiliensis in a fish species, Nile tilapia (Oreochromis niloticus), the most farmed and widely distributed fish in endemic areas for human PCM in Brazil. As a first step, the humoral immune response against the fungus was evaluated in an experimental group of three fish immunized with inactivated P. brasiliensis yeast cells. For the seroepidemiological study, serum samples of Nile tilapia raised in cages (n=109) and in ponds (n=105), collected from a fish slaughterhouse, were analyzed for P. brasiliensis antibodies by ELISA using gp43 as antigen. All the inoculated fish produced antibodies against the fungus. The seropositivity observed in fish raised in cages and ponds was 17.4 and 5.7%, respectively. Due to the higher seropositivity observed in caged fish, 100 tissue samples (encephalon, liver, and kidney), from another group of tilapia raised in cages, were analyzed by polymerase chain reaction (PCR; Pb-ITSR and Pb-ITSE). Three tissue samples (liver n=1, kidney n=1, and enchepahlon n=1) from three different fish resulted positive to PCR. This is the first report to show serological and molecular evidence of P. brasiliensis infection in a fish species.

Mesoporous SBA-16 silica nanoparticles as a potential vaccine adjuvant against Paracoccidioides brasiliensis

Abstract Nanostructured materials including mesoporous silica nanoparticles (MSNs) have attracted attention due to their recently discovered capability to increase the immune responses acting as an innovative vaccine adjuvant. Therefore, the present work aimed to study the potential use of mesoporous SBA-16 and silanized SBA-16 (APTES-SBA-16) nanoparticles as a vaccine adjuvant against the pathogenic fungus Paracoccidioides brasiliensis (PCM). In this sense, the antigenic protein rPb27 was incorporated into both mesoporous matrices. The synthesized nanomaterials were physicochemical and morphological characterized and the results obtained revealed consistent data with nanosized mesoporous nanoparticles in a monodisperse colloidal system. In the next step, the rPb27 antigen loading efficiency was evaluated using different ratios of nanoparticles/antigen and subsequently, the in vitro release kinetics was evaluated until 63 days. After, rPb27 was successfully radiolabeled with 99mTc and injected into thigh muscle of healthy mice in order to evaluate the in vivo release profile of rPb27 from nanoparticles to the bloodstream. The results revealed that APTES-SBA-16 matrix was capable to maintain a sustained release profile without insignificant cytotoxicity to normal human lineage cells. Altogether, these results suggest that APTES-SBA-16 nanoparticles can considered a potential adjuvant system for developing vaccines against the PCM.

Caspase-11-dependent IL-1α release boosts Th17 immunity against Paracoccidioides brasiliensis

The granulomatous lesion resulting from infection with the fungus Paracoccidioides brasiliensis is characterized by a compact aggregate of mature cells, surrounded by a fibroblast- and collagen-rich content. Granuloma formation requires signaling elicited by inflammatory molecules such as members of the interleukin-1 family. Two members of this family have been thoroughly studied, namely IL-1α and IL-1β. In this study, we addressed the mechanisms underlying IL-1α secretion and its functional role on the host resistance to fungal infection. We found that, the expression of caspase-11 triggered by P. brasiliensis infection of macrophages depends on IFN-β production, because its inhibition reduced procaspase-11 levels. Curiously, caspase-11 deficiency did not impair IL-1β production, however caspase-11 was required for a rapid pore-mediated cell lysis. The plasma membrane rupture facilitated the release of IL-1α, which was necessary to induce NO production and restrict fungal replication. Furthermore, P. brasiliensis-infected macrophages required IL-1α to produce optimal levels of IL-6, a major component of Th17 lymphocyte differentiation. Indeed, IL-1α deficiency accounted for a significant reduction of Th17 lymphocytes in lungs of infected mice, correlating with diminished neutrophil infiltration in the lungs. Strikingly, we identified that IL-1α directly reprograms the transcriptional profile of Th17-committed lymphocytes, increasing cellular proliferation, as for boosting IL-17 production by these cells. Beyond neutrophil chemotaxis in vivo, IL-17 also amplified IL-1α production by infected macrophages in vitro, endorsing a critical amplification loop of the inflammatory response. Therefore, our data suggest that the IFN-β/caspase-11/IL-1α pathway shapes a protective antifungal Th17 immunity, revealing a molecular mechanism underlying the cross-talk between innate and adaptive immunity.

The comparison between label-free and non-cross-linking methods with gold nanoparticles for colorimetric detection of Paracoccidioides brasiliensis

Paracoccidioidomycosis is a systemic fungal disease caused by thermos-dimorphic fungus Paracoccidioides brasiliensis (P. brasiliensis). Gold nanoparticles (AuNPs) are used in diagnosis because of its versatility and biocompatibility, optical properties influenced by surface plasmon resonance, and the size and geometry. The colorimetric detection of the fungus P. brasiliensis was performed by AuNPs and specific 5.8S ribosomal complementary DNA sequence probe. The label-free methodologies had a final concentration of 2.22 nM, 155.95 nM, and 433.33 μM for AuNPs, primers, and MgCl2.6H2O solution, respectively. For the non-cross-linking method, the final concentration of the thiolate oligonucleotides and MgCl2.6H2O solution were 291.54 mM and 0.39 mM, respectively. The Gaussian curve analyses provided Gaussian center, full width at half maximum value, and Gaussian area, which are complementary colorimetric results. The test accuracy calculated using ROC curve analyses for the label-free and non-cross-linking methods were found to be 0.994 and 0.976, respectively. The sensitivity and specificity were 92% and 98.1%, respectively for label free, and 92% and 80%, respectively, for non-cross-linking test. The alternative methodologies can be used in colorimetric detection of fungus P. brasiliensis, which the rRNA sequence could be differentiated by alteration in their staining and confirmed by the Gaussian curve and ROC curve analyses.

Photodynamic Antimicrobial Chemotherapy (PACT), using Toluidine blue (TBO) inhibits both growth and dimorphism in Paracoccidioides brasiliensis by a mechanism involving reactive oxygen species (ROS) production.

The thermo-dimorphic fungus Paracoccidioides brasiliensis is the pathogen of Paracoccidioidomycosis, an important public health problem in Latin American with prevalence in Brazil. Photodynamic Antimicrobial Chemotherapy (PACT) is a process that combines a photosensitizer and light, producing reactive oxygen species (ROS) that can promote damages to treated cells. In this work was study the effect of PACT, using Toluidine blue (TBO) on both yeast and mycelial cells of P. brasiliensis. It was observed that PACT decreased P. brasiliensis yeast growth, in a dependent manner of both TBO concentrations and fluence. In the presence of TBO 0.005 mg/mL, PACT reduced P. brasiliensis yeast growth in 63, 62 and 86%, using fluences of 20, 30 and 40 J/cm2, respectively. After PACT, ROS production increased 2.80, 4.64 and 7.90 times, in the presence of TBO 0.001, 0.002 and 0.005 mg/mL, respectively. It was observed that after PACT, the cells are predominantly in mycelia form, indicating that mycelial cells irradiated in the presence of TBO, maintained their filamentous form and absence and/or decreased presence of transition structures. These results demonstrated the potential of PACT, using TBO to inhibit both yeast and mycelium development of P. brasiliensis.

Rapid identification of Paracoccidioides lutzii and P. Brasiliensis using Fourier Transform Infrared spectroscopy

The inhalation of the fungus Paracoccidioides brasiliensis (P. brasiliensis, Pb03 and Pb18) causes the Parcoccidioidomycosis. Initially, only P. brasiliensis was thought to be responsible for it. Later the researchers found out that another pathogen: Paracoccidioides lutzii (P. lutzii, Pb01) may also cause the disease. Clinical manifestation and treatment differ based on the causative agent, making it important to identify them correctly. Therefore, this study focusses on distinguishing P. brasiliensis from P. lutzii using Fourier Transform Infrared (FTIR) spectroscopy - a rapid, highly specific and sensitive technique that can identify biochemical composition with minimal sample preparation. We acquired thirty spectra each from pure cultures of P. lutzii, and P. brasiliensis. The FTIR spectra showed the difference in biochemical composition, the major differences being in the polysaccharide and proteins vibrations. Principal Component Linear Discriminant Analysis (PC-LDA) could distinguish the species. We acquired nearly 10 spectra per sample in triplicates, resulting around 30 spectra per group. The analysis of spectra indicates biochemical difference. Multivariate analysis is important to identify spectral differences in specific chosen spectra regions where we can take biological or vibration information. PC-LDA could distinguish Pb01 (P. lutzii) with 96% efficiency and Pb03/Pb18 (P.brasiliensis) with 100% efficiency. Thus, FTIR may contribute to clinical diagnosis of this highly prevalent Latin American disease.

Biliary Paracoccidioidomycosis: An Unusual Infection Simulating Malignant Neoplasm

Paracoccidioidomycosis is a systemic granulomatous disease caused by the dimorphic fungus Paracoccidioides brasiliensis and is restricted to Latin America. It normally affects lungs, skin and lymph nodes. Abdominal organs are usually not involved. In rare cases paracoccidioidomycosis may simulate neoplasm. Herein we describe our experience with four cases of paracoccidioidomycosis mimicking cholangiocarcinoma. To the best of our knowledge, this is the largest case series on this subject produced in English. Paracoccidioidomycosis must be considered as a differential diagnosis of cholangiocarcinoma, especially in individuals who come from endemic areas.

Neuroparacoccidioidomycosis: Case Report and Literature Review

Introduction Paracoccidioidomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis, and it can compromise the central nervous system (CNS) in 10–27% of all cases. Case Report A 31-year-old man presented to the Emergency Department with headache, left-sided weakness, clonus at the ankle and a positive Babinski sign. Head computed tomography (CT) and magnetic resonance imaging (MRI) scans showed a 5.1 × 3.8 cm lobulated lesion with areas of liquefaction in the right centrum semiovale. Discussion Central nervous system PCM can mimic a brain tumor, and most cases are diagnosed by biopsy of the lesion. The treatment includes antibiotics, but some cases require surgery. Conclusion Due to high morbimortality rates, the diagnosis must be considered, and early treatment started in patients who live in rural regions endemic for PCM when a ring-enhancing mass associated with perilesional edema is observed on MRI scans.

<b>Influence of n-3 Polyunsaturated Fatty Acid in the Proliferative Activity of Lymphocytes During Experimental Infection with <i>Paracoccidioides brasiliensis

It has been shown that diets containing polyunsaturated omega-3 fatty acids may modulate the immune system. Paracoccidioidomycosis (PCM) is a systemic mycosis of great importance in Latin America, caused by the thermo-dimorphic fungus Paracoccidioides brasiliensis . The aim of this study was to evaluate the influence of n-3 PUFAs in lymphoproliferative activity in murine experimental PCM. Spleen lymphocytes from animals infected with an isolate of P. brasiliensis (Pb18) and fed with diets supplemented with flaxseed oil or a commercial diet for eight weeks, were obtained and cultured for evaluation of lymphoproliferative activity by MTT assay. In uninfected animals and those fed an enriched-flaxseed diet the evaluated lymphoproliferative activity was inhibited in the first week; however, this activity resumed at later stages. On the other hand, in animals infected and fed an enriched-flaxseed diet, the interaction between the stimulus given by the presence of the fungus and the action of n-3 PUFAs appeared to stimulate lymphocyte proliferation after the first week of infection. n-3 PUFAs are shown to influence lymphoproliferative activity of mice in experimental PCM.

Oral paracoccidioidomycosis affecting the buccal mucosa

Paracoccidioidomycosis (PCM) is a disease caused by the fungus Paracoccidioides brasiliensis, common in Brazil and in some other areas of Latin America. We report a case of a 50-year-old male patient, farm worker, smoker, presenting with asymptomatic ulcerated lesion with moriform appearance in the left buccal mucosa. The patient underwent incisional biopsy and diagnosed with PCM. He was referred to the infectologist for treatment of the lesion. Although PCM primarily affects the lungs, it is often diagnosed through oral manifestations. Thus, dentists play a fundamental role in the identification of these lesions and referral for appropriate treatment.