Fatal Fungemia due to Paracoccidioides lutzii

Rosane Christine Hahn Núcleo de Doenças Infecciosas e Tropicais, Universidade Federal do Mato Grosso (UFMT), Cuiabá, MT, Brazil; Universidade Federal de São Paulo (UNIFESP), Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, São Paulo, SP, Brazil

Search for other papers by Rosane Christine Hahn in
Current site
Google Scholar
PubMed
Close
,
Anderson Messias Rodrigues Núcleo de Doenças Infecciosas e Tropicais, Universidade Federal do Mato Grosso (UFMT), Cuiabá, MT, Brazil; Universidade Federal de São Paulo (UNIFESP), Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, São Paulo, SP, Brazil

Search for other papers by Anderson Messias Rodrigues in
Current site
Google Scholar
PubMed
Close
,
Cor Jesus Fernandes Fontes Núcleo de Doenças Infecciosas e Tropicais, Universidade Federal do Mato Grosso (UFMT), Cuiabá, MT, Brazil; Universidade Federal de São Paulo (UNIFESP), Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, São Paulo, SP, Brazil

Search for other papers by Cor Jesus Fernandes Fontes in
Current site
Google Scholar
PubMed
Close
,
Andreia Ferreira Nery Núcleo de Doenças Infecciosas e Tropicais, Universidade Federal do Mato Grosso (UFMT), Cuiabá, MT, Brazil; Universidade Federal de São Paulo (UNIFESP), Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, São Paulo, SP, Brazil

Search for other papers by Andreia Ferreira Nery in
Current site
Google Scholar
PubMed
Close
,
Tomoko Tadano Núcleo de Doenças Infecciosas e Tropicais, Universidade Federal do Mato Grosso (UFMT), Cuiabá, MT, Brazil; Universidade Federal de São Paulo (UNIFESP), Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, São Paulo, SP, Brazil

Search for other papers by Tomoko Tadano in
Current site
Google Scholar
PubMed
Close
,
Luiz de Pádua Queiroz Júnior Núcleo de Doenças Infecciosas e Tropicais, Universidade Federal do Mato Grosso (UFMT), Cuiabá, MT, Brazil; Universidade Federal de São Paulo (UNIFESP), Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, São Paulo, SP, Brazil

Search for other papers by Luiz de Pádua Queiroz Júnior in
Current site
Google Scholar
PubMed
Close
, and
Zoilo Pires de Camargo Núcleo de Doenças Infecciosas e Tropicais, Universidade Federal do Mato Grosso (UFMT), Cuiabá, MT, Brazil; Universidade Federal de São Paulo (UNIFESP), Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, São Paulo, SP, Brazil

Search for other papers by Zoilo Pires de Camargo in
Current site
Google Scholar
PubMed
Close
Restricted access

We report the first case of fungemia caused by Paracoccidioides lutzii in a 51-year-old male farm worker from the central-west region of Brazil. The fungus was isolated from blood cultures and the species was confirmed by phylogenetic identification. Despite specific treatment and intensive care, the patient died 39 days after admission.

Author Notes

* Address correspondence to Zoilo Pires de Camargo, Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil. 04023-062 Rua Botucatu, 862/8°andar. São Paulo, SP, Brazil. E-mail: zpcamargo@unifesp.br

Financial support: A. M. Rodrigues is a fellow and received financial support from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, 2011/07350-1). Z. P. de Camargo also received financial support from FAPESP (2009/54024-2).

Authors' addresses: Rosane Christine Hahn, Cor Jesus Fernandes Fontes, Andreia Ferreira Nery, Tomoko Tadano, and Luiz de Pádua Queiroz Júnior, Núcleo de Doenças Infecciosas e Tropicais, Universidade Federal do Mato Grosso, MT, Brasil, E-mails: rchahn@terra.com.br, corfontes@gmail.com, andreia_nery@yahoo.com.br, mokacba@terra.com.br, and luizpadua.biomedico@hotmail.com. Anderson Messias Rodrigues and Zoilo Pires de Camargo, Universidade Federal de São Paulo, Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, São Paulo, Brasil, E-mails: amrodrigues@unifesp.br and zpcamargo@unifesp.br.

  • 1.

    Brummer E, Castañeda E, Restrepo A, 1993. Paracoccidioidomycosis: an update. Clin Microbiol Rev 6: 89117.

  • 2.

    Barrozo LV, Benard G, Silva ME, Bagagli E, Marques SA, Mendes RP, 2010. First description of a cluster of acute/subacute paracoccidioidomycosis cases and its association with a climatic anomaly. PLoS Negl Trop Dis 4: e643.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Matute DR, McEwen JG, Puccia R, Montes BA, San-Blas G, Bagagli E, Rauscher JT, Restrepo A, Morais F, Niño-Vega G, Taylor JW, 2006. Cryptic speciation and recombination in the fungus Paracoccidioides brasiliensis as revealed by gene genealogies. Mol Biol Evol 23: 6573.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Teixeira MM, Theodoro RC, de Carvalho MJ, Fernandes L, Paes HC, Hahn RC, Mendoza L, Bagagli E, San-Blas G, Felipe MS, 2009. Phylogenetic analysis reveals a high level of speciation in the Paracoccidioides genus. Mol Phylogenet Evol 52: 273283.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Teixeira MM, Theodoro RC, Oliveira FF, Machado GC, Hahn RC, Bagagli E, San-Blas G, Felipe MS, 2013. Paracoccidioides lutzii sp. nov.: biological and clinical implications. Med Mycol 52: 1928.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Marques da Silva SH, de Mattos Grosso D, Lopes JD, Colombo AL, Blotta MH, Queiroz-Telles F, Pires de Camargo Z, 2004. Detection of Paracoccidioides brasiliensis gp70 circulating antigen and follow-up of patients undergoing antimycotic therapy. J Clin Microbiol 42: 44804486.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Marques-da-Silva SH, Rodrigues AM, de Hoog GS, Silveira-Gomes F, de Camargo ZP, 2012. Occurrence of Paracoccidioides lutzii in the Amazon region: description of two cases. Am J Trop Med Hyg 87: 710714.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Batista J Jr, de Camargo ZP, Fernandes GF, Vicentini AP, Fontes CJ, Hahn RC, 2010. Is the geographical origin of a Paracoccidioides brasiliensis isolate important for antigen production for regional diagnosis of paracoccidioidomycosis? Mycoses 53: 176180.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Camargo ZP, Berzaghi R, Amaral CC, Silva SH, 2003. Simplified method for producing Paracoccidioides brasiliensis exoantigens for use in immunodiffusion tests. Med Mycol 41: 539542.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Fava-Netto C, Vegas VS, Sciannamea IM, Guarnieri DB, 1969. The polysaccharidic antigen from Paracoccidioides brasiliensis. Study of the time of cultivation necessary for the preparation of the antigen. Rev Inst Med Trop Sao Paulo 11: 177181.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Teixeira MM, Theodoro RC, Derengowski LS, Nicola AM, Bagagli E, Felipe MS, 2013. Molecular and morphological data support the existence of a sexual cycle in species of the genus Paracoccidioides. Eukaryot Cell 12: 380389.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Cisalpino PS, Puccia R, Yamauchi LM, Cano MI, da Silveira JF, Travassos LR, 1996. Cloning, characterization, and epitope expression of the major diagnostic antigen of Paracoccidioides brasiliensis. J Biol Chem 271: 45534560.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Kasuga T, White TJ, Taylor JW, 2002. Estimation of nucleotide substitution rates in Eurotiomycete fungi. Mol Biol Evol 19: 23182324.

  • 14.

    Liu K, Warnow TJ, Holder MT, Nelesen SM, Yu J, Stamatakis AP, Linder CR, 2012. SATé-II: Very fast and accurate simultaneous estimation of multiple sequence alignments and phylogenetic trees. Syst Biol 61: 90106.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Tamura K, Peterson D, Peterson N, Stecher G, Nei M, Kumar S, 2011. MEGA5: molecular evolutionary genetics analysis using maximum likelihood, evolutionary distance, and maximum parsimony methods. Mol Biol Evol 28: 27312739.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Hadad DJ, Pieres M de F, Petry TC, Orozco SF, Melhem M de S, Paes RA, Gianini MJ, 1992. Paracoccidioides brasiliensis (Lutz, 1908) isolated by hemoculture in a patient with the acquired immunodeficiency syndrome (AIDS). Rev Inst Med Trop Sao Paulo 34: 565567.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Tan G, Kaufman L, Peterson EM, de la Maza LM, 1993. Disseminated atypical blastomycosis in two patients with AIDS. Clin Infect Dis 16: 107111.

  • 18.

    Rempe S, Sachdev MS, Bhakta R, Pineda-Roman M, Vaz A, Carlson RW, 2007. Coccidioides immitis fungemia: clinical features and survival in 33 adult patients. Heart Lung 36: 6471.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Assi MA, Sandid MS, Baddour LM, Roberts GD, Walker RC, 2010. Risk factor analysis of Histoplasma capsulatum fungemia. Med Mycol 48: 8589.

  • 20.

    Gonzalez CE, Venzon D, Lee S, Mueller BU, Pizzo PA, Walsh TJ, 1996. Risk factors for fungemia in children infected with human immunodeficiency virus: a case-control study. Clin Infect Dis 23: 515521.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Reimer LG, Wilson ML, Weinstein MP, 1997. Update on detection of bacteremia and fungemia. Clin Microbiol Rev 10: 444465.

  • 22.

    Unkmeir A, Latsch K, Dietrich G, Wintermeyer E, Schinke B, Schwender S, Kim KS, Eigenthaler M, Frosch M, 2002. Fibronectin mediates Opc-dependent internalization of Neisseria meningitidis in human brain microvascular endothelial cells. Mol Microbiol 46: 933946.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Kim KS, 2002. Strategy of Escherichia coli for crossing the blood-brain barrier. J Infect Dis 186: S220S224.

  • 24.

    Jong AY, Stins MF, Huang S-H, Chen SH, Kim KS, 2001. Traversal of Candida albicans across human blood-brain barrier in vitro. Infect Immun 69: 45364544.

  • 25.

    Chang YC, Stins MF, McCaffery MJ, Miller GF, Pare DR, Dam T, Paul-Satyasee M, Kim KS, Kwon-Chung KJ, 2004. Cryptococcal yeast cells invade the central nervous system via transcellular penetration of the blood-brain barrier. Infect Immun 72: 49854995.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Theodoro RC, Teixeira MM, Felipe MS, Paduan KS, Ribolla PM, San-Blas G, Bagagli E, 2012. Genus Paracoccidioides: species recognition and biogeographic aspects. PLoS ONE 7: e37694.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Arantes TD, Theodoro RC, Da Graça Macoris SA, Bagagli E, 2013. Detection of Paracoccidioides spp. in environmental aerosol samples. Med Mycol 51: 8392.

  • 28.

    Camargo ZP, 2008. Serology of paracoccidioidomycosis. Mycopathologia 165: 289302.

  • 29.

    Marques da Silva SH, Colombo AL, Blotta MH, Lopes JD, Queiroz-Telles F, Pires de Camargo Z, 2003. Detection of circulating gp43 antigen in serum, cerebrospinal fluid, and bronchoalveolar lavage fluid of patients with paracoccidioidomycosis. J Clin Microbiol 41: 36753680.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Silveira-Gomes F, Sarmento DN, Pinto TM, Pimentel RF, Nepomuceno LB, Espírito Santo EP, Mesquita-da-Costa M, Camargo ZP, Marques-da-Silva SH, 2011. Development and evaluation of a latex agglutination test for the serodiagnosis of paracoccidioidomycosis. Clin Vaccine Immunol 18: 604608.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Marques da Silva SH, Queiroz-Telles F, Colombo AL, Blotta MH, Lopes JD, Pires de Camargo Z, 2004. Monitoring gp43 antigenemia in paracoccidioidomycosis patients during therapy. J Clin Microbiol 42: 24192424.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Marques SA, Robles AM, Tortorano AM, Tuculet MA, Negroni R, Mendes RP, 2000. Mycoses associated with AIDS in the Third World. Med Mycol 38 (Suppl 1): 269279.

  • 33.

    Cruz RC, Werneck SM, Oliveira CS, Santos PC, Soares BM, Santos DA, Cisalpino PS, 2013. Influence of different media, incubation times, and temperatures for determining the MICs of seven antifungal agents against Paracoccidioides brasiliensis by microdilution. J Clin Microbiol 51: 436443.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Shikanai-Yasuda MA, Telles Filho F de Q, Mendes RP, Colombo AL, Moretti ML, 2006. Guidelines in paracoccidioidomycosis. Rev Soc Bras Med Trop 39: 297310.

  • 35.

    Queiroz-Telles F, Goldani LZ, Schlamm HT, Goodrich JM, Ingroff AE, Yasuda MAS, 2007. An open-label comparative pilot study of oral voriconazole and itraconazole for long-term treatment of paracoccidioidomycosis. Clin Infect Dis 45: 14621469.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Hahn RC, Morato Conceição YT, Santos NL, Ferreira JF, Hamdan JS, 2003. Disseminated paracoccidioidomycosis: correlation between clinical and in vitro resistance to ketoconazole and trimethoprim sulfamethoxazole. Mycoses 46: 342347.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 146 112 5
Full Text Views 487 14 0
PDF Downloads 121 7 1
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save