Background

Paracoccidioidomycosis (PCM) is an endemic disease in Latin America. In immunocompetent hosts, PCM occurs in two main clinical forms: acute and chronic. However, in HIV-infected patients PCM may show up simultaneous manifestations of acute and chronic forms.

Case report

We present the case of a patient diagnosed with HIV who had disseminated skin lesions and generalized lymphadenopathy, as well as respiratory and central nervous system involvement. The PCM diagnosis was confirmed by direct KOH examination, double immunodiffusion and the isolation of the fungus in samples of an abscess in the subcostal region. The isolate was identified as Paracoccidioides brasiliensis S1 by species-specific PCR using primers for protein-coding gene GP43 (exon 2) followed by PCR-RFLP of the alpha-tubulin gene.

Conclusions

There are few data in literature reporting species-specific molecular identification of Paracoccidioides in HIV/PCM patients. Therefore, this case report may contribute to improve the knowledge about this severe disease, its causative cryptic species, and its consequences to patients.

中文翻译：

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巴西副球孢子菌 S1 引起的副球孢子菌病与获得性免疫缺陷综合征相关：1 例报告

背景

副球孢子菌病 (PCM) 是拉丁美洲的一种地方病。在免疫活性宿主中，PCM 以两种主要的临床形式出现：急性和慢性。然而，在 HIV 感染患者中，PCM 可能同时出现急性和慢性形式。

案例报告

我们介绍了一名诊断为 HIV 的患者，该患者具有播散性皮肤病变和全身淋巴结肿大，以及呼吸和中枢神经系统受累。PCM 诊断通过直接 KOH 检查、双重免疫扩散和在肋下区域脓肿样本中分离真菌得到证实。该分离株被鉴定为Paracoccidioides brasiliensis S1，通过物种特异性 PCR 使用蛋白质编码基因GP43（外显子 2）的引物，然后是 α-微管蛋白基因的 PCR-RFLP。

结论

文献中很少有数据报告HIV/PCM 患者中副球孢子菌的物种特异性分子鉴定。因此，本病例报告可能有助于提高对这种严重疾病、其致病隐性物种及其对患者的影响的认识。