TY - JOUR KW - Antifungal Agents KW - Biopsy, Needle KW - Drug Administration Schedule KW - Humans KW - Itraconazole KW - Knee Joint KW - Male KW - Middle Aged KW - Osteomyelitis KW - Paracoccidioides KW - Paracoccidioidomycosis AU - Borgia G AU - Reynaud L AU - Cerini R AU - Ciampi R AU - Schioppa O AU - Dello Russo M AU - Gentile I AU - Piazza M AB -

We describe long-term therapy for paracoccidioidomycosis occurring in a 61-year-old house-painter from Venezuela. The diagnostic examinations made in South America had shown pulmonary granulomatous lesions and an osteolytic pattern of the left knee that had been considered suspect of malignant disease with an indication for limb amputation. With the aid of fine needle aspiration biopsy (FNAB) and culture examination we diagnosed an osteomyelitis by Paracoccidioides brasiliensis and initiated therapy with itraconazole, 400 mg per day, reduced to 200 mg per day after 2 months. At the end of 2 years of drug therapy, we observed complete regression of the pulmonary lesions and of the osteolytic area of the left knee. Moreover, we have periodically observed our patient to verify his clinical development and he is still in good health. We suggest that this pathology be considered in differential diagnosis of leprosy, tuberculosis, leishmaniasis, and systemic mycoses, even in non-endemic areas.

BT - Infection C1 - http://www.ncbi.nlm.nih.gov/pubmed/10782401?dopt=Abstract DA - 2000 Mar-Apr DO - 10.1007/s150100050060 IS - 2 J2 - Infection LA - eng N2 -

We describe long-term therapy for paracoccidioidomycosis occurring in a 61-year-old house-painter from Venezuela. The diagnostic examinations made in South America had shown pulmonary granulomatous lesions and an osteolytic pattern of the left knee that had been considered suspect of malignant disease with an indication for limb amputation. With the aid of fine needle aspiration biopsy (FNAB) and culture examination we diagnosed an osteomyelitis by Paracoccidioides brasiliensis and initiated therapy with itraconazole, 400 mg per day, reduced to 200 mg per day after 2 months. At the end of 2 years of drug therapy, we observed complete regression of the pulmonary lesions and of the osteolytic area of the left knee. Moreover, we have periodically observed our patient to verify his clinical development and he is still in good health. We suggest that this pathology be considered in differential diagnosis of leprosy, tuberculosis, leishmaniasis, and systemic mycoses, even in non-endemic areas.

PY - 2000 SP - 119 EP - 20 T2 - Infection TI - A case of paracoccidioidomycosis: experience with long-term therapy. VL - 28 SN - 0300-8126 ER -