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. 1996 Sep;34(9):2328–2330. doi: 10.1128/jcm.34.9.2328-2330.1996

Pulmonary paracoccidioidomycosis misdiagnosed as Pneumocystis pneumonia in an immunocompromised host.

R P Silletti 1, V Glezerov 1, I S Schwartz 1
PMCID: PMC229247  PMID: 8862614

Abstract

Yeast cells of Paracoccidioides brasiliensis can resemble the cysts of Pneumocystis carinii in smears stained with Grocott's modification of the Gomori methanamine silver stain. Furthermore, P. brasiliensis can cross-react in material stained with a widely used P. carinii immunofluorescent stain which uses monoclonal antibodies. The need to differentiate P. brasiliensis and P. carinii will become more important as the increasing incidence of immunosuppression results in the reactivation of latent P. brasiliensis infections.

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Selected References

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  1. Amin M. B., Mezger E., Zarbo R. J. Detection of Pneumocystis carinii. Comparative study of monoclonal antibody and silver staining. Am J Clin Pathol. 1992 Jul;98(1):13–18. doi: 10.1093/ajcp/98.1.13. [DOI] [PubMed] [Google Scholar]
  2. Arend S. M., Kroon F. P., van't Wout J. W. Pneumocystis carinii pneumonia in patients without AIDS, 1980 through 1993. An analysis of 78 cases. Arch Intern Med. 1995 Dec 11;155(22):2436–2441. [PubMed] [Google Scholar]
  3. Bakos L., Kronfeld M., Hampe S., Castro I., Zampese M. Disseminated paracoccidioidomycosis with skin lesions in a patient with acquired immunodeficiency syndrome. J Am Acad Dermatol. 1989 May;20(5 Pt 1):854–855. doi: 10.1016/s0190-9622(89)80126-4. [DOI] [PubMed] [Google Scholar]
  4. Balestra D. J., Hennigan S. H., Ross G. S. Clinical prediction of Pneumocystis pneumonia. Arch Intern Med. 1992 Mar;152(3):623–624. [PubMed] [Google Scholar]
  5. Benard G., Bueno J. P., Yamashiro-Kanashiro E. H., Shikanai-Yasuda M. A., Del Negro G. M., Melo N. T., Sato M. N., Amato Neto V., Shiroma M., Duarte A. J. Paracoccidioidomycosis in a patient with HIV infection: immunological study. Trans R Soc Trop Med Hyg. 1990 Jan-Feb;84(1):151–152. doi: 10.1016/0035-9203(90)90415-b. [DOI] [PubMed] [Google Scholar]
  6. Blattner W. A. HIV epidemiology: past, present, and future. FASEB J. 1991 Jul;5(10):2340–2348. doi: 10.1096/fasebj.5.10.2065886. [DOI] [PubMed] [Google Scholar]
  7. Brummer E., Castaneda E., Restrepo A. Paracoccidioidomycosis: an update. Clin Microbiol Rev. 1993 Apr;6(2):89–117. doi: 10.1128/cmr.6.2.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cadavid D., Restrepo A. Factors associated with Paracoccidiodes brasiliensis infection among permanent residents of three endemic areas in Colombia. Epidemiol Infect. 1993 Aug;111(1):121–133. doi: 10.1017/s0950268800056740. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Chequer-Bou-Habib D., Ferreira-da-Cruz M. de F., Galvão-Castro B. Immunosuppressive effect of paracoccidioidomycosis sera on the proliferative response of normal mononuclear cells. Identification of a Paracoccidioides brasiliensis 34-kDa polypeptide in circulating immune complexes. Mycopathologia. 1992 Aug;119(2):65–71. doi: 10.1007/BF00443935. [DOI] [PubMed] [Google Scholar]
  10. Do Valle A. C., Guimaraes M. R., Cuba J., Wanke B., Tendrich M. Recovery of adrenal function after treatment of paracoccidioidomycosis. Am J Trop Med Hyg. 1993 May;48(5):626–629. doi: 10.4269/ajtmh.1993.48.626. [DOI] [PubMed] [Google Scholar]
  11. Friedman E. P., Miller R. F., Severn A., Williams I. G., Shaw P. J. Cryptococcal pneumonia in patients with the acquired immunodeficiency syndrome. Clin Radiol. 1995 Nov;50(11):756–760. doi: 10.1016/s0009-9260(05)83214-3. [DOI] [PubMed] [Google Scholar]
  12. Goldani L. Z., Coelho I. C., Machado A. A., Martinez R. Paracoccidioidomycosis and AIDS. Scand J Infect Dis. 1991;23(3):393–393. doi: 10.3109/00365549109024331. [DOI] [PubMed] [Google Scholar]
  13. Goldani L. Z., Martinez R., Landell G. A., Machado A. A., Coutinho V. Paracoccidioidomycosis in a patient with acquired immunodeficiency syndrome. Mycopathologia. 1989 Feb;105(2):71–74. doi: 10.1007/BF00444027. [DOI] [PubMed] [Google Scholar]
  14. Homer K. S., Wiley E. L., Smith A. L., McCollough L., Clark D., Nightingale S. D., Vuitch F. Monoclonal antibody to Pneumocystis carinii. Comparison with silver stain in bronchial lavage specimens. Am J Clin Pathol. 1992 May;97(5):619–624. doi: 10.1093/ajcp/97.5.619. [DOI] [PubMed] [Google Scholar]
  15. Ishida T., Matsui Y., Matsumura Y., Furutani M. Ultrastructural observation of Pneumocystis carinii in bronchoalveolar lavage fluid from non-AIDS patients with P carinii pneumonia. Chest. 1994 May;105(5):1342–1346. doi: 10.1378/chest.105.5.1342. [DOI] [PubMed] [Google Scholar]
  16. Mahaffey K. W., Hippenmeyer C. L., Mandel R., Ampel N. M. Unrecognized coccidioidomycosis complicating Pneumocystis carinii pneumonia in patients infected with the human immunodeficiency virus and treated with corticosteroids. A report of two cases. Arch Intern Med. 1993 Jun 28;153(12):1496–1498. [PubMed] [Google Scholar]
  17. Marques S. A., Conterno L. O., Sgarbi L. P., Villagra A. M., Sabongi V. P., Bagatin E., Gonçalves V. L. Paracoccidioidomycosis associated with acquired immunodeficiency syndrome. Report of seven cases. Rev Inst Med Trop Sao Paulo. 1995 May-Jun;37(3):261–265. doi: 10.1590/s0036-46651995000300014. [DOI] [PubMed] [Google Scholar]
  18. Meeker D. P., Matysik G. A., Stelmach K., Rehm S. Diagnostic utility of lactate dehydrogenase levels in patients receiving aerosolized pentamidine. Chest. 1993 Aug;104(2):386–388. doi: 10.1378/chest.104.2.386. [DOI] [PubMed] [Google Scholar]
  19. Naranjo M. S., Trujillo M., Munera M. I., Restrepo P., Gomez I., Restrepo A. Treatment of paracoccidioidomycosis with itraconazole. J Med Vet Mycol. 1990;28(1):67–76. doi: 10.1080/02681219080000091. [DOI] [PubMed] [Google Scholar]
  20. Quist J., Hill A. R. Serum lactate dehydrogenase (LDH) in Pneumocystis carinii pneumonia, tuberculosis, and bacterial pneumonia. Chest. 1995 Aug;108(2):415–418. doi: 10.1378/chest.108.2.415. [DOI] [PubMed] [Google Scholar]
  21. Wassermann K., Pothoff G., Kirn E., Fätkenheuer G., Krueger G. R. Chronic Pneumocystis carinii pneumonia in AIDS. Chest. 1993 Sep;104(3):667–672. doi: 10.1378/chest.104.3.667. [DOI] [PubMed] [Google Scholar]
  22. de Lima M. A., Silva-Vergara M. L., Demachki S., dos Santos J. A. Paracoccidioidomicose em paciente com a infecço pelo vírus da imunodeficiência humana. Relato de necrópsia. Rev Soc Bras Med Trop. 1995 Jul-Sep;28(3):279–284. doi: 10.1590/s0037-86821995000300018. [DOI] [PubMed] [Google Scholar]

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