array:23 [ "pii" => "S1130140620300462" "issn" => "11301406" "doi" => "10.1016/j.riam.2020.09.003" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "573" "copyright" => "Asociación Española de Micología" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Iberoam Micol. 2021;38:5-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S1130140620300504" "issn" => "11301406" "doi" => "10.1016/j.riam.2020.10.002" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "574" "copyright" => "Asociación Española de Micología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Iberoam Micol. 2021;38:9-11" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Note</span>" "titulo" => "Lack of relationship between genotype and virulence in <span class="elsevierStyleItalic">Candida</span> species" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "9" "paginaFinal" => "11" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ausencia de relación entre el genotipo y la virulencia en especies de <span class="elsevierStyleItalic">Candida</span>" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 598 "Ancho" => 2955 "Tamanyo" => 92816 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Survival curves of <span class="elsevierStyleItalic">G. mellonella</span> larvae infected with <span class="elsevierStyleItalic">C. albicans</span> (a), <span class="elsevierStyleItalic">C. parapsilosis</span> (b), and <span class="elsevierStyleItalic">C. tropicalis</span> (c) isolates (clusters and singleton genotypes).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Judith Díaz-García, Maiken C. Arendrup, Rafael Cantón, Julio García-Rodríguez, Elia Gómez García de la Pedrosa, Gabriella Parisi, Javier Pemán, Brunella Posteraro, Maurizio Sanguinetti, Daniel Archimedes Da Matta, Arnaldo L. Colombo, Patricia Muñoz, Carlos Sánchez-Carrillo, Jesús Guinea, Pilar Escribano" "autores" => array:15 [ 0 => array:2 [ "nombre" => "Judith" "apellidos" => "Díaz-García" ] 1 => array:2 [ "nombre" => "Maiken C." "apellidos" => "Arendrup" ] 2 => array:2 [ "nombre" => "Rafael" "apellidos" => "Cantón" ] 3 => array:2 [ "nombre" => "Julio" "apellidos" => "García-Rodríguez" ] 4 => array:2 [ "nombre" => "Elia Gómez García" "apellidos" => "de la Pedrosa" ] 5 => array:2 [ "nombre" => "Gabriella" "apellidos" => "Parisi" ] 6 => array:2 [ "nombre" => "Javier" "apellidos" => "Pemán" ] 7 => array:2 [ "nombre" => "Brunella" "apellidos" => "Posteraro" ] 8 => array:2 [ "nombre" => "Maurizio" "apellidos" => "Sanguinetti" ] 9 => array:2 [ "nombre" => "Daniel Archimedes" "apellidos" => "Da Matta" ] 10 => array:2 [ "nombre" => "Arnaldo L." "apellidos" => "Colombo" ] 11 => array:2 [ "nombre" => "Patricia" "apellidos" => "Muñoz" ] 12 => array:2 [ "nombre" => "Carlos" "apellidos" => "Sánchez-Carrillo" ] 13 => array:2 [ "nombre" => "Jesús" "apellidos" => "Guinea" ] 14 => array:2 [ "nombre" => "Pilar" "apellidos" => "Escribano" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130140620300504?idApp=UINPBA00004N" "url" => "/11301406/0000003800000001/v3_202111180642/S1130140620300504/v3_202111180642/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S113014062030022X" "issn" => "11301406" "doi" => "10.1016/j.riam.2020.03.001" "estado" => "S300" "fechaPublicacion" => "2021-01-01" "aid" => "558" "copyright" => "Asociación Española de Micología" "documento" => "article" "crossmark" => 1 "subdocumento" => "ssu" "cita" => "Rev Iberoam Micol. 2021;38:3-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Mycologic Forum</span>" "titulo" => "Diagnosis of <span class="elsevierStyleItalic">Malassezia</span> dermatitis and otitis in dogs and cats, is it just a matter of counting?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "3" "paginaFinal" => "4" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Diagnóstico de las dermatitis y otitis por <span class="elsevierStyleItalic">Malassezia</span> en perros y gatos, ¿es sólo cuestión de contar?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1690 "Ancho" => 2667 "Tamanyo" => 207109 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Amplification plot (qPCR) after 30 cycles of two swab samples from two dogs. One sample was obtained from a dog in which <span class="elsevierStyleItalic">Malassezia pachydermatis</span> otitis externa was diagnosed (upper line); the other one was obtained from a healthy dog (bottom line).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisco Javier Cabañes" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Francisco Javier" "apellidos" => "Cabañes" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014062030022X?idApp=UINPBA00004N" "url" => "/11301406/0000003800000001/v3_202111180642/S113014062030022X/v3_202111180642/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Note</span>" "titulo" => "Paracoccidioidomycosis due to <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> S1 associated with acquired immunodeficiency syndrome: A case report" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "5" "paginaFinal" => "8" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Paulo Mendes Peçanha, Isabela Cruz Bahiense, Wdson Luis Lima Kruschewsky, Cláudia Biasutti, Carlos Urbano Gonçalves Ferreira Júnior, Breno Gonçalves Pinheiro, Simone Bravim Maifrede, Zoilo Pires de Camargo, Anderson Messias Rodrigues, Tânia Regina Grão-Velloso, Aloísio Falqueto, Sarah Santos Gonçalves" "autores" => array:12 [ 0 => array:3 [ "nombre" => "Paulo Mendes" "apellidos" => "Peçanha" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Isabela Cruz" "apellidos" => "Bahiense" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Wdson Luis Lima" "apellidos" => "Kruschewsky" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Cláudia" "apellidos" => "Biasutti" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Carlos Urbano Gonçalves Ferreira" "apellidos" => "Júnior" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Breno Gonçalves" "apellidos" => "Pinheiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 6 => array:3 [ "nombre" => "Simone Bravim" "apellidos" => "Maifrede" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "Zoilo Pires de" "apellidos" => "Camargo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 8 => array:3 [ "nombre" => "Anderson Messias" "apellidos" => "Rodrigues" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 9 => array:3 [ "nombre" => "Tânia Regina" "apellidos" => "Grão-Velloso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 10 => array:3 [ "nombre" => "Aloísio" "apellidos" => "Falqueto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 11 => array:4 [ "nombre" => "Sarah Santos" "apellidos" => "Gonçalves" "email" => array:1 [ 0 => "sarah.tavares@ufes.br" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Universidade Federal do Espírito Santo-UFES, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Universitário Cassiano Antônio Moraes-UFES, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Universidade Federal de São Paulo-UNIFESP, Brazil" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Paracoccidioidomicosis por <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> S1 asociado al síndrome de inmunodeficiencia adquirida: A propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1241 "Ancho" => 1500 "Tamanyo" => 199195 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Paracoccidioidomycosis diagnostic by computed tomography (CT) and magnetic resonance imaging (MRI). (A) Chest CT showing: (1) moderate bilateral pleural effusion; (2) bilateral pleural effusion and ground-glass opacities predominating in posterior fields of both lungs, sometimes confluent (consolidations). (B) Abdominal CT showing mesenteric lymphadenopathy with necrotic center, sometimes clustered. (C) Brain MRI showing an area of signal change in corona radiate, characterized by hypersignal in T2-FLAIR and hyposignal in T1, without contrast enhancement. In addition, an intra-axial lesion, partially calcified and with pathological enhancement by venous contrast, was observed near the left lateral wall of the fourth ventricle, without mass effect or peripheral edema.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Paracoccidioidomycosis (PCM) is an endemic mycosis in Latin America caused by a species of the genus <span class="elsevierStyleItalic">Paracoccidioides</span> and is the cause of approximately half of the total deaths due to systemic mycoses in Brazil.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">16</span></a> PCM in immunocompetent hosts may present with two clinical forms: acute/subacute and chronic. However, clinical findings related to PCM in HIV-infected patients show that both the acute and chronic presentations of the disease may occur simultaneously. Therefore, HIV/PCM co-infection can increase the clinical severity of patients.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">2,13,15</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The development of molecular tools for identifying the species of the genus <span class="elsevierStyleItalic">Paracoccidioides</span> helped to improve our knowledge of PCM in the field of epidemiology, although in the clinical setting the need to identify the species is uncertain. It is within this context of expanded knowledge about PCM that it is relevant to study <span class="elsevierStyleItalic">Paracoccidioides</span> phylogenetic cryptic species in vulnerable populations, such as HIV-infected patients. Our study focused on describing the clinical-epidemiological and microbiological characteristics, as well as the evolution of the infection, in a HIV/PCM co-infected patient seen at the reference center for PCM care from May 2019 to March 2020, at the University Hospital Cassiano Antonio Moraes at the Federal University of Espirito Santo, Brazil. This study was approved by the Ethics Committee CAAE 30505420.0.0000.5060. All personal medical data from medical records were anonymized. The patient signed a consent form authorizing the case's description and the release of the photographs taken to him.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Case report</span><p id="par0015" class="elsevierStylePara elsevierViewall">On August 2018, a 37-year-old male from an urban area of São Mateus-ES was diagnosed of an HIV infection. The man was smoker, drinker, and reported having carried out rural activities working as coffee farmer for 24 years. There were no records of previous diseases and tenofovir, lamivudine and dolutegravir were prescribed for the HIV infection. In the same month the patient presented with disseminated lesions (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B), as well as diffuse lymphadenopathy associated with asthenia, dyspnea on exertion and hyporexia. Nine months later, the patient's case evolved to a worsening asthenia, onset of productive cough and pleuritic chest pain, which led to his admission to the University Hospital (HUCAM). On physical examination, disseminated skin lesions, generalized lymph adenomegaly and bilateral basal crackles were observed. Additional tests were also conducted, showing an oxygen saturation of 92%, without signs of respiratory effort, C-reactive protein 33.3<span class="elsevierStyleHsp" style=""></span>mg/l, CD4<span class="elsevierStyleSup">+</span> 402<span class="elsevierStyleHsp" style=""></span>cells/mm<span class="elsevierStyleSup">3</span>, and undetectable viral load. Important findings were noted in a chest computed tomography (CT), abdominal CT and brain magnetic resonance imaging (MRI) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Samples of secretion discharge from an abcess in the subcostal region were collected, and direct mycological examination using Parker KOH stain showed yeast cells with multiple budding, consistent with <span class="elsevierStyleItalic">Paracoccidioides</span> species. Double immunodiffusion tests, conducted with an antigen prepared with the standard strain <span class="elsevierStyleItalic">P. brasiliensis</span> B-339, yielded positive results (1:32). The fungus was isolated in Sabouraud dextrose agar at 25<span class="elsevierStyleHsp" style=""></span>°C and 37<span class="elsevierStyleHsp" style=""></span>°C. The molecular identification of the species was performed by species-specific PCR of 43-kDa glycoprotein GP43 locus (exon 2) encoding gene, followed by PCR-RFLP of alpha-tubulin (TUB1) gene, as previously described.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">17</span></a> The patient received amphotericin B lipid complex (cumulative dose of 4600<span class="elsevierStyleHsp" style=""></span>mg), evolving with regression of skin lesions and improvement of dyspnea, chest pain and oxygen saturation in ambient air. Outpatient treatment consisted of sulfamethoxazole-trimethoprim 1600<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>320<span class="elsevierStyleHsp" style=""></span>mg/daily. After 10 months of regular treatment, the patient remains clinically well (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C), without sequelae of PCM or adverse effects of the medication.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">HIV/PCM co-infection is uncommon compared to other superficial and systemic mycoses as histoplasmosis, pneumocystosis, and cryptococcosis.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">10</span></a> The low frequency of this co-infection may be related to the fact that AIDS is still predominantly an urban disease, in contrast to PCM, that is more common in rural areas.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">18</span></a> In our case, the patient came from an urban area, but he worked in coffee harvesting for long time, where he probably was exposed to the mycotic infection. Diagnosis of PCM is established by a combination of clinical findings and agent identification in histopathological sections, culture of clinical specimen or direct microscopic examination. It is not possible to identify the microorganism at the species level only by morphological characteristics and yeast visualization in direct mycological examination. Thus, molecular tools have been used to accurately discriminate the species. Some molecular markers are applied for this purpose, among which the best choices are <span class="elsevierStyleItalic">gp43</span>, <span class="elsevierStyleItalic">arf</span>, α<span class="elsevierStyleItalic">-tubulin</span>, and <span class="elsevierStyleItalic">hsp70</span>.<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">17,20</span></a> Despite the multiple resources listed here, the recovery rate of this fungus in culture is very low, making the study of its molecular properties extremely difficult, and consequently impairing a more detailed study of the species of <span class="elsevierStyleItalic">Paracoccidioides</span> and their clinical implications.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">5,21</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">There are four studies (8 cases) in the literature reporting HIV/PCM co-infection in which a molecular approach to identify the isolates has been carried out.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">4,6,11,12</span></a> However, only two of those studies successfully achieved a specific discrimination of the species. The first one to do it was a case-study from Argentina, which identified the species <span class="elsevierStyleItalic">Paracoccidioides americana</span> sp. nov. (PS2) by PCR-RFLP.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">12</span></a> This species has been identified in eastern Brazil and it has been described in a single event in Venezuela. Nevertheless, it is less frequently found when compared to <span class="elsevierStyleItalic">P. brasiliensis</span>.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">4</span></a> In the second study, five isolates recovered from Brazilian patients were identified by partial DNA sequencing of two protein-coding genes (<span class="elsevierStyleItalic">arf</span> and <span class="elsevierStyleItalic">gp43</span>) as <span class="elsevierStyleItalic">P. brasiliensis</span> S1.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleItalic">P. brasiliensis</span> is constituted by two phylogenetic cryptic species, S1a and S1b, and they are better discriminated by <span class="elsevierStyleItalic">GP43</span>-exon-2 region DNA sequencing.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">9</span></a> These cryptic species have a distinct geographic distribution; they are widely present in Argentina and Brazil.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">14</span></a> A great diversity of PCR-based molecular tools has been developed as viable options for the identification of <span class="elsevierStyleItalic">Paracoccidioides</span>.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">1,7,8,20</span></a> It is worth mentioning that PCR-RFLP-based screening assays are very effective for genotyping, and provide important advantages as inexpensiveness and high discriminatory power depending on the target gene.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">17</span></a> All HIV/PCM Brazilian cases involving <span class="elsevierStyleItalic">P. brasiliensis</span> S1 came from the Brazil's southeast region, including the states of Minas Gerais, São Paulo and Rio de Janeiro. Our case report is the first from the state of Espírito Santo. In five out of eight HIV/PCM cases previously described, there was no record of patients having carried out rural labor, differing from the usual epidemiology of the disease. As HIV infection is spreading in South America's countryside, the possibility of HIV being associated with endemic diseases prevalent in such countries must be considered in our clinical reasoning.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">11</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">HIV/PCM patients can present a severe and disseminated disease even with normal CD4<span class="elsevierStyleSup">+</span> cell count, as observed in this case report. Nevertheless, most HIV/PCM patients present CD4<span class="elsevierStyleSup">+</span> cell counts below 200<span class="elsevierStyleHsp" style=""></span>cells/mm<span class="elsevierStyleSup">3</span>, suggesting that <span class="elsevierStyleItalic">Paracoccidioides</span> may take advantage of the immunosuppression to shift from quiescent infection to systemic disease.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">3</span></a> Regarding therapeutics for PCM, a particular drug combination is an important strategy in patients HIV/PCM due to the severity and refractoriness in these cases, particularly when there is a low treatment adherence and CD4<span class="elsevierStyleSup">+</span> cell counts are lower than 200<span class="elsevierStyleHsp" style=""></span>cells/mm<span class="elsevierStyleSup">3</span>. Amphotericin B should be promptly administered, followed by itraconazole or sulfamethoxazole-trimethoprim. Treatment duration depends on the severity of the clinical presentation, site of infection, restoration of the host's immune response, as well as on the clinical response to therapy and laboratorial findings.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">19</span></a> In our case, the patient's treatment was based on the above recommendations using amphotericin B for 22 days, followed by sulfamethoxazole-trimethoprim.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Molecular tools are important for an accurate identification of the pathogen, which then allows choosing a successful therapy while also providing epidemiological data. Furthermore, there are no studies about the phylogenetic species of <span class="elsevierStyleItalic">Paracoccidioides</span> in Espírito Santo. Thus, this case report may contribute to the knowledge about this severe disease, its causative cryptic species, and their consequences to the patients. Subsequent studies with more patients should be carried out to assess clinical implications for this type of infection and other peculiarities related to HIV/PCM co-infection.</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">AMR was supported by grants from the <span class="elsevierStyleGrantSponsor" id="gs1">São Paulo Research Foundation</span> (<span class="elsevierStyleGrantNumber" refid="gs1">FAPESP 2017/27265-5</span>).</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflict of interests</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:3 [ "identificador" => "xres1612025" "titulo" => "Abstract" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Case report" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1441394" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1612024" "titulo" => "Resumen" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1441395" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Case report" ] 5 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 6 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interests" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-06-05" "fechaAceptado" => "2020-09-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1441394" "palabras" => array:4 [ 0 => "Paracoccidioidomycosis" 1 => "<span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> S1" 2 => "Co-infection" 3 => "HIV" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1441395" "palabras" => array:4 [ 0 => "Paracoccidioidomicosis" 1 => "<span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> S1" 2 => "Coinfección" 3 => "VIH" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">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.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case report</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">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 <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> S1 by species-specific PCR using primers for protein-coding gene <span class="elsevierStyleItalic">GP43</span> (exon 2) followed by PCR-RFLP of the alpha-tubulin gene.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusions</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">There are few data in literature reporting species-specific molecular identification of <span class="elsevierStyleItalic">Paracoccidioides</span> 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.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Case report" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Antecedentes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La paracoccidioidomicosis (PCM) es una enfermedad endémica en Latinoamérica. En los pacientes inmunocompetentes, la PCM cursa con dos principales formas: aguda y crónica. Sin embargo, los pacientes infectados por el VIH pueden presentar manifestaciones simultáneas de las dos formas clínicas.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Caso clínico</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se presenta el caso de un paciente VIH-positivo, con lesiones cutáneas diseminadas, linfadenopatía generalizada y afectación del sistema nervioso central y respiratorio. El diagnóstico de PCM se confirmó mediante un examen directo con KOH, doble inmunodifusión y el aislamiento del hongo en cultivo, a partir de muestras de un absceso en la región subcostal. La cepa aislada se identificó como <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> S1 mediante PCR especie-específica del gen codificador de la proteína GP43 (exón 2), seguida de PCR-RFLP del gen de la alfa-tubulina.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusiones</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Existen pocos datos en la literatura que describan la identificación molecular especie-específica de <span class="elsevierStyleItalic">Paracoccidioides</span> en pacientes con VIH/PCM. Por lo tanto, la presentación de este caso clínico puede contribuir a mejorar el conocimiento sobre esta enfermedad grave, la especie críptica implicada y sus consecuencias para los pacientes.</p></span>" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "abst0020" "titulo" => "Antecedentes" ] 1 => array:2 [ "identificador" => "abst0025" "titulo" => "Caso clínico" ] 2 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 485 "Ancho" => 1750 "Tamanyo" => 136352 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Cutaneous lesions outcome before and after treatment. (A, B) Crusting lesions on the face and tumours in lower right hemithorax, right cervical chain and ribs before treatment. (C) Skin lesions on the face and thorax after treatment.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1241 "Ancho" => 1500 "Tamanyo" => 199195 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Paracoccidioidomycosis diagnostic by computed tomography (CT) and magnetic resonance imaging (MRI). (A) Chest CT showing: (1) moderate bilateral pleural effusion; (2) bilateral pleural effusion and ground-glass opacities predominating in posterior fields of both lungs, sometimes confluent (consolidations). (B) Abdominal CT showing mesenteric lymphadenopathy with necrotic center, sometimes clustered. (C) Brain MRI showing an area of signal change in corona radiate, characterized by hypersignal in T2-FLAIR and hyposignal in T1, without contrast enhancement. In addition, an intra-axial lesion, partially calcified and with pathological enhancement by venous contrast, was observed near the left lateral wall of the fourth ventricle, without mass effect or peripheral edema.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0110" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Detection of <span class="elsevierStyleItalic">Paracoccidioides</span> spp. in environmental aerosol samples" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T.D. Arantes" 1 => "R.C. Theodoro" 2 => "S.A. Da Graça Macoris" 3 => "E. Bagagli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/13693786.2012.698444. PubMed PMID: 22762209" "Revista" => array:6 [ "tituloSerie" => "Med Mycol" "fecha" => "2013" "volumen" => "51" "paginaInicial" => "83" "paginaFinal" => "92" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22762209" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0115" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paracoccidioidomycosis: a model for evaluation of the effects of human immunodeficiency virus infection on the natural history of endemic tropical diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Benard" 1 => "A.J.S. Duarte" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/318146" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2000" "volumen" => "31" "paginaInicial" => "1032" "paginaFinal" => "1039" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11049788" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0120" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paracoccidioidomycosis in immunocompromised patients: a literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.N. De Almeida Jr." 1 => "P.M. Peçanha-Pietrobom" 2 => "A.L. Colombo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Fungi" "fecha" => "2019" "volumen" => "5" "paginaInicial" => "e2" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0125" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paracoccidioidomycosis due to <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> S1 plus HIV co-infection" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.M. De Macedo" 1 => "R. Almeida-Paes" 2 => "M.A. Almeida" 3 => "R.A. Coelho" 4 => "H.B. Andrade" 5 => "A.B.T.B.C. Ferreira" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Mem Inst Oswaldo Cruz" "fecha" => "2018" "volumen" => "113" "paginaInicial" => "167" "paginaFinal" => "172" "itemHostRev" => array:3 [ "pii" => "S0890856709625557" "estado" => "S300" "issn" => "08908567" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0130" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute paracoccidioidomycosis due to <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> S1 mimicking hypereosinophilic syndrome with massive splenomegaly: diagnostic challenge" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.M. De Macedo" 1 => "L.C. de Oliveira" 2 => "D.F.S. Freitas" 3 => "J.A. da Rocha" 4 => "A.D. Freitas" 5 => "M. Nucci" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "PLoS Negl Trop Dis" "fecha" => "2016" "volumen" => "10" "paginaInicial" => "e0004487" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0135" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> causing a rib lesion in an adult AIDS patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.S. Freitas" 1 => "K.C. Dantas" 2 => "R.S. Garcia" 3 => "M.M. Magri" 4 => "H.F. Andrade Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Hum Pathol" "fecha" => "2010" "volumen" => "41" "paginaInicial" => "1350" "paginaFinal" => "1354" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0140" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PCR for diagnosis of paracoccidioidomycosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.M. Gomes" 1 => "P.S. Cisalpino" 2 => "C.P. Taborda" 3 => "Z.P. de Camargo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.38.9.3478-3480.2000" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2000" "volumen" => "38" "paginaInicial" => "3478" "paginaFinal" => "3480" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10970409" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0145" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomly amplified polymorphic DNA as a valuable tool for epidemiological studies of <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.C. Hahn" 1 => "A.M. Macedo" 2 => "C.J. Fontes" 3 => "R.D. Batista" 4 => "N.L. Santos" 5 => "J.S. Hamdan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.41.7.2849-2854.2003" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2003" "volumen" => "41" "paginaInicial" => "2849" "paginaFinal" => "2854" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12843011" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0150" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ecology of <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> P. lutzii and related species: infection in armadillos, soil occurrence and mycological aspects" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.F. Hrycyk" 1 => "H. Garcia Garces" 2 => "S.M.G. Bosco" 3 => "S.L. de Oliveira" 4 => "S.A. Marques" 5 => "E. Bagagli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/mmy/myx142" "Revista" => array:6 [ "tituloSerie" => "Med Mycol" "fecha" => "2018" "volumen" => "56" "paginaInicial" => "950" "paginaFinal" => "962" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29325170" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0155" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fungal Infections in HIV/AIDS" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.H. Limper" 1 => "A. Adenis" 2 => "T. Le" 3 => "T.S. Harrison" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1473-3099(17)30303-1" "Revista" => array:6 [ "tituloSerie" => "Lancet Infect Dis" "fecha" => "2017" "volumen" => "17" "paginaInicial" => "e334" "paginaFinal" => "e343" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28774701" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0160" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paracoccidioidomycosis and HIV coinfection presenting severe disease even with CD4+ cells in the normal range" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.A. Marques" 1 => "L. Petrechen" 2 => "A.C. Kakuda" 3 => "M.P. Chiossi" 4 => "M.E. Marques" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.riam.2012.12.004" "Revista" => array:6 [ "tituloSerie" => "Rev Iberoam Micol" "fecha" => "2014" "volumen" => "31" "paginaInicial" => "154" "paginaFinal" => "155" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23563486" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0165" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and microbiological characteristics of paracoccidioidomycosis in patients with AIDS in Buenos Aires, Argentina" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Messina" 1 => "M. Romero" 2 => "A. Benchetrit" 3 => "E. Marin" 4 => "A. Arechavala" 5 => "R. Depardo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/mmy/myz021" "Revista" => array:6 [ "tituloSerie" => "Med Mycol" "fecha" => "2020" "volumen" => "58" "paginaInicial" => "22" "paginaFinal" => "29" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30874811" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0170" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paracoccidioidomycosis in patients infected with and not infected with human immunodeficiency virus: a case–control study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K.M.L. Morejón" 1 => "A.A. Machado" 2 => "R. Martinez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Trop Med Hyg" "fecha" => "2009" "volumen" => "80" "paginaInicial" => "359" "paginaFinal" => "366" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19270282" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0175" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genome diversity, recombination, and virulence across the major lineages of <span class="elsevierStyleItalic">Paracoccidioides</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.F. Muñoz" 1 => "R.A. Farrer" 2 => "C.A. Desjardins" 3 => "J.E. Gallo" 4 => "S. Sykes" 5 => "S. Sakthikumar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/mSphere.00213-16" "Revista" => array:6 [ "tituloSerie" => "mSphere" "fecha" => "2016" "volumen" => "1" "paginaInicial" => "e00213" "paginaFinal" => "e216" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27704050" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0180" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paracoccidioidomycosis in patients with human immunodeficiency virus: review of 12 cases observed in an endemic region in Brazil" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Paniago" 1 => "A.C. Freitas" 2 => "E.S. Aguiar" 3 => "J.I. Aguiar" 4 => "R.V. Cunha" 5 => "A.R. Castro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jinf.2005.01.010" "Revista" => array:6 [ "tituloSerie" => "J Infect" "fecha" => "2005" "volumen" => "51" "paginaInicial" => "248" "paginaFinal" => "252" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16230222" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0185" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mortality due to systemic mycoses as a primary cause of death or in association with AIDS in Brazil: a review from 1996 to 2006" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Prado" 1 => "M.B. Silva" 2 => "R. Laurenti" 3 => "L.R. Travassos" 4 => "C.P. Taborda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Mem Inst Oswaldo Cruz" "fecha" => "2009" "volumen" => "104" "paginaInicial" => "513" "paginaFinal" => "521" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0190" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identifying <span class="elsevierStyleItalic">Paracoccidioides</span> phylogenetic species by PCR-RFLP of the alpha-tubulin gene" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T.N. Roberto" 1 => "A.M. Rodrigues" 2 => "R.C. Hahn" 3 => "Z.P. de Camargo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/mmy/myv083" "Revista" => array:6 [ "tituloSerie" => "Med Mycol" "fecha" => "2016" "volumen" => "54" "paginaInicial" => "240" "paginaFinal" => "247" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26667263" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0195" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paracoccidioidal infection in HIV patients at an endemic area of paracoccidioidomycosis in Brazil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.C.F.B. Sarti" 1 => "S.M.V.L. Oliveira" 2 => "L.F.S. Santos" 3 => "Z.P. Camargo" 4 => "A.M.M. Paniago" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11046-011-9495-6" "Revista" => array:6 [ "tituloSerie" => "Mycopathologia" "fecha" => "2012" "volumen" => "173" "paginaInicial" => "145" "paginaFinal" => "149" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22081255" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0200" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Brazilian guidelines for the clinical management of paracoccidioidomycosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Shikanai-Yasuda" 1 => "R.P. Mendes" 2 => "A.L. Colombo" 3 => "F.Q. Telles" 4 => "A. Kono" 5 => "A.M.M. Paniago" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Soc Brasil Med Trop" "fecha" => "2017" "volumen" => "50" "paginaInicial" => "715" "paginaFinal" => "740" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0205" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Paracoccidioides</span> species complex: ecology, phylogeny, sexual reproduction, and virulence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.M. Teixeira" 1 => "R.C. Theodoro" 2 => "G. Nino-Vega" 3 => "E. Bagagli" 4 => "M.S. Felipe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.ppat.1004397" "Revista" => array:5 [ "tituloSerie" => "PLoS Pathog" "fecha" => "2014" "volumen" => "10" "paginaInicial" => "e1004397" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25357210" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0210" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serological diagnosis of paracoccidioidomycosis: high rate of inter-laboratorial variability among medical mycology reference centers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.S. Vidal" 1 => "G.M. Del Negro" 2 => "A.P. Vicentini" 3 => "T.I. Svidzinski" 4 => "M.J. Mendes-Giannini" 5 => "A.M. Almeida" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "PLoS Negl Trop Dis" "fecha" => "2014" "volumen" => "8" "paginaInicial" => "e3174" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/11301406/0000003800000001/v3_202111180642/S1130140620300462/v3_202111180642/en/main.assets" "Apartado" => array:4 [ "identificador" => "7995" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Notas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/11301406/0000003800000001/v3_202111180642/S1130140620300462/v3_202111180642/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130140620300462?idApp=UINPBA00004N" ]
Información de la revista
Compartir
Descargar PDF
Más opciones de artículo
Note
Paracoccidioidomycosis due to Paracoccidioides brasiliensis S1 associated with acquired immunodeficiency syndrome: A case report
Paracoccidioidomicosis por Paracoccidioides brasiliensis S1 asociado al síndrome de inmunodeficiencia adquirida: A propósito de un caso
Paulo Mendes Peçanhaa, Isabela Cruz Bahiensea, Wdson Luis Lima Kruschewskya, Cláudia Biasuttib, Carlos Urbano Gonçalves Ferreira Júniorb, Breno Gonçalves Pinheiroc, Simone Bravim Maifredea, Zoilo Pires de Camargoc, Anderson Messias Rodriguesc, Tânia Regina Grão-Vellosoa, Aloísio Falquetoa, Sarah Santos Gonçalvesa,
Autor para correspondencia