Fatal septic shock caused by Paracoccidioides brasiliensis phylogenetic species S1 in a young immunocompetent patient: a case report

The authors report the first case of fatal septic shock, a rare clinical presentation of paracoccidioidomycosis (PCM) caused by Paracoccidioides brasiliensis S1. We also provide an immunological evaluation of the patient. Severe clinical signs such as organ dysfunction and digital gangrene occurred...

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Bibliographic Details
Published in:Revista da Sociedade Brasileira de Medicina Tropical 2018, Vol.51 (1), p.111-114
Main Authors: Macedo, Priscila Marques de, Almeida-Paes, Rodrigo, Almeida, Marcos de Abreu, Coelho, Rowena Alves, Oliveira Filho, Marcio Amaral de, Medeiros, Denise Machado, Gomes-Silva, Adriano, Lima, Jéssica Ribeiro de, Da-Cruz, Alda Maria, Zancopé-Oliveira, Rosely Maria, Valle, Antonio Carlos Francesconi do
Format: Report
Language:English
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Summary:The authors report the first case of fatal septic shock, a rare clinical presentation of paracoccidioidomycosis (PCM) caused by Paracoccidioides brasiliensis S1. We also provide an immunological evaluation of the patient. Severe clinical signs such as organ dysfunction and digital gangrene occurred in this case. The patient presented a remarkable cell activation profile and diminished percentage of peripheral blood T regulatory cells. A decrease in anti-inflammatory IL-1RA plasma level showed the potential for endothelium damage, probably contributing to a vasculitis process. Together with P. lutzii, P. brasiliensis appears to be involved in severe cases of PCM.
ISSN:1678-9849
DOI:10.1590/0037-8682-0318-2017