Paracoccidioidomycosis of the central nervous system: case report

• Published in: Arquivos de neuro-psiquiatria 2000-09, Vol.58 (3A), p.741-747
• Main Authors: da Silva, C E, Cordeiro, A F, Gollner, A M, Cupolilo, S M, Quesado-Filgueiras, M, Curzio, M F
• Format: Article
• Language: eng ; por ; spa
• Subjects: Adult; Antifungal Agents - therapeutic use; Brain Abscess - diagnosis; Brain Abscess - drug therapy; Brain Abscess - microbiology; Chronic Disease; Female; Humans; Paracoccidioides brasiliensis; Paracoccidioidomycosis - complications; Paracoccidioidomycosis - diagnosis; Paracoccidioidomycosis - drug therapy; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use
• ISSN: 0004-282X
• DOI: 10.1590/s0004-282x2000000400024

The involvement of the central nervous system in paracoccidioidomycosis is more frequent than previously thought. The first reference to the possibility that Paracoccidioides brasiliensis could affect the central nervous system was by Pereira & Jacobs in 1919. Since then, a great number of other studies has showed this form of clinical behavior and, in some of them, the frequency has ranged 27.27%. We report a clinical case of a 34-year-old white Brazilian woman admitted because of bacterial pneumonia. In the sixth day of admission, the patient developed cerebellar symptomatology with nausea, vomiting, dysmetria and gait disturbance. Central nervous system computer tomographic scanning disclosed a hypodense lesion in the right cerebellar hemisphere. The patient was submitted to surgery with total excision of the lesion. Histopathological examination confirmed the diagnosis of neuroparacoccidioidomycosis. Coadjuvant treatment with sulfamethoxazole-trimetoprim was introduced. The patient had a good outcome and was discharge 30 days after surgery.