Aspergillus fumigatus fungus ball in a patient with healed paracoccidioidomycosis.
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Biomedical subjects
Publications and source records attributed to N S Porto.
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We have attempted to elucidate the natural history of pulmonary aspergillus intracavitary colonization (PAIC) based on more than 350 cases of the disease observed in the last 11 years and on data collected from the literature. The data indicate that PAIC is a dynamic process consequent to the continual growth and death of fungal elements and also with their relationships to the anatomic features of the cavity (valvular mechanisms, vascular alteration). The clinical presentations reflect immunological changes in the host. Metabolites produced by the species of Aspergillus involved affect the clinical presentation of the syndrome.
We describe four cases of actinomycotic intracavitary lung colonization and review the literature on the subject. Aspergillus fumigatus, A. niger, A. flavus, Pseudallescheria boydii are responsible for the majority of fungi intracavitary lung colonization (fungus ball). The similarities in clinical symptom (haemoptysis) and radiologic feature (pulmonary air meniscus) of fungus ball and actinomycotic intracavitary colonization prompted the investigation into a range of microorganisms, including Nocardia spp. and Actinomyces spp. We report four cases of such actinomycotic syndrome, three of them in diabetic patients, and review briefly the literature.
We describe a case of adiaspiromycosis in a 37-year-old male Caucasian. This is the first reported case with diffuse involvement of both lungs in a severely ill patient treated successfully with antifungal chemotherapy.
Five cases of paracoccidioidomas are reviewed. One case with multiple coin-lesions simulating Wegener's granulomatosis is described.
A case of an acute pulmonary paracoccidioidomycosis following the use of immunosuppressive therapy in a solid cancer patient is reported.
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The first two Brazilian cases of human pulmonary nocardiosis are reported. Diagnosis was established on material obtained by direct lung puncture. A review of selected aspects on pulmonary nocardiosis in Latin American countries is presented.
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Of 156 cases of histoplasmosis observed in the State of Rio Grande do Sul (Brazil), during a 21-year period (1978-1999) 137 were included in this study. Sixty-seven per cent of the patients had hematogeneous disseminated histoplasmosis, 24% had a self-limited syndrome (acute pulmonary histoplasmosis, histoplasmoma or primary pulmonary lymph node complex), and 9 per cent had chronic pulmonary histoplasmosis. Clinical, mycological, and epidemiological data were reviewed and commented.