Resumen

PEREZ, Domingo; OVIEDO, José A  y  DE LOS SANTOS GILL. Paracoccidioidomicosis: características clínicas de 94 casos. Rev. am. med. respir. [online]. 2014, vol.14, n.1, pp.20-27. ISSN 1852-236X.

Paraguay is an endemic country for paracoccidiomycosis. There is no analytical work in our country evaluating the clinical presentation and the outcomes of the chronic form of paracoccidioidomycosis. Objective: To describe the clinical characteristics of paracoccidioidomycosis cases with pulmonary involvement. Material and Methods: Observational study of clinical records of patients admitted with a diagnosis of paracoccidioidomycosis during the period of January 1980 - December 2003 in INERAM, a reference medical center. Statistical analysis consisted of a bivariate analysis (X2 and ANOVA), considering significant a p < 0.05.   Results: 94 cases diagnosed during the study period were identified. The mean age of presentation was 49 ± 11 years old. The patients had notorious low average body mass index (16.6) and a high prevalence of smoking habit (77%). Respiratory symptoms, mucosal lesions (33%) and cervical lymphadenopathy (19%) were noted. Blood testing and radiographic results are described. The analysis of the variables between the group who died and the survival group showed significant difference in the respiratory rate and the radiographic images at admission. Most patients (97%) were treated with imidazole antifungal drugs; clinical improvement was observed after on average 1.6 weeks of treatment. Lethality among hospitalized patients was 11.7%. Patients were hospitalized for 63 ± 58 days, in order to receive treatment but once at home, 88% discontinued the drugs . Conclusion: Despite the nonspecific symptoms, diagnosis should be suspected in patients with subacute or chronic respiratory symptoms which are concomitant with mucosal lesions and lymphadenopathy. General measures should be taken to decrease the high rate of treatment default at home.

Palabras clave : Endemic mycosis; Chronic infections; Paracoccidiodiomycosis; Systemic mycosis.

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