Paracoccidioidomycosis is a systemic granulomatous disease caused by fungus,and must be considered in the differential diagnosis of intra-abdominal tumors in endemic areas.We report a rare case of paracoccidioidomycos...Paracoccidioidomycosis is a systemic granulomatous disease caused by fungus,and must be considered in the differential diagnosis of intra-abdominal tumors in endemic areas.We report a rare case of paracoccidioidomycosis in the pancreas.A 45-year-old man was referred to our institution with a 2-mo history of epigastric abdominal pain that was not diet-related,with night sweating,inappetence,weight loss,jaundice,pruritus,choluria,and acholic feces,without signs of sepsis or palpable tumors.Abdominal ultrasonography(US)showed a solid mass of approximately 7 cm×5.5 cm on the pancreas head.Abdominal computerized tomography showed dilation of the biliary tract,an enlarged pancreas(up to 4.5 in the head region),with dilation of the major pancreatic duct.The patient underwent exploratory laparotomy,and the surgical description consisted of a tumor,measuring 7 to 8 cm with a poorly-defined margin,adhering to posterior planes and mesenteric vessels,showing an enlarged bile duct.External drainage of the biliary tract,Rouxen-Y gastroenteroanastomosis,lymph node excision,and biopsies were performed,but malignant neoplasia was not found.Microscopic analysis showed chronic pancreatitis and a granulomatous chronic inflammatory process in the choledochal lymph node.Acid-alcohol resistant bacillus and fungus screening were negative.Fine-needle aspiration of the pancreas was performed under US guidance.The smear was compatible with infection by Paracoccidioides brasiliensis.We report a rare case of paracoccidioidomycosis simulating a malignant neoplasia in the pancreas head.展开更多
Paracoccidioidomycosis is the most prevalent systemic mycosis in Latin America. It is a fungal infection caused by the dimorphic fungus Paracoccidioides brasiliensis. This microorganism can penetrate the human body th...Paracoccidioidomycosis is the most prevalent systemic mycosis in Latin America. It is a fungal infection caused by the dimorphic fungus Paracoccidioides brasiliensis. This microorganism can penetrate the human body through direct contact and can cause intense lymphadenopathy, ulcerated lesions in the oral cavity and in the skin among other alterations. In this study, we report a case of paracoccidioidomycosis with unusual clinical presentation, as it manifested in the female sex and although it did not present any relevant complaints of respiratory focus, it presented a single ulcerated lesion in the buccal mucosa. A biopsy of the lesion and a mycological examination revealed Paracoccidioidesbrasiliensis infection.展开更多
VEGF （Vascular endothelial growth factor） signaling is critical for endothelial cell survival and maintenance of the vasculature. Deregulation of VEGF signaling contributes to the physiopathology of many diseases. H...VEGF （Vascular endothelial growth factor） signaling is critical for endothelial cell survival and maintenance of the vasculature. Deregulation of VEGF signaling contributes to the physiopathology of many diseases. However, the ways in which infection with Paracoccidioides brasiliensis affects VEGF signaling and the influence of immunization with rPb27 （recombinant protein Pb27） on VEGF signaling have not yet been studied. Animals were immunized with rPb27 and subsequently infected with a virulent strain of P. brasiliensis. The fungal load was evaluated by measuring CFU （colony-forming unit） and histology was performed to evaluate the inflammatory reaction. At the two time points analyzed, the PC （positive control） and TREAT （treated） animals had decreased levels of pulmonary VEGF compared to basal levels. However, in the immunized （Pb27） and treated mice （Pb27 ＋ TREAT）, VEGF expression remained unchanged after infection. In the case of VEGFR-2, the Pb27 and Pb27 ＋ TREAT groups showed increased levels of expression. Regarding the levels of the eNOS enzyme, only the Pb27 group did not reduce the expression levels relative to baseline. The immunization with rPb27 kept VEGF signaling, NO production and increased VEGFR-2 expression, after infection with P. brasiliensis. Thus, the authors infer that immunization with rPb27 protects mice from the disruption of VEGF signaling in Paracoccidioides brasiliensis infection.展开更多
文摘Paracoccidioidomycosis is a systemic granulomatous disease caused by fungus,and must be considered in the differential diagnosis of intra-abdominal tumors in endemic areas.We report a rare case of paracoccidioidomycosis in the pancreas.A 45-year-old man was referred to our institution with a 2-mo history of epigastric abdominal pain that was not diet-related,with night sweating,inappetence,weight loss,jaundice,pruritus,choluria,and acholic feces,without signs of sepsis or palpable tumors.Abdominal ultrasonography(US)showed a solid mass of approximately 7 cm×5.5 cm on the pancreas head.Abdominal computerized tomography showed dilation of the biliary tract,an enlarged pancreas(up to 4.5 in the head region),with dilation of the major pancreatic duct.The patient underwent exploratory laparotomy,and the surgical description consisted of a tumor,measuring 7 to 8 cm with a poorly-defined margin,adhering to posterior planes and mesenteric vessels,showing an enlarged bile duct.External drainage of the biliary tract,Rouxen-Y gastroenteroanastomosis,lymph node excision,and biopsies were performed,but malignant neoplasia was not found.Microscopic analysis showed chronic pancreatitis and a granulomatous chronic inflammatory process in the choledochal lymph node.Acid-alcohol resistant bacillus and fungus screening were negative.Fine-needle aspiration of the pancreas was performed under US guidance.The smear was compatible with infection by Paracoccidioides brasiliensis.We report a rare case of paracoccidioidomycosis simulating a malignant neoplasia in the pancreas head.
文摘Paracoccidioidomycosis is the most prevalent systemic mycosis in Latin America. It is a fungal infection caused by the dimorphic fungus Paracoccidioides brasiliensis. This microorganism can penetrate the human body through direct contact and can cause intense lymphadenopathy, ulcerated lesions in the oral cavity and in the skin among other alterations. In this study, we report a case of paracoccidioidomycosis with unusual clinical presentation, as it manifested in the female sex and although it did not present any relevant complaints of respiratory focus, it presented a single ulcerated lesion in the buccal mucosa. A biopsy of the lesion and a mycological examination revealed Paracoccidioidesbrasiliensis infection.
文摘VEGF （Vascular endothelial growth factor） signaling is critical for endothelial cell survival and maintenance of the vasculature. Deregulation of VEGF signaling contributes to the physiopathology of many diseases. However, the ways in which infection with Paracoccidioides brasiliensis affects VEGF signaling and the influence of immunization with rPb27 （recombinant protein Pb27） on VEGF signaling have not yet been studied. Animals were immunized with rPb27 and subsequently infected with a virulent strain of P. brasiliensis. The fungal load was evaluated by measuring CFU （colony-forming unit） and histology was performed to evaluate the inflammatory reaction. At the two time points analyzed, the PC （positive control） and TREAT （treated） animals had decreased levels of pulmonary VEGF compared to basal levels. However, in the immunized （Pb27） and treated mice （Pb27 ＋ TREAT）, VEGF expression remained unchanged after infection. In the case of VEGFR-2, the Pb27 and Pb27 ＋ TREAT groups showed increased levels of expression. Regarding the levels of the eNOS enzyme, only the Pb27 group did not reduce the expression levels relative to baseline. The immunization with rPb27 kept VEGF signaling, NO production and increased VEGFR-2 expression, after infection with P. brasiliensis. Thus, the authors infer that immunization with rPb27 protects mice from the disruption of VEGF signaling in Paracoccidioides brasiliensis infection.
