ÿþ<HTML><HEAD><TITLE>XI International Meeting on Paracoccidioidomycosis</TITLE><link rel=STYLESHEET type=text/css href=css.css></HEAD><BODY aLink=#ff0000 bgColor=#FFFFFF leftMargin=0 link=#000000 text=#000000 topMargin=0 vLink=#000000 marginheight=0 marginwidth=0><table align=center width=700 cellpadding=0 cellspacing=0><tr><td align=left bgcolor=#cccccc valign=top width=550><font face=arial size=2><strong><font face=Verdana, Arial, Helvetica, sans-serif size=3><font size=1>XI International Meeting on Paracoccidioidomycosis</font></font></strong><font face=Verdana size=1><b><br></b></font><font face=Verdana, Arial,Helvetica, sans-serif size=1><strong> </strong></font></font></td><td align=right bgcolor=#cccccc valign=top width=150><font face=arial size=2><strong><font face=Verdana, Arial, Helvetica, sans-serif size=1><font  size=1>Resume:133-2</font></em></font></strong></font></td></tr><tr><td colspan=2><br><br><table align=center width=700><tr><td><b>Poster (Painel)</b><br><table width="100%"><tr><td width="60">133-2</td><td><b>Disseminated Paracoccidioidomycosis with osteoarticular involvement: case report</b></td></tr><tr><td valign=top>Authors:</td><td><u>Paulo Peçanha </u>  (NDI - Nucleo de Doenças Infecciosas / UFES) ; Maria Angelica  Peçanha   (UFES - Universidade Federal do Espirito Santo) ; Carlos Ferreira Jr   (NDI - Nucleo de Doenças Infecciosas / UFES) ; Merielly Leal   (UFES - Universidade Federal do Espirito Santo) ; Mariceli Araujo   (NDI - Nucleo de Doenças Infecciosas / UFES) </td></tr></table><p align=justify><b><font size=2>Abstract</font></b><p align=justify class=tres><font size=2>Introduction: Paracoccidioidomycosis is a systemic mycosis restricted to Latin America that affects mainly males and is related with agricultural activities in  endemic areas. Although the highest incidence of disease in Brazil is registered in the southeastern, there is scant information about its prevalence in the Espirito Santo, motivating investigations for best knowledge and management of  paracoccidioidomycosis in this state of southeast of Brazil.
Methods and results: Case report: male patient, 59 years old, HIV-negative, non-diabetic, with hypertension, cardiopathy and an early history of drinking and smoking habits. He was born in Resplendor (southeastern) and worked with maintenance of agricultural machines. He presented a five-months history of right arm pain, swelling and progression for cutaneous lesions with fistulaes. During this period it was noticed fever and weight loss and two months before, the patient complained cough with expectoration and dyspnea. Of the diagnostic procedures performed, chest radiograph X-ray showed pulmonary diffuse reticulonodular infiltrates. The diagnosis of fungal infection was confirmed by direct examination with 20% KOH and isolation of Paracoccidioides brasiliensis from sputum, in addition the positive double agar gel immunodiffusion testing (1:4). The diagnosis was disseminated Paracoccidioidomycosis with osteoarticular involvement. The patient initiated treatment with oral trimethoprim-sulfamethoxazole but without clinical answer. Sulfonamide was successfully replaced by Amphotericin B deoxycholate. 

Conclusion: this report highlights the wide spectrum of clinical manifestations in paracoccidioidomycosis and confirms that final diagnosis may depend on, simultaneously, of clinical, laboratorial and epidemiological evaluations
</font></p><br><b>Keyword: </b>&nbsp;Paracoccidioidomycosis, osteoarticular, immunodiffusion</td></tr></table></tr></td></table></body></html>