Puzzling paracoccidioidomycosis - Factors associated with the severity of Paracoccidioides lutzii infections

Andreia Ferreira Nery; Zoilo Pires de Camargo; Anderson Messias Rodrigues; Tiago Ferreira Portela; Hugo Dias Hoffmann-Santos; Breno Gonçalves Pinheiro; Ana Paula Possa; Letícia Rossetto da Silva Cavalcante; Ferry Hagen; Rosane Christine Hahn

doi:10.1016/j.ijid.2021.05.002

Puzzling paracoccidioidomycosis - Factors associated with the severity of Paracoccidioides lutzii infections

Andreia Ferreira Nery, Zoilo Pires de Camargo, Anderson Messias Rodrigues, Tiago Ferreira Portela, Hugo Dias Hoffmann-Santos, Breno Gonçalves Pinheiro, Ana Paula Possa, Letícia Rossetto da Silva Cavalcante, Ferry Hagen, Rosane Christine Hahn

Research output: Contribution to journal/periodical › Article › Scientific › peer-review

8 Citations (Scopus)

Abstract

OBJECTIVES: Historically, the Brazilian midwestern region has had a high number of paracoccidioidomycosis (PCM) cases caused by the dimorphic fungus Paracoccidioides lutzii.

METHODS: We investigated by an epidemiological, observational, analytical cross-sectional study the clinical and laboratory data of 44 PCM patients with a culture-proven P. lutzii infection. All patients were referred to the Systemic Mycosis Center, Júlio Muller University Hospital, Cuiabá, Brazil, during January 2017-March 2020. The neutrophil to lymphocyte ratio (RNL) was calculated and dichotomized by its median to include in the identification of factors associated with severity.

RESULTS: At admission 13 (31.7%) patients showed the disseminated multifocal chronic PCM form and 16 (36.4%) patients met clinical severity criteria. Treatment prescribed on admission did not followed the 'Brazilian Guideline for the Clinical Management of Paracoccidioidomycosis' recommendations in 26% (PR: 0.26; 95% CI: 0.14-0.49; p < 0.0001) of the severe PCM cases. Patients with severe PCM had a higher neutrophil/lymphocyte ratio (NLR) that was greater than the median (≥4.11).

CONCLUSIONS: The NLR biomarker complements the criteria of PCM severity. Applying the low-cost NLR test can greatly increase the diagnostic sensitivity when screening patients for PCM and contribute to a better control the disease, complications and therapeutic strategies.

Original language	English
Journal	International Journal of Infectious Diseases
DOIs	https://doi.org/10.1016/j.ijid.2021.05.002
Publication status	Published - Jun 2021

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10.1016/j.ijid.2021.05.002

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Nery, A. F., Pires de Camargo, Z., Rodrigues, A. M., Ferreira Portela, T., Hoffmann-Santos, H. D., Gonçalves Pinheiro, B., Possa, A. P., Rossetto da Silva Cavalcante, L., Hagen, F., & Hahn, R. C. (2021). Puzzling paracoccidioidomycosis - Factors associated with the severity of Paracoccidioides lutzii infections. International Journal of Infectious Diseases. https://doi.org/10.1016/j.ijid.2021.05.002

@article{dd4ef36975a84474b48db79664a749e0,

title = "Puzzling paracoccidioidomycosis - Factors associated with the severity of Paracoccidioides lutzii infections",

abstract = "OBJECTIVES: Historically, the Brazilian midwestern region has had a high number of paracoccidioidomycosis (PCM) cases caused by the dimorphic fungus Paracoccidioides lutzii.METHODS: We investigated by an epidemiological, observational, analytical cross-sectional study the clinical and laboratory data of 44 PCM patients with a culture-proven P. lutzii infection. All patients were referred to the Systemic Mycosis Center, J{\'u}lio Muller University Hospital, Cuiab{\'a}, Brazil, during January 2017-March 2020. The neutrophil to lymphocyte ratio (RNL) was calculated and dichotomized by its median to include in the identification of factors associated with severity.RESULTS: At admission 13 (31.7%) patients showed the disseminated multifocal chronic PCM form and 16 (36.4%) patients met clinical severity criteria. Treatment prescribed on admission did not followed the 'Brazilian Guideline for the Clinical Management of Paracoccidioidomycosis' recommendations in 26% (PR: 0.26; 95% CI: 0.14-0.49; p < 0.0001) of the severe PCM cases. Patients with severe PCM had a higher neutrophil/lymphocyte ratio (NLR) that was greater than the median (≥4.11).CONCLUSIONS: The NLR biomarker complements the criteria of PCM severity. Applying the low-cost NLR test can greatly increase the diagnostic sensitivity when screening patients for PCM and contribute to a better control the disease, complications and therapeutic strategies.",

author = "Nery, {Andreia Ferreira} and {Pires de Camargo}, Zoilo and Rodrigues, {Anderson Messias} and {Ferreira Portela}, Tiago and Hoffmann-Santos, {Hugo Dias} and {Gon{\c c}alves Pinheiro}, Breno and Possa, {Ana Paula} and {Rossetto da Silva Cavalcante}, Let{\'i}cia and Ferry Hagen and Hahn, {Rosane Christine}",

year = "2021",

month = jun,

doi = "10.1016/j.ijid.2021.05.002",

language = "English",

journal = "International Journal of Infectious Diseases",

issn = "1201-9712",

publisher = "Elsevier B.V.",

}

Nery, AF, Pires de Camargo, Z, Rodrigues, AM, Ferreira Portela, T, Hoffmann-Santos, HD, Gonçalves Pinheiro, B, Possa, AP, Rossetto da Silva Cavalcante, L, Hagen, F & Hahn, RC 2021, 'Puzzling paracoccidioidomycosis - Factors associated with the severity of Paracoccidioides lutzii infections', International Journal of Infectious Diseases. https://doi.org/10.1016/j.ijid.2021.05.002

TY - JOUR

T1 - Puzzling paracoccidioidomycosis - Factors associated with the severity of Paracoccidioides lutzii infections

AU - Nery, Andreia Ferreira

AU - Pires de Camargo, Zoilo

AU - Rodrigues, Anderson Messias

AU - Ferreira Portela, Tiago

AU - Hoffmann-Santos, Hugo Dias

AU - Gonçalves Pinheiro, Breno

AU - Possa, Ana Paula

AU - Rossetto da Silva Cavalcante, Letícia

AU - Hagen, Ferry

AU - Hahn, Rosane Christine

PY - 2021/6

Y1 - 2021/6

N2 - OBJECTIVES: Historically, the Brazilian midwestern region has had a high number of paracoccidioidomycosis (PCM) cases caused by the dimorphic fungus Paracoccidioides lutzii.METHODS: We investigated by an epidemiological, observational, analytical cross-sectional study the clinical and laboratory data of 44 PCM patients with a culture-proven P. lutzii infection. All patients were referred to the Systemic Mycosis Center, Júlio Muller University Hospital, Cuiabá, Brazil, during January 2017-March 2020. The neutrophil to lymphocyte ratio (RNL) was calculated and dichotomized by its median to include in the identification of factors associated with severity.RESULTS: At admission 13 (31.7%) patients showed the disseminated multifocal chronic PCM form and 16 (36.4%) patients met clinical severity criteria. Treatment prescribed on admission did not followed the 'Brazilian Guideline for the Clinical Management of Paracoccidioidomycosis' recommendations in 26% (PR: 0.26; 95% CI: 0.14-0.49; p < 0.0001) of the severe PCM cases. Patients with severe PCM had a higher neutrophil/lymphocyte ratio (NLR) that was greater than the median (≥4.11).CONCLUSIONS: The NLR biomarker complements the criteria of PCM severity. Applying the low-cost NLR test can greatly increase the diagnostic sensitivity when screening patients for PCM and contribute to a better control the disease, complications and therapeutic strategies.

AB - OBJECTIVES: Historically, the Brazilian midwestern region has had a high number of paracoccidioidomycosis (PCM) cases caused by the dimorphic fungus Paracoccidioides lutzii.METHODS: We investigated by an epidemiological, observational, analytical cross-sectional study the clinical and laboratory data of 44 PCM patients with a culture-proven P. lutzii infection. All patients were referred to the Systemic Mycosis Center, Júlio Muller University Hospital, Cuiabá, Brazil, during January 2017-March 2020. The neutrophil to lymphocyte ratio (RNL) was calculated and dichotomized by its median to include in the identification of factors associated with severity.RESULTS: At admission 13 (31.7%) patients showed the disseminated multifocal chronic PCM form and 16 (36.4%) patients met clinical severity criteria. Treatment prescribed on admission did not followed the 'Brazilian Guideline for the Clinical Management of Paracoccidioidomycosis' recommendations in 26% (PR: 0.26; 95% CI: 0.14-0.49; p < 0.0001) of the severe PCM cases. Patients with severe PCM had a higher neutrophil/lymphocyte ratio (NLR) that was greater than the median (≥4.11).CONCLUSIONS: The NLR biomarker complements the criteria of PCM severity. Applying the low-cost NLR test can greatly increase the diagnostic sensitivity when screening patients for PCM and contribute to a better control the disease, complications and therapeutic strategies.

U2 - 10.1016/j.ijid.2021.05.002

DO - 10.1016/j.ijid.2021.05.002

M3 - Article

C2 - 33989777

SN - 1201-9712

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

ER -

Puzzling paracoccidioidomycosis - Factors associated with the severity of Paracoccidioides lutzii infections

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