Paracoccidioidomycosis

Description:

Paracoccidioidomycosis (Xing.: Aljmeydy-Lyuttsa-Splendore's disease, a zymonematosis Brazilian, a zymonematosis South American, a paracoccidioidosis) - the deep system chronic mycosis which is characterized by damage of skin, mucous membranes and internals (is more often than lungs) with formation of granulomas and ulcers.

Parakoktsidioidomikoz's symptoms:

Classification of a paracoccidioidomycosis
- Pulmonary form: slowly developing granulematozny centers of primary infection in lungs with substitution by fibrous fabric.
- Skin form: multiple ulcers of skin and mucous membranes, increase in regional lymph nodes.
- Lymphatic form: increase and morbidity at a palpation of cervical, subclavial or axillary lymph nodes.
- Visceral form: pain in a stomach, a hyperadenosis of abdominal organs (a liver, a spleen, adrenal glands).
- The mixed form: combination of pulmonary, skin, lymphatic and visceral forms.
- Juvenile паракокиидиоидомикоз observe at persons more young than 30 years; it is characterized by an acute and podostry current; typical consider damage of pulmonary lymph nodes and distribution of the activator to various bodies. Forecast of a disease adverse.
- The paracoccidioidomycosis of adults proceeds more inertly; the centers can also be localized in lungs or disseminate in a liver, a spleen, adrenal glands; damages of a mucous membrane of a mouth and a nose, an ulceration on a face are typical. Note a dysphagy and a dysphonia; pulmonary defeats are shown by fever, shallow breathing, cough with a bloody and purulent phlegm and stethalgias. Forecast of a disease more favorable.

In 80% lungs in the field of a mediastinum, at roots of lungs are surprised. Versions of the name of a disease reflect its possible forms: parakoktsidioidny granuloma, pulmonary, visceral, mucous and skin and lymphangitic паракокцидиоимикоз. According to age, allocate juvenile паракокциоидоз and паракокциоидоз adults. Meets in acute and chronic forms.

At acute pulmonary defeat of disturbance from respiratory bodies are noted by patients seldom. Most often erethistic ulcers on mucous a mouth and a nose, arising owing to hematogenous distribution are found. At patients increase in cervical lymph nodes and the warty, covered with crusts defeats on a face (the granulematozny centers) can be also observed. Complaints to a thoracic mialgiya, development of symptomatology of bronchitis, the focal and abscessing pneumonia, and also miliary dissimination in lungs are possible. The centers of primary infection usually come to light in lungs where they can samoogranichivatsya with substitution by fibrous fabric.

The chronic form is characterized by a granulematozny purulent inflammation of interstitial fabric with fibrosis and necrotic manifestations.

Damages of bones are found in 25% of cases. Damages of skin and mucous are followed by development of the reactions reminding a planocellular carcinoma.

The generalized form is shown by gastrointestinal tract diseases, gepato-and a splenomegaly, ascites, can cause damages of adrenal glands, TsNS also. At a disseminirovaniye there are multiple ulcers of skin and mucous membranes. Defeat develops slowly and has character of a granulematozny inflammation. Regional lymphadenites, damages of many internals with involvement of cells of macrophagic and monocytic system are often observed. The forecast is heavy, often lethal.

Parakoktsidioidomikoz's reasons:

The paracoccidioidomycosis activator – a dimorphous mushroom of Paracoccidioides brasiliense (synonyms: Blastomyces brasiliensis, Lutziomyces histiosporocellularis, Mycoderma vrasiliense). A natural (saprofitichesky) form is the mitselialny form of a mushroom, and fabric (parasitic) – a drozhzhepodobny phase. Fabric forms – in the form of large roundish cells from 10-60 microns, with the expressed double walls and a set of kidneys on the periphery.

Parakoktsidioidomikoz's treatment:

- Amphotericinum In at first 100 PIECES/kg, then daily to raise a dose on 100 PIECES/kg to 500-1 000 PIECES/kg (no more than 50 000 PIECES) in/in kapelno in 5% glucose solution during 2-6 h every other day, a course dose of 2 mln units. Can cause a fever, fervescence, a headache, nausea; for the prevention or easing of side effects purpose of acetylsalicylic acid or Dimedrol (50 mg) to an injection, in 3 h after its beginning is recommended and upon termination of. During treatment it is necessary to investigate the content of creatinine and potassium of serum
- Ketokonazol of 200-400 mg/days inside. Drug can have a hepatotoxic action.