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Abstract：
BACKGROUND: Paracoccidioidomycosis is a systemic mycosis considered endemic and limited to Latin America with the majority of registered cases originating from Brazil. The purpose of this paper was to report a case of a female patient with paracoccidioidomycosis mimicking inflammatory bowel disease and to systematically review available cases of the intestinal presentation of this infectious disease.
METHODS: Female patient, 32-years old, previously asymptomatic, presenting with acute pain in the lower right abdomen, associated with signs of peritoneal irritation and abdominal distension. Urgent surgery was performed, which identified a severe suppurative perforated ileitis. The anatomopathological study revealed fungal structures shaped as a ship\'s pilot wheel in Grocott-Gomori\'s staining, suggestive of Paracoccidioides spp.
METHODS: Studies were retrieved based on Medical Subject Headings and Health Sciences Descriptors, which were combined using Boolean operators. Searches were run on the electronic databases Scopus, Web of Science, MEDLINE (PubMed), BIREME (Biblioteca Regional de Medicina), LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), Embase, and Opengray.eu. Languages were restricted to English, Spanish and Portuguese. There was no date of publication restrictions. The reference lists of the studies retrieved were searched manually. Simple descriptive analysis was used to summarize the results.
RESULTS: Our search strategy retrieved 581 references. In the final analysis, 34 references were included, with a total of 46 case reports. The most common clinical finding was abdominal pain and weight loss present in 31 (67.3%) patients. Most patients were treated with itraconazole (41.3%) and amphotericin B (36.9%). All-cause mortality was 12.8%.
CONCLUSIONS: Paracoccidioidomycosis should be suspected in endemics areas, specially as a differential diagnosis for inflammatory bowel disease. Endoscopic tests and biopsy are useful for diagnosis and treatment with antifungal drugs seem to be the first treatment option to achieve a significant success rate.
METHODS: Female patient, 32-years old, previously asymptomatic, presenting with acute pain in the lower right abdomen, associated with signs of peritoneal irritation and abdominal distension. Urgent surgery was performed, which identified a severe suppurative perforated ileitis. The anatomopathological study revealed fungal structures shaped as a ship\'s pilot wheel in Grocott-Gomori\'s staining, suggestive of Paracoccidioides spp.
METHODS: Studies were retrieved based on Medical Subject Headings and Health Sciences Descriptors, which were combined using Boolean operators. Searches were run on the electronic databases Scopus, Web of Science, MEDLINE (PubMed), BIREME (Biblioteca Regional de Medicina), LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), Embase, and Opengray.eu. Languages were restricted to English, Spanish and Portuguese. There was no date of publication restrictions. The reference lists of the studies retrieved were searched manually. Simple descriptive analysis was used to summarize the results.
RESULTS: Our search strategy retrieved 581 references. In the final analysis, 34 references were included, with a total of 46 case reports. The most common clinical finding was abdominal pain and weight loss present in 31 (67.3%) patients. Most patients were treated with itraconazole (41.3%) and amphotericin B (36.9%). All-cause mortality was 12.8%.
CONCLUSIONS: Paracoccidioidomycosis should be suspected in endemics areas, specially as a differential diagnosis for inflammatory bowel disease. Endoscopic tests and biopsy are useful for diagnosis and treatment with antifungal drugs seem to be the first treatment option to achieve a significant success rate.
摘要：
背景：副角菌病是一种全身性真菌病，被认为是地方性的，仅限于拉丁美洲，大多数注册病例起源于巴西。本文的目的是报告一例模仿炎症性肠病的副孢子菌病女性患者，并系统地回顾这种感染性疾病的肠道表现。
方法：女性患者，32岁,以前无症状，右下腹部出现急性疼痛，与腹膜刺激和腹胀的迹象有关。进行了紧急手术，发现了严重的化脓性穿孔回肠炎.解剖病理学研究显示，在Grocott-Gomori染色中，真菌结构形状为船的先导轮，副球菌属。
方法：根据医学主题词和健康科学描述符检索研究，使用布尔运算符进行组合。搜索是在电子数据库Scopus上运行的，WebofScience,MEDLINE(PubMed),BIREME（BibliotecaRegionaldeMedicina），LILACS（拉丁美洲和加勒比健康科学文献），SciELO（科学电子图书馆在线），Embase,Opengray欧盟。语言仅限于英语，西班牙语和葡萄牙语。没有发布日期限制。手动搜索检索的研究的参考列表。使用简单的描述性分析来总结结果。
结果：我们的搜索策略检索到581个参考。归根结底，包括34个参考文献，共46例病例报告。最常见的临床发现是31例（67.3％）患者出现腹痛和体重减轻。大多数患者接受伊曲康唑（41.3%）和两性霉素B（36.9%）治疗。全因死亡率为12.8%。
结论：在流行地区应怀疑副孢子菌病，特别是作为炎症性肠病的鉴别诊断。内镜检查和活检可用于诊断和抗真菌药物治疗，似乎是获得显着成功率的首选治疗选择。
方法：女性患者，32岁,以前无症状，右下腹部出现急性疼痛，与腹膜刺激和腹胀的迹象有关。进行了紧急手术，发现了严重的化脓性穿孔回肠炎.解剖病理学研究显示，在Grocott-Gomori染色中，真菌结构形状为船的先导轮，副球菌属。
方法：根据医学主题词和健康科学描述符检索研究，使用布尔运算符进行组合。搜索是在电子数据库Scopus上运行的，WebofScience,MEDLINE(PubMed),BIREME（BibliotecaRegionaldeMedicina），LILACS（拉丁美洲和加勒比健康科学文献），SciELO（科学电子图书馆在线），Embase,Opengray欧盟。语言仅限于英语，西班牙语和葡萄牙语。没有发布日期限制。手动搜索检索的研究的参考列表。使用简单的描述性分析来总结结果。
结果：我们的搜索策略检索到581个参考。归根结底，包括34个参考文献，共46例病例报告。最常见的临床发现是31例（67.3％）患者出现腹痛和体重减轻。大多数患者接受伊曲康唑（41.3%）和两性霉素B（36.9%）治疗。全因死亡率为12.8%。
结论：在流行地区应怀疑副孢子菌病，特别是作为炎症性肠病的鉴别诊断。内镜检查和活检可用于诊断和抗真菌药物治疗，似乎是获得显着成功率的首选治疗选择。
