PDF(Pubmed)
Abstract：
Paracoccidioidomycosis (PCM) is a infection caused by the thermodimorphic fungus Paracoccidioides spp. (P. lutzii and, mainly, P. brasiliensis). This infection predominantly affects rural male workers aged between 30 and 50 years old who deal with soil on daily activities. Clinically, the disease is classified as acute/subacute phase, which evolves rapidly, secondary to dissemination of the fungus through to the phagocytic-mononuclear system, leading to fever, weight loss, and anorexia, associated with hepatosplenomegaly and lymphadenopathy, which can be complicated with suppuration and fistulization; and chronic phase, which corresponds to 74% to 95% of symptomatic cases, with a common pulmonary involvement. Central nervous system involvement is almost always a characteristic of the chronic form. Inhalation is the most common route of primary infection, usually affecting the lungs, forming the primary complex. From the primary complex, hematogenic dissemination can occur to any organ, including the brain and spinal cord. Although PCM of the central nervous system diagnosis is usually based on histopathological analysis and the imaging features are not specific for PCM, computed tomography and magnetic resonance imaging can demonstrate evidences of granuloma, abscess, meningitis, or a combination of these lesions, contributing to a preoperative diagnosis, especially when considered in conjunction with epidemiology. In this article, we review the pathophysiology, clinical manifestations and imaging aspects of neuro-PCM.
摘要：
副角菌病（PCM）是由热态真菌副角菌病引起的感染。(P.卢茨和,主要是,巴西P.巴西）。这种感染主要影响30至50岁的农村男性工人，他们在日常活动中处理土壤。临床上,该疾病分为急性/亚急性期，发展迅速，继发于真菌通过吞噬-单核系统传播，导致发烧,减肥,和厌食症,与肝脾肿大和淋巴结肿大有关，这可能是复杂的化脓和造瘘；和慢性期，这相当于74%到95%的有症状病例，有常见的肺部受累。中枢神经系统受累几乎总是慢性形式的特征。吸入是最常见的原发感染途径，通常影响肺部，形成主要复合体。从初级建筑群中，任何器官都可以发生血源性传播，包括大脑和脊髓.尽管中枢神经系统的PCM诊断通常基于组织病理学分析，并且影像学特征并不针对PCM。计算机断层扫描和磁共振成像可以显示肉芽肿的证据，脓肿,脑膜炎,或者这些病变的组合，有助于术前诊断，特别是当与流行病学结合考虑时。在这篇文章中,我们回顾了病理生理学，神经PCM的临床表现和影像学方面。
