Abstract：
We report an autochthonous case of mild unifocal chronic pulmonary paracoccidioidomycosis in a 48-year-old previously healthy woman with no history of possible environmental exposures in endemic rural areas, supposedly resulting from reactivation of a latent pulmonary focus secondary to the use of methotrexate for the control of Chikungunya arthropathy. Laboratory investigation ruled out other immunosuppression. Her only symptoms were a dry cough and chest pain. Diagnosis confirmed by needle lung biopsy. There were no abnormalities on physical examination nor evidence of central nervous system involvement. MRI of the total abdomen showed no involvement of other organs. Computed chest tomography showed a favorable evolution under the use of itraconazole (200 mg/day). Different tomographic presentations findings are highlighted when performed before and after treatment. CONCLUSIONS: PCM should be considered even in a woman without a history of consistent environmental exposure and in a non-endemic geographic area.
摘要：
我们报告了一名48岁的先前健康的女性的轻度单发慢性肺副球孢子菌病的本土病例，在地方性农村地区没有可能的环境暴露史，据推测是由于使用甲氨蝶呤控制基孔肯雅关节病继发的潜在肺灶重新激活所致。实验室检查排除了其他免疫抑制。她唯一的症状是干咳和胸痛。经穿刺肺活检确诊。体格检查没有异常，也没有中枢神经系统受累的证据。全腹部MRI显示其他器官未受累。计算机断层扫描显示，在使用伊曲康唑（200mg/天）的情况下，进展良好。在治疗前后进行时，会突出显示不同的断层摄影表现。结论：即使在没有持续环境暴露史和非地方性地理区域的女性中，也应考虑PCM。
