CLINICAL AND SEROLOGIC FEATIJRES OF 47 PATIENTS WITH PARACOCCIDIOIDOMYCOSIS TREATED BY AMPHOTERICIN B

In the present study, clinic and serologic aspects of. 47 patacoccidioidomy-cosÍs patients were reviewed. The clinic-radiologic-laboratorial data o each patient 'were obtained from the rnedical chart belore, during and after therapy with Amphotericin B. The age of the patients ranged betw-een 13 to b0 years; the ratio male: female was 10:1. The most frequently associated. diseases,\Mere alco-holism and tabagism; tuberculosis was present in L4.2 % of the cases. Most pa-tients came from Botucatu of adjacent towns (central area of the State of São Paulo). Cough with sputum production, dyspnea and anorexia,were the most frequent clinic manifestations. All 47 patients, but 5 presented pulmonary invol-vement'which sho,wed the radiologic pattern of interstitial exudate nodular Wpe and fibrocicatritial lesions in B5.7vo. There was associated emphysema jn B7.7vo of the patients. Blood urea, creatinin and kaliemia increased during therapy with Arnphotericin B. Clinic-laboratorial follow-up showed electro-cardiographic changes in 13, þypertension in g and hyporreactivity in Thorn test in 1 patient. Complement fixation was the best serologic test for monitoring patients with paracoccidioidomycosis. Incomplete dosdge of Amphotericin B led to thera-peutic ineffectivenes. UDC 616.992.282 Paracoccidioidomycosis, also known as LIJTZ, SPLENDORE and ALMEIDA's disease. is caused by Paracoccidioides brasiliensis (p. brasiliensis), a wideþ diffuse fungus in nature. Contamination appears to occur most frequen-tly by inhalation,,with installation of the fun-gus in the lungs, follo,wed by lympho-hemato-genic dissemination 7,2,76,r8,t9,27,22. The main therapy utilized in our practice for the treatment of the disease is Amphoteri-cin B, a toxic drug that requires long periods of patients hospitalization for the administra-li6 ¡ 3,9,10,16,21,22,23