WordNet

of or relating to the United States of America or its people or language or culture; "American citizens"; "American English"; "the American dream"
a native or inhabitant of a North American or Central American or South American country
a native or inhabitant of the United States
of or relating to or characteristic of the continents and islands of the Americas; "the American hemisphere"; "American flora and fauna"
situated in or facing or moving toward or coming from the south; "the south entrance"
the cardinal compass point that is at 180 degrees (同)due south, southward, S
the direction corresponding to the southward cardinal compass point
a location in the southern part of a country, region, or city
in a southern direction; "we moved south" (同)to the south, in the south
North America and South America and Central America
any of several infections of the skin or mucous membrane caused by Blastomyces
of or pertaining to or characteristic of the continent or countries of South America or their peoples

PrepTutorEJDIC

『アメリカ合衆国の』,米国の;アメリカ人の / 北アメリカの;北米人の / 南アメリカの;南米人の / 南北アメリカの;南北アメリカ人の / 米国人,アメリカ人 / 北(南)アメリカ人 / =American English
〈U〉《通例the south》『南』,南方 / 《the south, the South》南方[地方] / 《the South》(米国の)南部地方 / 『南の』,南部の,南向きの;南からの / 『南の方へ(に)』
『アメリカ合衆国』,米国,アメリカ(《略》『Am.,Amer.』) / 《the Americas》南北アメリカ[イタリアの航海者･探検家Amerigo Vespucciの名前に由来]

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/22 22:19:44」(JST)

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Paracoccidioidomycosis (also known as "Brazilian blastomycosis,"^[1] "South American blastomycosis,",^[1]"Lutz-Splendore-de Almeida disease"^[2] and "Paracoccidioidal granuloma"^[3]^:320) is a fungal infection caused by the fungus Paracoccidioides brasiliensis. Sometimes called South American blastomycosis, paracoccidioidomycosis is caused by a different fungus than that which causes blastomycosis.

Agent

P. brasiliensis is a thermally dimorphic fungus distributed in Brazil and South America. The habitat of the infectious agent is not known but appears to be aquatic. In biopsies the fungus appears as a polygemulating yeast with a pilot's wheel-like appearance.

Disease

Paracoccidioidomycosis is a systemic mycosis caused by the dimorphic fungus Paracoccidioides. There is strong evidence that the fungus causing paracoccidioidomycosis infects the host through the respiratory tract.^[4] It frequently involves mucous membranes, lymph nodes, bone and lungs. Unlike other systemic mycoses, it can cause disease in immunocompetent hosts, although immunosuppression increases the aggressiveness of the fungus. Also uniquely, it rarely causes disease in fertile-age women, probably due to a protective effect of estradiol.^[5]

Primary infection is thought to be autolimited and almost asymptomatic as histoplasmosis or coccidioidomycosis (Valley Fever). In young people, there is a progressive form of the disease (akin of tuberculous septicemia in tuberculous priminfection) with high prostrating fever, generalized lymphadenopathy and pulmonary involvement with milliary lesions. This juvenile form has a more severe prognosis even with treatment. The most common form is the so-called adult form of paracoccidioidomycosis that is almost certainly a reactivation of the disease.

Painful lesions with a violaceous hue in lips and oral mucosa are common as is cervical lymphadenitis teeming with polygemulating yeasts in the biopsy. In this form, differential diagnosis must be made with mucocutaneous leishmaniasis, yaws and TB.

Pulmonary involvement is also common, it starts as lobar pneumonia or pleurisy but without remission at ninth day; the patient remains febrile, coughs, loses weight and the X rays reveal milliary shadows throughout lung fields. Other organs can be involved, like bones, meninges, arteries and spleen but this is very rare.

Diagnosis is made with a biopsy of affected tissue, this shows the characteristic helm-shaped yeasts and culture shows the agent. Serology is also used in endemic areas.

Epidemiology

Paracoccidioidomycosis has been reported as an autochthonous disease from southern Mexico to northern Argentina. There have been no reports from Belize and Nicaragua in Central America, or from Chile, French Guiana, Guiana, and Suriname in South America. Paracoccidioidomycosis is prevalent in Brazil, Colombia, Venezuela, and Argentina and is classically associated with individuals from rural areas. The typical patient is a man aged 30 to 50 years.^[4]

Treatment

Sulfonamides are the traditional remedies to paracoccidiodomycosis. They were introduced by Oliveira Ribeiro and used for more than fifty years with good results. The most used sulfa drugs in this infection are sulfadimethoxime, sulfadiazine and co-trimoxazole. This treatment is generally safe but several adverse effects can appear, the most severe of which are the Stevens Johnson Syndrome and agranulocytosis. Similarly to tuberculosis treatment, it must be continued for up to 3 years to eradicate the fungus, and relapse and treatment failures aren't unusual.

Antifungal drugs like amphotericin B or itraconazole and ketoconazole are more effective in clearing the infection but limited by their cost when compared with sulfonamides.

During therapy fibrosis can appear and surgery may be needed to correct this. Other possible complication is Addisonian crisis. The death rate is approximately ten percent.

Discovery

Lutz-Splendore-de Almeida disease^[2] is named for the physicians Adolfo Lutz,^[6] Alfonso Splendore,^[7] and Floriano Paulo de Almeida,^[8]^[9] who first characterized the disease in Brazil in the early 20th century.

References

^ ^a ^b Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007), Dermatology: 2-Volume Set, St. Louis: Mosby, ISBN 1-4160-2999-0
^ ^a ^b Lutz-Splendore-de Almeida disease at Who Named It?
^ James, William D.; Berger, Timothy G.; et al. (2006), Andrews' Diseases of the Skin: clinical Dermatology, Saunders Elsevier, ISBN 0-7216-2921-0
^ ^a ^b Marques, SA (Nov–Dec 2012). "Paracoccidioidomycosis.". Clinics in dermatology 30 (6): 610–5. doi:10.1016/j.clindermatol.2012.01.006. PMID 23068148.
^ Severo LC, Roesch EW, Oliveira EA, Rocha MM, Londero AT (June 1998), "Paracoccidioidomycosis in women", Rev Iberoam Micol 15 (2): 88–9, PMID 17655417.
^ Lutz A (1908), "Uma mycose pseudococcidioidica localizada no boca e observada no Brasil. Contribuicao ao conhecimento das hypoblastomycoses americanas.", Imprensa médica (in Portuguese) (Rio de Janeiro) 16: 151–163
^ Splendore A (1912), "Zimonematosi con localizzazione nella cavita della bocca osservata nel Brasile", Bulletin de la Société de pathologie exotique (in French) (Paris) 5: 313–319
^ De Almeida FP (1928), "Lesoes cutaneas da blastomicose en cabaios experimentalmente infeetados", Anais da Faculdade de medicina de Universidade de São Paulo (in Portuguese) 3: 59–64
^ de Almeida FP, da Silva Lacaz C (1942), "Micoses broco-pulmonares", Comp. Melhoramentos (in Portuguese) (São Paulo): 98 pages

External links

Overview at University of Adelaide

UpToDate Contents

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English Journal

Participation of dectin-1 receptor on NETs release against Paracoccidioides brasiliensis: Role on extracellular killing.

Bachiega TF1, Dias-Melicio LA2, Fernandes RK1, de Almeida Balderramas H1, Rodrigues DR1, Ximenes VF3, de Campos Soares ÂM4.
Immunobiology.Immunobiology.2016 Feb;221(2):228-35. doi: 10.1016/j.imbio.2015.09.003. Epub 2015 Sep 14.
Paracoccidioides brasiliensis is a dimorphic fungus from the Paracoccidioides genus, which is the causative agent of paracoccidioidomycosis, a chronic, subacute or acute mycosis, with visceral and cutaneous involvement. This disease that is acquired through inhalation primarily attacks the lungs but
PMID 26416210

Distinct patterns of yeast cell morphology and host responses induced by representative strains of Paracoccidioides brasiliensis (Pb18) and Paracoccidioides lutzii (Pb01).

Siqueira IM1, Fraga CL1, Amaral AC2, Souza AC1, Jerônimo MS1, Correa JR3, Magalhães KG3, Inácio CA4, Ribeiro AM3, Burguel PH1, Felipe MS5, Tavares AH3, Bocca AL6.
Medical mycology.Med Mycol.2016 Feb 1;54(2):177-88. doi: 10.1093/mmy/myv072. Epub 2015 Sep 17.
Paracoccidioidomycosis (PCM) is a systemic mycosis, widespread in Latin America. PCM is a granulomatous disease characterized by a polymorphism of lesions depending on the pathogen's virulence, the immune status of the host and its genetic susceptibility. The thermodimorphic fungus Paracoccidioides
PMID 26384386

Paracoccidioidomycosis Mimicking Sarcoidosis: A Review of 8 Cases.

Coelho MG1, Severo CB2,3, de Mattos Oliveira F2, Hochhegger B4, Severo LC5,6.
Mycopathologia.Mycopathologia.2016 Feb;181(1-2):137-43. doi: 10.1007/s11046-015-9938-6. Epub 2015 Sep 12.
Sarcoidosis is a multisystem disorder that is characterized by noncaseous epithelioid cell granulomas, which may affect almost any organ. Thoracic involvement is common and accounts for most of the morbidity and mortality associated with this disease. The diagnosis is based on exhaustive exclusion o
PMID 26363920

Japanese Journal

Oral Manifestations of Paracoccidioidomycosis

Matsumoto Mariza Akemi,de Carvalho Dekon Aparício Fiúza,Kawakami Roberto Yoshio,de Assis Diogo Souza Ferreira Rubim,de Albuquerque Gustavo Cavalcanti
International Journal of Oral-Medical Sciences 4(2), 111-115, 2005
Deep mycoses are caused by fungal infections and can lead to serious systemic complications and even death. Some mycoses can present with oral manifestations, and recognizing these different oral mani …
NAID 130000652933

慢性肺paracoccidioidomycosisと考えられた日本人例

川山智隆,澤亜希子,末安禎子,有川圭介,白石恒明,市川洋一郎,大泉耕太郎
日本胸部疾患学会雑誌 = The Japanese journal of thoracic diseases 34(8), 911-915, 1996-08-25
NAID 10008110777

舌潰瘍をきたした南米型分芽菌症の1例

高木誠治,梅崎俊郎,草場靖,津田邦良,進武幹
耳鼻と臨床 42(6Supplement3), 929-932, 1996
… その病理組織所見から, 真菌の一種である南米型分芽菌症 (South American Blastomycosis) と診断された. …
NAID 130004404293

Related Pictures

Mycotic infections paracoccidioidomycosis(South American Blastomycosis, Brazilian Blastomycosis, Lutz Podcast, challenge yourself, Blastomyces dermatitidis, Sy Paracoccidioidomycosis or South American blastomycosis 🔊 - YouTube

★リンクテーブル★

リンク元	「パラコクシジオイデス症」「South Americanブラストミセス症」「南アメリカブラストミセス症」
関連記事	「American」「America」「blastomycosis」

「パラコクシジオイデス症」

Paracoccidioidomycosis
	Classification and external resources
	Paracoccidioides brasiliensis
ICD-10	B41
ICD-9	116.1
DiseasesDB	29815
eMedicine	med/1731
MeSH	D010229