RESUMO
Paracoccidioidomycosis (PCM) is the most important systemic mycosis in Latin America. About 80% of PCM patients are present with its chronic form. The lungs are affected in most patients with the chronic form; however, pleural involvement has rarely been reported. We describe nine cases of PCM that presented with lung involvement and spontaneous pneumothorax. All patients, except one whose condition was not investigated, were smokers. PCM was diagnosed during the pneumothorax episode in three patients, and from 3 to 16 years before the pneumothorax episode in six patients. A total of six patients underwent chest drainage and one died as a direct result of the pneumothorax. We suggest that pneumothorax, although rare, should be considered in PCM patients who present with suddenly worsening dyspnoea. PCM should also be investigated in cases of pneumothorax in adult men from mycosis-endemic areas.
Assuntos
Doenças Endêmicas , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/microbiologia , Pneumotórax/microbiologia , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Biópsia , Brasil/epidemiologia , Drenagem , Evolução Fatal , Humanos , Pulmão/microbiologia , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Paracoccidioides/efeitos dos fármacos , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/tratamento farmacológico , Paracoccidioidomicose/epidemiologia , Pneumotórax/diagnóstico por imagem , Fumar/efeitos adversos , Combinação Trimetoprima e Sulfametoxazol/uso terapêuticoRESUMO
Coccidioidomycosis is a systemic infection caused by the soil fungus Coccidioides immitis. It is endemic in northern Mexico and the southwest part of the United States. Radiologic manifestations are varied. Rupture of a coccidioidal pulmonary cavity with subsequent pneumothorax is a rare clinical event, even in endemic areas. We present a case with a brief review of this rare condition.
Assuntos
Coccidioides , Coccidioidomicose/complicações , Pneumotórax/microbiologia , Coccidioidomicose/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Pneumotórax/diagnóstico por imagem , RadiografiaRESUMO
This paper reviewed 8 cases of spontaneous pneumothorax, associated to pulmonary tuberculosis during a period of time of two years at the A.L.M. General Hospital of Toluca, Mex. The diagnosis was confirmed by clinical picture, radiology and bacteriology studies. Six males and two females proceding of the low class; farmers all of them. Their age ranged between 18 and 35 years. Two of the patients showed cavitary lesions, five had difusse fibrosis of the lung. We analized the clinical manifestations and reviewed the pathogenic mechanisms as well the medical and surgical treatment. No deaths ocurred en this series. We concluded that the direct relation between active pulmonary tuberculosis and spontaneous pneumothorax is not clear, but their association in this serie suggested further studies to stablished this. We emphasized the importance of this complication rare in the world literature.