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Intestinal paracoccidioidomycosis resembling Crohn's disease in a teenager: a case report.
Lomazi, Elizete Aparecida; de Negreiros, Leandro Minatel Vidal; Magalhães, Pedro Vitor Veiga Silva; Togni, Raquel de Castro Siqueira; de Paiva, Nielce Maria; Ribeiro, Antonio Fernando; Leal, Raquel Franco.
Afiliação
  • Lomazi EA; Department of Pediatrics, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
  • de Negreiros LMV; Inflammatory Bowel Disease Research Laboratory, University of Campinas, UNICAMP, João Lopes Vieira Street, no 108, 61, Tower 2, Campinas, Sao Paulo, 13087-734, Brazil.
  • Magalhães PVVS; Department of Pediatrics, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
  • Togni RCS; Department of Pediatrics, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
  • de Paiva NM; Inflammatory Bowel Disease Research Laboratory, University of Campinas, UNICAMP, João Lopes Vieira Street, no 108, 61, Tower 2, Campinas, Sao Paulo, 13087-734, Brazil.
  • Ribeiro AF; Department of Pediatrics, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
  • Leal RF; Inflammatory Bowel Disease Research Laboratory, University of Campinas, UNICAMP, João Lopes Vieira Street, no 108, 61, Tower 2, Campinas, Sao Paulo, 13087-734, Brazil. rafranco.unicamp@gmail.com.
J Med Case Rep ; 12(1): 108, 2018 Apr 30.
Article em En | MEDLINE | ID: mdl-29706133
BACKGROUND: Differential diagnosis of inflammatory bowel disease is often very challenging. Paracoccidioidomycosis is a fungal disease that can mimic manifestations of Crohn's disease. CASE PRESENTATION: We report a case of a 13-year-old Caucasian boy with abdominal pain for 1.5 years associated with nausea, diarrhea, and weight loss of 10 kg. He presented increased C-reactive protein and an increased erythrocyte sedimentation rate. A colonoscopy showed deep serpiginous ulcers throughout his entire colon and rectum, which suggested Crohn's disease. He received one dose of infliximab, which is an anti-tumor necrosis factor-α, and showed no improvement. After the second dose, he got worse and started to have bloody diarrhea. A new colonoscopy was performed and pathological examination revealed ulcerative chronic inflammation with non-caseating granulomas and fungal structures (budding forms) compatible with Paracoccidioides brasiliensis. He underwent intravenously administered and then orally administered trimethoprim-sulfamethoxazole treatment. Due to drug intolerance, he was treated with amphotericin B and itraconazole, then he showed clinical improvement and mucosal healing with good outcome. CONCLUSION: Paracoccidioidomycosis must be part of the differential diagnosis of inflammatory bowel diseases in endemic areas and must be excluded before starting immunosuppressive therapy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Paracoccidioidomicose / Doença de Crohn Tipo de estudo: Diagnostic_studies Limite: Adolescent / Humans Idioma: En Revista: J Med Case Rep Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Paracoccidioidomicose / Doença de Crohn Tipo de estudo: Diagnostic_studies Limite: Adolescent / Humans Idioma: En Revista: J Med Case Rep Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido