From Big Medical Encyclopedia

PARACOCCIDIOIDOSIS (paracoccidioidosis brasiliensis; synonym: the southern American zymonematosis, paracoccidioidomycosis, the Brazilian zymonematosis, Lyutts's disease — Splendore — Almeyda, a parakoktsidioidny granuloma) — deep, chronic mycosis. More often persons aged from 30 up to 50 years are ill. The item is distributed in the countries of South America.

Activator The item — a dimorphous fungus of Paracoccidioides brasiliensis (Splendore) of Almeida, 1930 (a synonym of Zymonema brasiliense), the size to-rogo from 30 to 60 microns; in the struck fabrics has the spherical or elliptic shape and it is presented by large round cells with a double-circuit cover, with small kidneys on a surface in the form of a crown.

Pathogeny it is not studied. Assume that the activator gets into an organism through mucous membranes. The infection is not transmitted directly from the patient to healthy. There are messages on allocation of P. brasiliensis from the soil.

In the struck fabric granulematozny reaction in a combination with a purulent inflammation and existence of a large amount of colossal cells, and also the large budding forms of the activator («crowns»), a focal or diffusion necrosis limf, nodes is noted.

Often initially mucous membranes of an oral cavity, a nasopharynx, a throat, and also skin, especially proctal area are surprised; further process passes to other bodies. Grayaulematozno-ulcer is observed ulitis (see), stomatitis (see), glossitis (see), the hypodermic easily ulcerating infiltrates. Also ostrovospalitelny are characteristic limfangiita (see) and lymphadenites (see) in a nose, a mouth, a neck, further generalizuyushchiyesya with formation of fistulas. In internals (lungs, a stomach, a spleen, a liver) there are granulomas with abscessing.

Diagnosis establish on the basis a wedge, data, detection in patol, material of the activator (obtaining culture of the activator and experimental infection of animals — white mice, hamsters, Guinea pigs is possible).

Differential diagnosis carry out with tuberculosis, with manifestations secondary and tertiary syphilis (see), sporotrichosis (see), leushmaniosis (see), zymonematoses (see).

Treatment consists in purpose of Amphotericinum In intravenously (kapelno).

Forecast adverse; without treatment in several years there comes the lethal outcome from a cachexia, a perforation of ulcers of intestines.

Prevention it is not developed.

Bibliography: Cat's P. N. and Shek varnishes N. D. Guide to a medical mycology, M., 1978; G about - nant N. F. and. lake of Manual of clinical mycology, Philadelphia, 1971; E innuo n s With h. W. and. o. Medical mycology, Philadelphia, 1977.

H. D. Sheklakov.