Brazilian Neurosurgery (Apr 2018)

Neuroparacoccidioidomycosis: Case Report and Literature Review

  • Marcus Vinicius de Morais,
  • Sérgio Murilo Georgeto,
  • Marcelo Lourenço Haddad,
  • José Guilherme da Silva Amorim,
  • Luis Guilherme Scaliante,
  • Anderson Luiz de Paula,
  • Igor Vasconcelos de Andrade,
  • Paulo Henrique Pires de Aguiar

DOI
https://doi.org/10.1055/s-0038-1641578
Journal volume & issue
Vol. 37, no. 02
pp. 134 – 139

Abstract

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Abstract Introduction Paracoccidioidomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis, and it can compromise the central nervous system (CNS) in 10–27% of all cases. Case Report A 31-year-old man presented to the Emergency Department with headache, left-sided weakness, clonus at the ankle and a positive Babinski sign. Head computed tomography (CT) and magnetic resonance imaging (MRI) scans showed a 5.1 × 3.8 cm lobulated lesion with areas of liquefaction in the right centrum semiovale. Discussion Central nervous system PCM can mimic a brain tumor, and most cases are diagnosed by biopsy of the lesion. The treatment includes antibiotics, but some cases require surgery. Conclusion Due to high morbimortality rates, the diagnosis must be considered, and early treatment started in patients who live in rural regions endemic for PCM when a ring-enhancing mass associated with perilesional edema is observed on MRI scans.

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