, Volume 176, Issue 1–2, pp 41–47 | Cite as

Evaluation of Paracoccidioides brasiliensis Infection by gp 43 Intradermal Test in Rural Settlements in Central-West Brazil

  • Ana Paula da C. Marques
  • Sandra Maria V. L. Oliveira
  • Grazielli R. Rezende
  • Dayane A. Melo
  • Sonia M. Fernandes-Fitts
  • Elenir Rose J. C. Pontes
  • Maria da Glória Bonecini-Almeida
  • Zoilo P. Camargo
  • Anamaria M. M. Paniago


Epidemiological studies of paracoccidioidomycosis have been based on surveys achieved with intradermal tests, and paracoccidioidin is the most common antigen used in most cases. The glycoprotein of 43-kDa (gp43) has been used in intradermal tests. It is the most antigenic component of Paracoccidioides brasiliensis, and it provides greater specificity to evaluate infection for this fungus. In this study, the prevalence of P. brasiliensis infection was estimated with intradermal tests involving gp43 for 695 people in rural Central-West Brazil. The infection rate was 45.8 % (95 % CI = 42.1–49.5), and the average age of those infected was 45.8 ± 18.2 years. The prevalence did not show gender-based differences but increased with age. The results demonstrate the importance of P. brasiliensis infection in rural settlements and the early exposure of children in the region to the fungus. Despite the high antigenicity and specificity of gp43, its usage must be standardized, so that epidemiological surveys will be comparable and more accurately reflect P. brasiliensis infection in endemic areas.


Paracoccidioides infection Intradermal tests Paracoccidioides brasiliensis Paracoccidioidomycosis and gp43 



We thank the Health Department of the Municipality of Jaraguari (Mato Grosso do Sul, Brazil) and Post Graduation Program for Health and Development of the Central-West Region Brazil, for their assistance and financial support.


  1. 1.
    Rodrigues CC. Evaluation of Histoplasma capsulatum infection in inhabitants of the urban and rural areas of Pratânia, São Paulo, by means of intradermal reactions. J Verom Anim Toxims incl Trop Dis. 2005;11:214.CrossRefGoogle Scholar
  2. 2.
    Cadavid D, Restrepo-Moreno A. Factors associated with Paracoccidioides brasiliensis infection among permanent residents of three areas in Colombia. Epidemiol Infect. 1993;111:121–33.PubMedCrossRefGoogle Scholar
  3. 3.
    Cermeño JR, Cermeño JJ, Hernandez I, Godoy G, Cermeño JJ, Cabello I, Orellan Y, Blanco Y, Penna S. Histoplasmine and paracoccidiodine epidemiological study in Upata, Bolivar state, Venezuela. Trop Med Int Health. 2005;10:216–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Diogenes MJ, Goncalves HM, Mapurunga AC, Alencar KF, Andrade FB, Nogueira-Queiroz JA. Histoplasmin and paracoccidioidin reactions in Serra de Pereiro. (Ceara State-Brazil). Rev Inst Med Trop São Paulo. 1990;32:116–20.PubMedCrossRefGoogle Scholar
  5. 5.
    Vieira ICG, Toledo PM, Silva JMC, Higuchi H. Deforestation and threats to the biodiversity of Amazonia. Braz J Biol. 2008;68:949–56.PubMedCrossRefGoogle Scholar
  6. 6.
    Hotez PJ, Bottazzi ME, Franco-Paredes C, Ault SK, Periago MR. The neglected tropical disease of Latin America and the Caribbean: a review of disease burden and distribution and a roadmap for control and elimination. Plos Negl Trop Dis. 2008;2:1–11.Google Scholar
  7. 7.
    Coutinho ZF, Silva D, Lázera M, Petri V, Oliveira RM, Sabroza PC, Wanke B. Paracoccidioidomycosis mortality in Brazil (1980–1995). Cad Saúde Pública. 2002;18:1441–54.PubMedCrossRefGoogle Scholar
  8. 8.
    Franco M, Bagagli E, Scapolio S, da Silva Lacaz C. A critical analysis of isolation of Paracoccidioides brasiliensis from soil. Med Mycol. 2000;38:185–91.PubMedGoogle Scholar
  9. 9.
    Paniago AMM, Aguiar JIA, Aguiar ES, Cunha RV, Pereira GROL, Londero AT, Wanke B. Paracoccidioidomycosis: a clinical and epidemiological study of 422 cases observed in Mato Grosso do Sul. Rev Soc Bras Med Trop. 2003;36:455–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Silveira LH, Domingos IH, Kouchi K, Itano EN, Silva EA, Landgraf VO, et al. Serological detection of antibodies against Paracoccidioides brasiliensis in dogs with leishmaniasis. Mycopathologia. 2006;162:325–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Silveira LH, Paes RCS, Medeiros EV, Itano EN, Camargo ZP, Ono MA. Occurrence of antibodies to Paracoccidioides brasiliensis in dairy cattle from Mato Grosso do Sul, Brasil. Mycopathologia. 2008;165:367–71.PubMedCrossRefGoogle Scholar
  12. 12.
    Oliveira GG, Silveira LH, Itano EN, Soares RM, Freire RL, Watanabe MAE, et al. Serological evidence of Paracoccidioides brasiliensis infection in chickens from Paraná and Mato Grosso do Sul states, Brazil. Mycopathologia. 2011;171:197–202.PubMedCrossRefGoogle Scholar
  13. 13.
    Brummer E, Castaneda E, Restrepo A. Paracoccidioidomycosis: an update. Clin Microbiol Rev. 1993;6:89–117.PubMedGoogle Scholar
  14. 14.
    Fava Netto C. Paracoccidioidomycosis immunology. Rev Inst Med Trop São Paulo. 1976;18:42–53.PubMedGoogle Scholar
  15. 15.
    Lacaz CS. Paracoccidioidomicose. In: Lacaz CS, Porto E, Martins JEC, Heins-Vaccari EM, Melo NT, editors. Tratado de Micologia Médica Lacaz. São Paulo: Sarvier; 2002. p. 639–729.Google Scholar
  16. 16.
    Fava SC, Fava Netto C. Epidemiologic surveys of histoplasmin and paracoccidioidin sensitivity in Brazil. Rev Inst Med Trop São Paulo. 1998;40:155–64.CrossRefGoogle Scholar
  17. 17.
    Saraiva EC, Altemani A, Franco MF, Unterkircher CS, Camargo ZP. Paracoccidioides brasiliensis-gp43 used as paracoccidioidin. J Med Vet Mycol. 1996;34:155–61.PubMedCrossRefGoogle Scholar
  18. 18.
    Puccia R, Schenkman S, Gorin PA, Travassos LR. Exocellular components of Paracoccidioides brasiliensis: identification of a specific antigen. Infect Immun. 1986;53:199–206.PubMedGoogle Scholar
  19. 19.
    Mackinnon JE, Artagaveytia-Allende RC, Arroyo L. Specificity of cutaneous reaction with paracoccidioidin. An Fac Med Univ Repub Montev Urug. 1953;38:363–82.PubMedGoogle Scholar
  20. 20.
    Silva-Vergara ML, Martinez R. Inquérito epidemiológico com paracoccidioidina e histoplasmina em área agrícola de café em Ibia, Minas Gerais, Brasil. Rev Iberoam Micol. 1998;15:294–7.PubMedGoogle Scholar
  21. 21.
    Kalmar EM, Alencar FEC, Alves FP, Pang LW, Del Negro GMB, Camargo ZP, Shikanai-Yasuda MA. Paracoccidioidomycosis: an epidemiologic survey in a pediatric population from the Brazilian Amazon using skin tests. Am J Trop Med Hyg. 2004;71:82–6.PubMedGoogle Scholar
  22. 22.
    Camargo ZP, Unterkircher C, Campoy SP, Travassos LR. Production of Paracoccidioides brasiliensis exoantigens for immunodiffusion tests. J Clin Microbiol. 1988;26:2147–51.PubMedGoogle Scholar
  23. 23.
    Camargo ZP, Taborda CP, Rodrigues EG, Travassos LR. The use of cell free antigen of Paracoccidioides brasiliensis serological tests. J Med Vet Mycol. 1991;29:31–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Travassos LR, Puccia R, Cisalpino P, Taborda C, Rodrigues EG, Rodrigues M, Silveira JF, Almeida IC. Biochemistry and molecular biology of the main diagnostic antigen of Paracoccidioides brasiliensis. Arch Med Res. 1995;26:297–304.PubMedGoogle Scholar
  25. 25.
    Mendes-Giannini MJS, Bueno JP, Shikanai-Yasuda MA, Ferreira AW, Masuda A. Detection of the 43,000-molecular-weight glycoprotein in sera of patients with paracoccidioidomycosis. J Clin Microbiol. 1989;27:2842–5.PubMedGoogle Scholar
  26. 26.
    Rodrigues EG, Travassos LR. Nature of the reactive epitopes in Paracoccidioides brasiliensis polysaccharide antigen. J Med Vet Mycol. 1994;32:77–81.PubMedCrossRefGoogle Scholar
  27. 27.
    Sarti ECFB, Oliveira SMVL, Santos LF, Camargo ZP, Paniago AMM. Paracoccidioidal infection in HIV patients at an endemic area of paracoccidioidomycosis in Brazil. Mycopathologia. 2012;173:145–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Fornajeiro N, Maluf ML, Takahachi G, Svidzinski TI. Paracoccidioidomycosis epidemiological survey using gp43, in two cities of northwestern region of Parana, Brazil. Rev Soc Bras Med Trop. 2005;38:191–3.PubMedCrossRefGoogle Scholar
  29. 29.
    Somensi DC, Somensi CC, Itano EN, Camargo ZP, Oliveira OLP. A utilização da gp43 de Paracoccidioides brasiliensis em testes intradérmicos na região de Londrina—PR. Rev Farmácia Química. 1997;29:14–8.Google Scholar
  30. 30.
    Instituto Brasileiro de Geográfia e Estatística. Censo Demográfico 2010. 2011. Accessed 15 Feb 2011.
  31. 31.
    Cermeño J, Cermeño J, Godoy G, Hernandez I, Orellan Y, Blanco Y, Penna S, Garcia L, Mender T, Gonsálvez M, Lópes C, Hernándes N, Longa I, Gottberg E, Basanta A, Castro M, Millán I, León W, Plaz F, Jahouhari C, Cabello I. Epidemiological study of paracoccidioidomycosis and histoplasmosis in a suburb of San Felix city, Bolivar state, Venezuela. Invest Clin. 2009;50:213–20.PubMedGoogle Scholar
  32. 32.
    Mangiaterra M, Alonso J, Galvan M, Giusiano G, Gorodner J. Histoplasmin and paracoccidioidin skin reactivity in infantile population of northern Argentina. Rev Inst Med Trop São Paulo. 1996;38:349–53.PubMedCrossRefGoogle Scholar
  33. 33.
    van Gelderen de Komaid A, Duran E, de Borges KI. Histoplasmosis and paracoccidioidomycosis in northwestern Argentina III. Epidemiological survey in Vipos, La Toma, and Choromoro—Trancas, Tucuman, Argentina. Eur J Epidemiol. 1999;15:383–8.PubMedGoogle Scholar
  34. 34.
    Santos WA, Silva BM, Passos ED, Zandonade E, Falqueto A. Association between smoking and paracoccidioidomycosis: a case-control study in the State of Espirito Santo, Brazil. Cad Saude Publica. 2003;19:245–53.PubMedCrossRefGoogle Scholar
  35. 35.
    Carandina L, Magaldi C. Skin test survey for South American blastomycosis in a rural community of Botucatu, SP (Brazil). Rev Saude Publica. 1974;8:171–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Ono MA, Itano EN, Mizuno EH, Camargo ZP. Inhibition of Paracoccidioides brasiliensis by pesticides: is this a partial explanation for the difficulty in isolating this fungus from the soil? Med Mycol. 2002;40:493–9.PubMedGoogle Scholar
  37. 37.
    Marques SA. Paracoccidioidomicose: atualização epidemiológica, clínica e terapêutica. An Bras Dermatol. 2003;78:135–50.CrossRefGoogle Scholar
  38. 38.
    Restrepo A, Salazar ME, Cano LE, Stover EP, Feldman D, Stevens DA. Estrogens inhibit mycelium-to-yeast transformation in the fungus Paracoccidioides brasiliensis: implications for resistance of females to paracoccidioidomycosis. Infect Immun. 1984;46:346–53.PubMedGoogle Scholar
  39. 39.
    Martinez R, Moya MJ. The relationship between paracoccidioidomycosis and alcoholism. Rev Saude Publica. 1992;26:12–6.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Ana Paula da C. Marques
    • 1
  • Sandra Maria V. L. Oliveira
    • 1
  • Grazielli R. Rezende
    • 1
  • Dayane A. Melo
    • 1
  • Sonia M. Fernandes-Fitts
    • 1
  • Elenir Rose J. C. Pontes
    • 1
  • Maria da Glória Bonecini-Almeida
    • 2
  • Zoilo P. Camargo
    • 3
  • Anamaria M. M. Paniago
    • 1
  1. 1.Universidade Federal do Mato Grosso do SulCampo GrandeBrazil
  2. 2.Laboratório de Imunologia e Imunogenética do Instituto de Pesquisa Clínica Evandro ChagasFundação Oswaldo CruzRio de JaneiroBrazil
  3. 3.Laboratório de Micologia Médica, Faculdade de Medicina, Hospital das ClínicasUniversidade Federal de São PauloSão PauloBrazil

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