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Paracoccidioides brasiliensis Infection Mimicking Recurrent Hodgkin Lymphoma: A Case Report and Review of the Literature

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Abstract

Paracoccidioides infection is a rare entity in the USA. This dimorphic fungus is found in Central and South America and is thought to be acquired by inhalation through the soil. We report a case of Paracoccidioides brasiliensis infection presenting as a clavicular bone lesion, peripancreatic mass, and various skin lesions. A 35-year-old man with a history significant for Hodgkin lymphoma presented with a left clavicular mass that was suspected clinically and radiologically as recurrent Hodgkin lymphoma. He was not experiencing any associated symptoms and was undergoing chemotherapy treatment for his known Hodgkin disease. On CT imaging, the mass was seen as a lytic bone lesion with an overlying soft tissue mass. This was biopsied and histologically diagnosed as a Paracoccidioides brasiliensis infection with associated necrotizing granulomatous inflammation. Also found on the CT scan was an enlarging peripancreatic mass which on endoscopic biopsy had similar histologic findings. In conclusion, this report presents a rare case of Paracoccidioides brasiliensis infection mimicking recurrent Hodgkin lymphoma.

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References

  1. Restrepo A, Tobon AM, Agudelo CA. Paracoccidioidomycosis. In: Hospenthal DR, Rinaldi MG, editors. Diagnosis and treatment of human mycoses, 1st edition. Totowa: Humana Press; 2008. p. 331.

  2. Brummer E, Castaneda E, Restrepo A. Paracoccidioidomycosis: an update. Clin Microbiol Rev. 1993;6:89.

    Article  CAS  Google Scholar 

  3. Restrepo A. The ecology of Paracoccidioides brasiliensis: a puzzle still unsolved. Sabouraudia. 1985;23:323.

    Article  CAS  Google Scholar 

  4. Travassos LR, Taborda CP, Colombo AL. Treatment options for paracoccidioidomycosis and new strategies investigated. Expert Rev Anti Infect Ther. 2008;6:251.

    Article  CAS  Google Scholar 

  5. Calle D, Rosero DS, Orozco LC, et al. Paracoccidioidomycosis in Colombia: an ecological study. Epidemiol Infect. 2001;126:309.

    Article  CAS  Google Scholar 

  6. Blotta MH, Mamoni RL, Oliveira SJ, et al. Endemic regions of paracoccidioidomycosis in Brazil: a clinical and epidemiologic study of 584 cases in the southeast region. Am J Trop Med Hyg. 1999;61:390.

    Article  CAS  Google Scholar 

  7. Bustamante B, McEwen JG, Tabares AM, Arango M, Restrepo A. Characteristics of the conidia produced by the mycelial form of Paracoccidioides brasiliensis. Sabouraudia. 1985;23:407–14.

    Article  Google Scholar 

  8. Restrepo A, Tobon AM. Paracoccidioides brasiliensis. In: Mandell GL, Bennett JE, Dolin R, Editors. Principles and practice of infectious diseases, 6th ed. Philadelphia: Elsevier; 2005. p. 3062.

  9. Buccheri R, Khoury Z, Barata LC, Benard G. Incubation period and early natural history events of the acute form of paracoccidioidomycosis: lessons from patients with a single paracoccidioides spp. Exposure. Mycopathologia. 2016;181:435.

    Article  Google Scholar 

  10. Pereira RM, Bucaretchi F, Barison Ede M, et al. Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome. Rev Inst Med Trop Sao Paulo. 2004;46:127.

    Article  Google Scholar 

  11. Restrepo A, Benard G, de Castro CC, et al. Pulmonary paracoccidioidomycosis. Semin Respir Crit Care Med. 2008;29:182.

    Article  Google Scholar 

  12. Correa AL, Franco L, Restrepo A. Paracoccidioidomicosis: coexistencia de lesiones pulmonares y patologia pulmonar silente. Acta Med Colomb. 1991;16:304.

    Google Scholar 

  13. Tobón AM, Agudelo CA, Osorio ML, et al. Residual pulmonary abnormalities in adult patients with chronic paracoccidioidomycosis: prolonged follow-up after itraconazole therapy. Clin Infect Dis. 2003;37:898.

    Article  Google Scholar 

  14. Arango M, Restrepo A. Mycopathologia. 1976;59:163. https://doi.org/10.1007/BF00627878.

    Article  CAS  PubMed  Google Scholar 

  15. McDonough S, Georg ES, Brinkman LK. Growth of dimorphic human fungi on a medium containing cycloheximide and chloramphenicol. Mycopath Mycol Appl. 1960;13:113–20.

    Article  Google Scholar 

  16. Nucci M, Colombo A. Clinical manifestations and diagnosis of chronic paracoccidioidomycosis. In: Mitty J, editor. UpToDate. Waltham, Mass.: UpToDate, 2017.

  17. Shikanai-Yasuda MA, Telles Filho Fde Q, Mendes RP, et al. Guidelines in paracoccidioidomycosis. Rev Soc Bras Med Trop. 2006;39:297.

    Article  Google Scholar 

  18. Shankar J, Wu TD, Clemons KV, Monteiro JP, Mirels LF, Stevens DA. Influence of 17β-estradiol on gene expression of Paracoccidioides during mycelia-to-yeast transition. PLoS ONE. 2011;6(12):e28402. https://doi.org/10.1371/journal.pone.0028402.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Ruiz e Resende LS, Yasuda AG, Mendes RP, Marques SA, Niéro-Melo L, Defaveri J, Domingues MA. Paracoccidioidomycosis in patients with lymphoma and review of published literature. Mycopathologia. 2015;179(3–4):285–91.

  20. Cacere CR, Mendes-Giannini MJ, Fontes CJ, Kono A, Duarte AJ, Benard G. Altered expression of the costimulatory molecules CD80, CD86, CD152, PD-1 and ICOS on T-cells from paracoccidioidomycosis patients: lack of correlation with T-cell hyporesponsiveness. Clin Immunol. 2008;129(2):341–9.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Danbury Hospital, Western Connecticut Health Network, 24 Hospital Ave, Danbury, CT, 06810, USA

    Ayaz Ghani, Molly Weinberg, Nusrat Pathan, Ramapriya Vidhun & Steven Sieber

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  1. Ayaz Ghani
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  2. Molly Weinberg
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  3. Nusrat Pathan
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  4. Ramapriya Vidhun
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  5. Steven Sieber
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Correspondence to Ayaz Ghani.

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Ghani, A., Weinberg, M., Pathan, N. et al. Paracoccidioides brasiliensis Infection Mimicking Recurrent Hodgkin Lymphoma: A Case Report and Review of the Literature. Mycopathologia 183, 973–977 (2018). https://doi.org/10.1007/s11046-018-0252-y

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