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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2023; 42(03): e262-e265
DOI: 10.1055/s-0041-1730335
Case Report

Spinal Cord Paracoccidioidomycosis: Case Report

Paracoccidioidomicose na medula espinhal: Relato de caso
Ivan Hack 
1   Division of Neurosurgery, Hospital Regina, Novo Hamburgo, Rio Grande do Sul, RS, Brasil
,
Alcides Brandalise Junior
1   Division of Neurosurgery, Hospital Regina, Novo Hamburgo, Rio Grande do Sul, RS, Brasil
,
Luciano Marques Furlanetto
2   Division of Internal Medicine and Infectious Diseases, Hospital Regina, Novo Hamburgo, Rio Grande do Sul, RS, Brasil
,
Fernando Bergel Lipp
2   Division of Internal Medicine and Infectious Diseases, Hospital Regina, Novo Hamburgo, Rio Grande do Sul, RS, Brasil
,
Roque Furian
3   Division of Pathology, Hospital Regina, Novo Hamburgo, Rio Grande do Sul, RS, Brasil
,
Cyrio Luiz Nácul
4   Division of Radiology, Hospital Regina, Novo Hamburgo, Rio Grande do Sul, RS, Brasil
,
Eduardo Werlang Rota
4   Division of Radiology, Hospital Regina, Novo Hamburgo, Rio Grande do Sul, RS, Brasil
,
Rodrigo Muller
4   Division of Radiology, Hospital Regina, Novo Hamburgo, Rio Grande do Sul, RS, Brasil
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Abstract

Paracoccidioidomycosis (PCM) is a systemic mycosis caused by fungi Paracoccidioides brasiliensis and Paracoccidiodes Lutzii. Its distribution is limited to subtropical regions of Central and South America, where it is endemic, and Brazil accounts for ∼ 80% of the reported cases. Even in endemic zones, its incidence is low, ranging from 3 to 4 new cases per million to 1 to 3 new cases per 100 thousand inhabitants per year. Granulomas in the spinal cord are rare, and they account for 0,6% of all cases of systemic PCM. The authors report a case of a woman with crural paraparesis caused by dorsal spinal cord PCM granulomasin T7-T8 and T8-T9, with no evidence of systemic disease. The patient was submitted to microsurgery, with total excision of the lesions, and is experiencing positive neurological recovery. Though rare, PCM intramedullary granulomas must be considered in differential diagnosis of the tumoral expansive process of the spinal cord, especially in patients coming from endemic rural zones.

Resumo

A paracoccidioidomicose (PCM) é uma micose sistêmica causada pelos fungos Paracoccidioides brasiliensis e Paracoccidioides Lutzii. A doença é endêmica nas regiões subtropicais das Américas do Sul e Central, sendo o Brasil responsável por aproximadamente 80% dos casos relatados. A sua incidência, até mesmo em zonas endêmicas, é baixa, e varia de 3 a 4 casos novos por milhão até 1 a 3 casos novos por 100 mil habitantes ao ano. Os granulomas intramedulares são raros, e acometem 0,6% dos indivíduos com PCM. Os autores relatam o caso de uma paciente de 81 anos com paraparesia crural devido a granulomas intramedulares de PCM em T7-T8 e T8-T9, sem evidências de doença sistêmica. A paciente foi submetida a microcirurgia, com boa evolução pós-operatória. Embora raros, os granulomas intramedulares de PCM devem ser considerados no diagnóstico diferencial das lesões da medula espinhal, especialmente naqueles pacientes provenientes de zonas rurais endêmicas.

Keywords

paracoccidioidomycosis - spinal cord - granuloma

Palavras-chave

paracoccidioidomicose - medula espinhal - granuloma


Publication History

Received: 21 September 2020

Accepted: 22 February 2021

Article published online:
27 September 2022

© 2022. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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