Abstract

CARRENO-ALMANZAR, Fabián Ramiro; HERNANDEZ-VARGAS, Juan Carlos; FAJARDO-RIVERO, Javier Enrique  and  MANTILLA-HERNANDEZ, Julio Cesar. Chronic Paracoccidioidomycosis with isolated pulmonary involvement, When should be treated in hospital? Case report. Neumol. cir. torax [online]. 2018, vol.77, n.3, pp.213-217. ISSN 0028-3746.

Paracoccidioidomycosis is the most important systemic and endemic mycosis in Latin America, Colombia is the second country with the highest number of cases. According to the clinical manifestations, the forms of presentation of this disease can be acute or chronic; the last one occurs in patients older than 30 years causing lung involvement, in skin and mucous membranes. The antifungal treatment is based on the administration of sulfa drugs and azole derivatives in cases of mild to moderate manifestations, and amphotericin B, which is reserved for patients with severe disease and requires in-hospital management. We present the case of a 66-year-old patient with severe pulmonary manifestations as the only manifestation of chronic paracoccidioidomycosis that did not respond initially to management with oral itraconazole, therefore management was offered with amphotericin B. In the absence of clear clinical criteria for hospitalization by pulmonary commitment, we consider that the clinical - radiological commitment must be taken into account when initiating early parenteral management.

Keywords : Amphotericin B; clinical-radiological compromise; intrahospital management; pulmonary manifestations; chronic paracoccidioidomycosis.