Disseminated paracoccidioidomycosis associated with lymph node tuberculosis in a non immunocompromised child

Raúl Montalvo; Anibal Díaz; Josdan Montalvo; Manuel Pomazongo; Miguel Montalvo; Edison Tunque

doi:10.1016/j.idcr.2022.e01507

Disseminated paracoccidioidomycosis associated with lymph node tuberculosis in a non immunocompromised child

IDCases. 2022 May 20:29:e01507. doi: 10.1016/j.idcr.2022.e01507. eCollection 2022.

Authors

Raúl Montalvo¹, Anibal Díaz², Josdan Montalvo³, Manuel Pomazongo⁴, Miguel Montalvo⁵, Edison Tunque⁵

Affiliations

¹ Universidad Cesar Vallejo, Peru.
² Universidad de Huánuco, Peru.
³ Facultad de Medicina Humana, Universidad Continental, Peru.
⁴ Universidad Nacional Daniel Alcides Carrión, Cerro de Pasco, Peru.
⁵ Hospital Regional Materno Infantil El Carmen, Huancayo, Peru.

Abstract

The association of paracoccidioidomycosis (PCM) and tuberculosis (TB) produces an uncommon hyperinflammatory syndrome, causing multiorgan dysfunction. TB associated PCM is a rare condition, but it is fatal if not treated. Herein, we present a immunocompetent child who is admitted for fever and painful lymphadenopathy, with evidence of acid-alcohol-resistant bacillus (AARB) in cervical lymph node biopsy, antituberculous treatment was started with partial clinical improvement and is given discharge from hospital. At 3 weeks, he was readmitted by fever, weight loss, dyspnea and a greater number of adenopathies, in the new biopsy multiple yeasts were found compatible with PCM, our patient responded well to the combination of antituberculosis therapy(ATT), corticosteroid, and amphotericin B deoxycholate, presenting clinical improvement and subsequently continued with itraconazole.

Keywords: Acid-alcohol-resistant bacillus; Amphotericin B; Itraconazole; Paracoccidioidomycosis; Tuberculosis.

Publication types

Case Reports