Screening paracoccidioidomycosis by double immunodiffusion test in a referred diagnostic center in Brazilian southeastern: an accessible tool

Infection. 2021 Dec;49(6):1257-1264. doi: 10.1007/s15010-021-01704-8. Epub 2021 Sep 28.

Abstract

Purpose: This article shows reports of the clinical-epidemiological characteristics and serological screening in patients assisted by a reference center for PCM care, University Hospital Cassiano Antonio Moraes, Federal University of Espirito Santo, Brazil.

Methods: The patient's sera with PCM were analyzed by DID test at the beginning and the end treatment. Clinical and demographic data were also collected to characterize the sample.

Results: One hundred patients with a suspected diagnosis of PCM were evaluated. Serology by DID test was used as a screen in all patients. The test was positive for 79 patients (72 for Paracoccidioides brasiliensis and 7 for Paracoccidioides lutzii). Serology was negative in 21 sera, although all of them were diagnosed PCM by histopathologic or direct exam. Serological follow-up was performed during the treatment of all patients. After treatment, 58(58%) had negative serology and 33(33%) low levels of antibodies (≤ 1:16).

Conclusion: Our results indicate the importance of the DID test for the screening and monitoring of PCM and that the incidence of P. lutzii might be greater than expected in areas where it is not the predominant PCM species. Therefore, this article may contribute to improving the knowledge and clinical management about this disease.

Keywords: Diagnosis; Paracoccidioidomycosis; Serology; Systemic infection, mycosis, double immunodiffusion test.

MeSH terms

  • Antigens, Fungal
  • Brazil
  • Humans
  • Immunodiffusion
  • Paracoccidioides
  • Paracoccidioidomycosis* / diagnosis
  • Paracoccidioidomycosis* / epidemiology

Substances

  • Antigens, Fungal

Supplementary concepts

  • Paracoccidioides lutzii