{"title":"【医学真菌学临床问题:第56题】","authors":"Fernando Messina , Emmanuel Marin , Alejandro Sansostera , Mercedes Romero , Roxana Depardo , Ricardo Negroni , Blanca Leonel , Gabriela Santiso","doi":"10.1016/j.riam.2022.12.001","DOIUrl":null,"url":null,"abstract":"<div><p>We present the case of a twenty six year-old woman with rheumatoid arthritis, treated with certolizumab. She sought medical attention due to cough, fever and night sweats. X-ray exam showed a miliary pneumonia. She was treated for tuberculosis and 50<!--> <!-->days later she presented with aphasia. Magnetic nuclear resonance revealed brain lesions. <em>Histoplasma capsulatum</em> PCR test and urinary antigen were positive, so an antifungal treatment with voriconazole was started. Visual adverse effects forced to change the antifungal schedule in both the length of treatment and the antifungal drug. With this measure the patient progressed favorably. The test of urinary <em>Histoplasma capsulatum</em> antigen and PCR amplification were key to make a diagnosis and also for a follow-up.</p></div>","PeriodicalId":21291,"journal":{"name":"Revista Iberoamericana De Micologia","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Problemas clínicos en Micología Médica: problema número 56\",\"authors\":\"Fernando Messina , Emmanuel Marin , Alejandro Sansostera , Mercedes Romero , Roxana Depardo , Ricardo Negroni , Blanca Leonel , Gabriela Santiso\",\"doi\":\"10.1016/j.riam.2022.12.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>We present the case of a twenty six year-old woman with rheumatoid arthritis, treated with certolizumab. She sought medical attention due to cough, fever and night sweats. X-ray exam showed a miliary pneumonia. She was treated for tuberculosis and 50<!--> <!-->days later she presented with aphasia. Magnetic nuclear resonance revealed brain lesions. <em>Histoplasma capsulatum</em> PCR test and urinary antigen were positive, so an antifungal treatment with voriconazole was started. Visual adverse effects forced to change the antifungal schedule in both the length of treatment and the antifungal drug. With this measure the patient progressed favorably. The test of urinary <em>Histoplasma capsulatum</em> antigen and PCR amplification were key to make a diagnosis and also for a follow-up.</p></div>\",\"PeriodicalId\":21291,\"journal\":{\"name\":\"Revista Iberoamericana De Micologia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Iberoamericana De Micologia\",\"FirstCategoryId\":\"99\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1130140623000013\",\"RegionNum\":4,\"RegionCategory\":\"生物学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"MYCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Iberoamericana De Micologia","FirstCategoryId":"99","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1130140623000013","RegionNum":4,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MYCOLOGY","Score":null,"Total":0}
Problemas clínicos en Micología Médica: problema número 56
We present the case of a twenty six year-old woman with rheumatoid arthritis, treated with certolizumab. She sought medical attention due to cough, fever and night sweats. X-ray exam showed a miliary pneumonia. She was treated for tuberculosis and 50 days later she presented with aphasia. Magnetic nuclear resonance revealed brain lesions. Histoplasma capsulatum PCR test and urinary antigen were positive, so an antifungal treatment with voriconazole was started. Visual adverse effects forced to change the antifungal schedule in both the length of treatment and the antifungal drug. With this measure the patient progressed favorably. The test of urinary Histoplasma capsulatum antigen and PCR amplification were key to make a diagnosis and also for a follow-up.
期刊介绍：
Revista Iberoamericana de Micología (Ibero-American Journal of Mycology) is the official journal of the Asociación Española de Micología, Asociación Venezolana de Micología and Asociación Argentina de Micología (The Spanish, Venezuelan, and Argentinian Mycology Associations). The Journal gives priority to publishing articles on studies associated with fungi and their pathogenic action on humans and animals, as well as any scientific studies on any aspect of mycology. The Journal also publishes, in Spanish and in English, original articles, reviews, mycology forums, editorials, special articles, notes, and letters to the editor, that have previously gone through a scientific peer review process.
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