Tracheoesophageal fistula associated with paracoccidioidomicosis

  • Antonio Carlos Nogueira Divisão de Clínica Médica do Hospital Universitário da Universidade de São Paulo, São Paulo/SP, Brasil
  • Daniel Soares de Sousa Dantas Instituto de Infectologia Emílio Ribas
  • Francisco Garcia Soriano Divisão de Clínica Médica do Hospital Universitário da Universidade de São Paulo, São Paulo/SP, Brasil
  • Simone Peres Pilli Serviço de Endoscopia do Hospital Universitário da Universidade de São Paulo, São Paulo/SP, Brasil
  • João Epalanga Júnior Vidro Hospital das Clínicas da Faculdade de Medicina da USP
  • Edmar Tafner Serviço de Endoscopia do Hospital Universitário da Universidade de São Paulo, São Paulo/SP, Brasil
  • Lincoln Tavares de Andrade Serviço de Endoscopia do Hospital Universitário da Universidade de São Paulo, São Paulo/SP, Brasil
  • Luis Masuo Maruta Serviço de Endoscopia do Hospital Universitário da Universidade de São Paulo, São Paulo/SP, Brasil
  • Hélio Minamoto Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo/SP, Brasil
  • José Pinhata Otoch Divisão de Clínica Cirúrgica do Hospital Universitário da Universidade de São Paulo, São Paulo/SP, Brasil
  • João Augusto dos Santos Martines Serviço de Imagenologia do Hospital Universitário da Universidade de São Paulo, São Paulo/SP, Brasil
Keywords: Paracoccidioidomycosis, Tracheoesophageal fistula, Prostheses and implants.

Abstract

Paracoccidioidomycosis is a systemic fungal disease caused by
Paracoccidioides brasiliensis, agent geographically distributed to certain
areas of Central and South America. The infection by P. brasiliensis has
been reported from north Mexico to south Argentina. Paracoccidioidomycosis
presents similar clinical findings of many other diseases whatever in acute or chronic scenarios. Chronic pulmonary paracoccidioidomycosis is frequently
misdiagnosed as malignancy or tuberculosis. The authors present a case
of a 57 year-old man admitted to the hospital due to a chronic consumptive
syndrome. He underwent anti-tuberculous treatment with rifampin, isoniazid and
pyrazinamide 1 year ago without resolution of the simptoms. During the clinical
investigation, pulmonary paracoccidioidomycosis with tracheoesophageal
fistula was diagnosed. The systemic infection was treated with deoxicolate B
amphotericin followed by sulfametoxazole and trimetoprin due to acute renal
function impairment. The fistula was endoscopically treated; inittialy with the
protection of left main bronchus with a tracheal prosthesis followed by the
esophageal fistula’s ostium clipping.

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Published
2011-09-29
How to Cite
Nogueira, A., Dantas, D., Soriano, F., Pilli, S., Vidro, J., Tafner, E., Andrade, L., Maruta, L., Minamoto, H., Otoch, J., & Martines, J. (2011). Tracheoesophageal fistula associated with paracoccidioidomicosis. Autopsy and Case Reports, 1(3), 31-38. https://doi.org/10.4322/acr.%y.26065
Section
Article / Clinical Case Report