Disseminated mycosis in a patient with yellow fever

Authors

  • Gustavo Vieira Rodrigues Maciela Federal University of Minas Gerais (UFMG), Brazilian Company of Hospital Services, Clinical Hospital, Pathologic Anatomy Laboratory.
  • Marcelo Combat de Faria Tavares Federal University of Minas Gerais (UFMG), Brazilian Company of Hospital Services, Clinical Hospital, Pathologic Anatomy Laboratory.
  • Leonardo Soares Pereira Hospital Foundation of Minas Gerais, Hospital Eduardo de Menezes.
  • Guilherme Lima Castro Silva Hospital Foundation of Minas Gerais, Hospital Eduardo de Menezes
  • Neimy Ramos de Oliveira Hospital Foundation of Minas Gerais, Hospital Eduardo de Menezes.
  • Eduardo Paulino Júnior Federal University of Minas Gerais (UFMG), Brazilian Company of Hospital Services, Clinical Hospital, Pathologic Anatomy Laboratory.
  • Marcelo Antonio Pascoal-Xavier Federal University of Minas Gerais (UFMG), Brazilian Company of Hospital Services, Clinical Hospital, Pathologic Anatomy Laboratory.

DOI:

https://doi.org/10.4322/acr.2018.038

Keywords:

Invasive Fungal Infections; Mycosis; Yellow Fever; Autopsy

Abstract

Disseminated mycosis (DM)—with cardiac involvement and shock—is an unexpected and severe opportunistic infection in patients with yellow fever. DM can mimic bacterial sepsis and should be considered in the differential diagnosis of causes of systemic inflammatory response syndrome in this group of patients, especially in areas where an outbreak of yellow fever is ongoing. We report the case of a 53-year-old male patient who presented to the emergency department with fever, myalgia, headache, and low back pain. The laboratory investigation revealed a positive molecular test for yellow fever, hepatic injury, and renal failure. During hospitalization, the patient developed hepatic encephalopathy, ascending leukocytosis, and ascites, with signs consistent with peritonitis. On the 11th day of hospitalization, the patient developed atrioventricular block, shock and died. At autopsy, angioinvasive mycosis was evidenced mainly in the heart, lungs, kidneys, and adrenals.

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Author Biographies

Eduardo Paulino Júnior, Federal University of Minas Gerais (UFMG), Brazilian Company of Hospital Services, Clinical Hospital, Pathologic Anatomy Laboratory.

Federal University of Minas Gerais (UFMG), Faculty of Medicine, Pathologic Anatomy Department

Marcelo Antonio Pascoal-Xavier, Federal University of Minas Gerais (UFMG), Brazilian Company of Hospital Services, Clinical Hospital, Pathologic Anatomy Laboratory.

Federal University of Minas Gerais (UFMG), Faculty of Medicine, Pathologic Anatomy Department. Oswaldo Cruz Foundation, René Rachou Institute, Research Group Immunology of Viral Diseases.

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Published

2018-08-31

How to Cite

Maciela, G. V. R., Tavares, M. C. de F., Pereira, L. S., Silva, G. L. C., Oliveira, N. R. de, Paulino Júnior, E., & Pascoal-Xavier, M. A. (2018). Disseminated mycosis in a patient with yellow fever. Autopsy and Case Reports, 8(3), e2018038. https://doi.org/10.4322/acr.2018.038

Issue

Section

Article / Autopsy Case Report