SynthesisMycopathologia2025
Paracoccidioidomycosis in Childhood and Adolescence: Clinical-Epidemiological Review of South American Cases (1970-2023).
Synthesis in Mycopathologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Paracoccidioidomycosis (PCM) is a severe systemic mycosis classified as a neglected disease, predominantly found in South America, with Brazil reporting the highest number of cases. In children and adolescents, PCM primarily manifests as an acute/subacute (juvenile) form. This systematic review focused on PCM cases in individuals under 15 years of age, analyzing 163 reports published between 1970 and 2023. The literature search was conducted across LILACS, SciELO, and PubMed databases using DeCS and MeSH descriptors in Portuguese, English, and Spanish.Most cases (70%) occurred in Brazil, followed by Argentina, Peru, Venezuela, and Colombia. The mean age was 8.4 years, with a male predominance (63%) and a median diagnostic delay of six months, reflecting underreporting and late disease recognition. The predominant clinical presentation was the disseminated form (90%), with generalized lymphadenopathy as the most frequent manifestation. Common symptoms included fever (66%), weight loss (54%), hepatomegaly (30%), and splenomegaly (25%). Severe complications such as lymph node fistulization (27%) and bone involvement (16%) were associated with poorer prognosis.Among the cases, 53% were classified as severe, frequently exhibiting marked eosinophilia (> 25,000 cells/mm
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