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Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil

The occurrence of acute paracoccidioidomycosis (PCM) in urban areas of the Rio de Janeiro state, Brazil, has emerged in recent years. Therefore, young populations, including pregnant women, are at a higher risk of infection. Furthermore, young women undergoing itraconazole treatment for PCM have inc...

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Autores principales: Benko, Lorena Macedo Pestana, Vieira da Silva, Mariana Evangelista de Souza, Falcão, Eduardo Mastrangelo Marinho, Freitas, Dayvison Francis Saraiva, Calvet, Guilherme Amaral, Almeida, Marcos de Abreu, Almeida-Paes, Rodrigo, Zancopé-Oliveira, Rosely Maria, do Valle, Antonio Carlos Francesconi, de Macedo, Priscila Marques
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522026/
https://www.ncbi.nlm.nih.gov/pubmed/37708219
http://dx.doi.org/10.1371/journal.pntd.0011645
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author Benko, Lorena Macedo Pestana
Vieira da Silva, Mariana Evangelista de Souza
Falcão, Eduardo Mastrangelo Marinho
Freitas, Dayvison Francis Saraiva
Calvet, Guilherme Amaral
Almeida, Marcos de Abreu
Almeida-Paes, Rodrigo
Zancopé-Oliveira, Rosely Maria
do Valle, Antonio Carlos Francesconi
de Macedo, Priscila Marques
author_facet Benko, Lorena Macedo Pestana
Vieira da Silva, Mariana Evangelista de Souza
Falcão, Eduardo Mastrangelo Marinho
Freitas, Dayvison Francis Saraiva
Calvet, Guilherme Amaral
Almeida, Marcos de Abreu
Almeida-Paes, Rodrigo
Zancopé-Oliveira, Rosely Maria
do Valle, Antonio Carlos Francesconi
de Macedo, Priscila Marques
author_sort Benko, Lorena Macedo Pestana
collection PubMed
description The occurrence of acute paracoccidioidomycosis (PCM) in urban areas of the Rio de Janeiro state, Brazil, has emerged in recent years. Therefore, young populations, including pregnant women, are at a higher risk of infection. Furthermore, young women undergoing itraconazole treatment for PCM have increased chances to get pregnant because this medication may reduce the effectiveness of contraceptives. Acute PCM is invasive, reaching abdominal organs, posing a maternal-fetal risk. PCM treatment in pregnant women is also challenging due to the teratogenicity associated with the currently available oral drugs. There are scarce studies on PCM and pregnancy, mainly consisting of case reports and experimental murine models that highlight the severity of this association. We conducted a database research at a PCM reference center in Rio de Janeiro state from 1980 to 2020. We included patients diagnosed with PCM who were pregnant shortly before, at admission, or at any moment of their PCM follow-up care. Data related to pregnancy, childbirth, and the newborn were obtained from the Brazilian official public databases. We also reviewed the epidemiological and clinical features of these patients. During the study period, we identified 18 pregnant patients, with a median age of 26 years (range: 16–38). Among these cases, six (33.3%) were detected in the last 5 years, and 14 (77.8%) presented acute PCM, supporting the recent shift in the epidemiological profile towards acute PCM. Most pregnancies occurred during PCM treatment (n = 11, 61.1%), which led to challenges in the therapeutic management. Maternal-fetal complications occurred in some of these cases, including vaginal bleeding (n = 1), preeclampsia (n = 1), prematurity (n = 2), low birth weight (n = 4), and fetal deaths (n = 2). PCM during pregnancy presents a significant public health concern in the context of the emergence of acute PCM in urban areas.
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spelling pubmed-105220262023-09-27 Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil Benko, Lorena Macedo Pestana Vieira da Silva, Mariana Evangelista de Souza Falcão, Eduardo Mastrangelo Marinho Freitas, Dayvison Francis Saraiva Calvet, Guilherme Amaral Almeida, Marcos de Abreu Almeida-Paes, Rodrigo Zancopé-Oliveira, Rosely Maria do Valle, Antonio Carlos Francesconi de Macedo, Priscila Marques PLoS Negl Trop Dis Research Article The occurrence of acute paracoccidioidomycosis (PCM) in urban areas of the Rio de Janeiro state, Brazil, has emerged in recent years. Therefore, young populations, including pregnant women, are at a higher risk of infection. Furthermore, young women undergoing itraconazole treatment for PCM have increased chances to get pregnant because this medication may reduce the effectiveness of contraceptives. Acute PCM is invasive, reaching abdominal organs, posing a maternal-fetal risk. PCM treatment in pregnant women is also challenging due to the teratogenicity associated with the currently available oral drugs. There are scarce studies on PCM and pregnancy, mainly consisting of case reports and experimental murine models that highlight the severity of this association. We conducted a database research at a PCM reference center in Rio de Janeiro state from 1980 to 2020. We included patients diagnosed with PCM who were pregnant shortly before, at admission, or at any moment of their PCM follow-up care. Data related to pregnancy, childbirth, and the newborn were obtained from the Brazilian official public databases. We also reviewed the epidemiological and clinical features of these patients. During the study period, we identified 18 pregnant patients, with a median age of 26 years (range: 16–38). Among these cases, six (33.3%) were detected in the last 5 years, and 14 (77.8%) presented acute PCM, supporting the recent shift in the epidemiological profile towards acute PCM. Most pregnancies occurred during PCM treatment (n = 11, 61.1%), which led to challenges in the therapeutic management. Maternal-fetal complications occurred in some of these cases, including vaginal bleeding (n = 1), preeclampsia (n = 1), prematurity (n = 2), low birth weight (n = 4), and fetal deaths (n = 2). PCM during pregnancy presents a significant public health concern in the context of the emergence of acute PCM in urban areas. Public Library of Science 2023-09-14 /pmc/articles/PMC10522026/ /pubmed/37708219 http://dx.doi.org/10.1371/journal.pntd.0011645 Text en © 2023 Benko et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Benko, Lorena Macedo Pestana
Vieira da Silva, Mariana Evangelista de Souza
Falcão, Eduardo Mastrangelo Marinho
Freitas, Dayvison Francis Saraiva
Calvet, Guilherme Amaral
Almeida, Marcos de Abreu
Almeida-Paes, Rodrigo
Zancopé-Oliveira, Rosely Maria
do Valle, Antonio Carlos Francesconi
de Macedo, Priscila Marques
Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil
title Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil
title_full Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil
title_fullStr Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil
title_full_unstemmed Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil
title_short Paracoccidioidomycosis and pregnancy: A 40-year single-center cohort study in the endemic area of Rio de Janeiro, Brazil
title_sort paracoccidioidomycosis and pregnancy: a 40-year single-center cohort study in the endemic area of rio de janeiro, brazil
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522026/
https://www.ncbi.nlm.nih.gov/pubmed/37708219
http://dx.doi.org/10.1371/journal.pntd.0011645
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