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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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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. |
format | Online Article Text |
id | pubmed-10522026 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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