Mário A. P. Moraes; Antônio Emanuel Silva; Alberto Nicolau Raick
RESUMO
E apresentado um caso de adiaspiromícose pulmonar disseminada, em paciente oriundo de Corrente, Estado do Piauí. Trata-se do segundo caso dessa forma clínica diagnosticado no Distrito Federal. As manifestações principais consistiram em febre, calafrios, tosse e dispnéia. Com dez meses da doença, veio o paciente à consulta, motivado por exacerbação dos sintomas ocorrida cerca de dois meses antes. Após toracotomia direita, numerosas lesões nodulares, brancas, miiiares, aparecem disseminadas por toda a superfície exposta do órgão. O exame microscópico de um fragmento do pulmão permitiu reconhecer-se a presença de microabscessos e granulomas, alguns contendo no seu interior estruturas redondas, queforam identificadas como adiaconidios de Chrysosporium parvum var. crescens. O aspecto variado das lesões foi considerado por representar estádios evolutivos diferentes do processo inflamatório, estando a variação ligada a inóculos diversos do fungo, separados no tempo. Admite-se que a exacerbação, referida pelo paciente, resultou de uma nova exposição ao fungo, sugerida pela existência de lesões recentes, de natureza supurativa, entre outras, de aspecto granulomatoso, tidas como mais antigas.
Palavras-chave: Adiaspiromícose. Haplomicose. Emmonsia crescens. Chrysosporium parvum var. crescens.
ABSTRACT
A case of disseminated pulmonary form of adiaspiromycosis is reported This is the second case of the disease found in Brasilia, DF. The patient, a 42-year-old peasant, lived in Corrente – State of Piaui, where he certainly acquired the infection. He was admitted to the Social Security Hospital, in Brasilia, with fever, chills, dry cough and dyspnea. At that time, he had been sick for about ten months and the decision of seeking medical care in Brasilia resulted from an exacerbation of the symptoms that had occurred two months before. At a right thoracotomy for a lung biopsy, disseminated white nodular lesions, a few millimeters in diameter, could be observed on the lung sutface. Microscopically, round structures, 300jim or more in diameter, identified as adiaconidia of Chrysosporium parvum var. crescens were seen in the center ofsome of these lesions. The tissue response to the causative agent consisted of microabscesses, surrounded by cells in palisading arrangement, and granulomas of the mixed and foreign body types. The two kinds of lesions were thought to represent evolutive stages of the inflammatory process, and to be related to different exposures to the conidia, on separated occasions. The suppurative lesions would be recent lesions, started some weeks ora few months before, while the others, in which the granulomatous reaction predominated, were possibly older lesions, with an evolutions of at least several months.
Keywords: Adiaspiromycosis. Haplomycosis. Emmonsia crescens. Chrysosporium parvum var. crescens.
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REFERÊNCIAS BIBLIOGRÁFICAS
1. Carmichael JW. Chrysosporium and some other aleuriosporic hyphomycetes. Canadian Journal of Botany 40: 1137-1173, 1962. [ Links ]
2. Doby-Dubois M, Chevrel ML, Doby JM, Louvet M. Premier cas humain d’adiaspiromycose par Emmonsia crescens, Emmons et Jellison, 1960. Bulletin de la Société de Pathologie Éxotique 57: 240-244, 1964. [ Links ]
3. Emmons CW, Jellison WL. Emmonsia crescens sp. n. and adiaspiromycosis (haplomycosis) in mammals. Annals of the New York Academy of Sciences 89: 91- 101, 1960. [ Links ]
4. Kadousek R, Vortel V, Fingerland A, Vojtek V, Sery Z, Hajek V, Kucera K. Pulmonary adiaspiromycosis in man caused by Emmonsia crescens; report of a unique case. American Journal of Clinical Pathology 56: 394-399, 1971. [ Links ]
5. Moraes MAP, Almeida MC, Raick AN. Caso fatal de adiaspiromicose pulmonar humana. Revista do Instituto de Medicina Tropical de São Paulo 31: 188-194, 1989. [ Links ]
Endereço para correspondência:
Dr. Mário A.P. Moraes.
FS/PTL/ UnB
CP: 15-3031.
70910
Brasília, DF.
Recebido para publicação em 05/09/90.
Facuidade de Ciências da Saúde, Universidade de Brasília, Brasília, DF.
