Relato de Caso: Coinfecção Histoplasmose e Paracoccidioidomicose disseminadas em idoso com AIDS avançada

Abstract

Fungal infections affect 1 billion people worldwide (1/8 of the world's population) according to the Global Action Fund for Fungal Infections (GAFFI). Since Brazil, especially the Central-West region, is an area of high incidence for endemic mycoses. It is important to discuss the association and presentation of these mycoses in patients immunosuppressed by AIDS, in order to raise awareness of suspicion and early diagnosis. Thus, our report intends to describe a case of co-infection of Histoplasmosis and Paracoccidioidomycosis, in a disseminated and septic presentation with a practically accidental diagnosis, in an elderly patient with advanced AIDS, who was treated at the Dr. Anuar Auad State Hospital for Tropical Diseases. Highlighting the hyper-endemicity of these mycoses, the need for more effective diagnostic and therapeutic resources, as well as reviewing the flow and solvability of the current care network for PLWHA in the State of Goiás. This study was developed based on clinical- epidemiological findings found in the aforementioned patient's medical records, as well as laboratory results issued by the Dr. Giovanni Cysneiros State Public Health Laboratory (LACEN-GO) and the Laboratory Testing Control System of the National CD4+/CD8+ Lymphocyte Count and Viral Load Network of HIV (SISCEL) of the Ministry of Health. This work complied with the criteria of Resolution 466/12 of the National Health Council (CNS), with authorization being signed by the person responsible for the patient through the Free and Informed Consent Form (ICF). ). Furthermore, the aforementioned work was submitted to Plataforma Brasil, with CAAE: 62904622.1.0000.0034, opinion n. 5,926,978, dated 03/06/2023, by the Research Ethics Committee of the State Hospital for Tropical Diseases Dr. Anuar Auad (HDT), with the aim of using participant data in this study. This case of HD and PCM co-infection in PLWHA is unprecedented in the scientific community. The importance of HIV prevention and testing campaigns is highlighted, especially aimed at the older population. Furthermore, it is necessary to implement public policies that add technology and improve access to less toxic and more effective diagnostic tests and medications (Ex. L-AmB) for the treatment of AIDS, Histoplasmosis and PCM, since early intervention is essential to reduce mortality in these patients.