Predictor for pulmonary sequelae in paracoccidioidomycosis patients

• Grant number: 23/00257-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: April 01, 2023
• End date: March 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Ricardo de Souza Cavalcante
• Grantee: Beatriz Tokoy
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Paracoccidioidomycosis (PCM) is a granulomatous disease, caused by a fungus of the genus Paracoccidiodes spp, endemic in Latin America, in which Brazil is the country with the highest number of cases. Its main clinical form is the chronic one, which is characterized by high prevalence of pulmonary involvement, above 90%. In spite of effective antifungal treatment, many patients develop pulmonary sequelae, characterized by fibrosis and emphysema, regarded as the residual form of this disease. It is known that patients with sequelae can develop complications such as recurrent pneumonia, pulmonary hypertension, heart failure and death. They are also responsible for increasing the patients' social vulnerability, who are unable to return to work, and, many, are unable to receive pension aid.There are many gaps about the knowledge of these sequelae, including their triggering factors. This project's aims to evaluate the factors associated with the development of pulmonary sequelae in patients with PCM. For this, a non concurrent cohort study will be carried out, in which patients with the chronic form of PCM and pulmonary involvment will be evaluate, will be followed up at the infectology service of Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP, and who have completed the antifungal treatment. They will be submitted to high-resolution chest computed tomography and pulmonary function testing. This assesment will allow knowing the prevalence of sequelae and their intensity. According to the intensity parameters, patients will be classified in case, for those with severe sequelae, and non-case for those with minimal or absent sequelae, to identify the factors present at the time of diagnosis and during the therapy associated with the occurrence of this pulmonary involvement.