Systemic Paracoccidioidomycosis in a Patient With Enzymatic Myeloperoxidase Deficiency and Acute Lymphoblastic Leukemia: Case Report

Author:

Hoyos Sebastian1ORCID,Quintero Cristián Camilo Agudelo2,Lozano Diana Mercedes3,Naranjo Luis Eduardo Buitrago4

Affiliation:

1. Clínica Somer: Clinica Somer

2. Universidad de Antioquia Facultad de Medicina

3. Clinica Somer

4. Hospital Pablo Tobon Uribe

Abstract

Abstract Background: Paracoccidioidomycosis is a systemic fungal infection that is potentially fatal, and the most prevalent of its kind in Latin America. The predisposition to infection appears to be related to abnormalities in cellular immunity, given its low prevalence in endemic regions. The role of myeloperoxidase deficiency has not been elucidated. Case presentation: We present a case of 48-year-old female patient with acute lymphoblastic leukemia, stem cell transplant candidate, who developed a fever with lymphadenopathy and lung nodules, consistent with paracoccidioidomycosis infection, in whom a myeloperoxidase deficiency was later discovered. The treatment of the hematologic malignancy had a good impact solving the enzymatic deficiency and antifungal therapy achieve controlling the infection. Conclusions: This case lays out the possible association between acute leukemia, an alteration in neutrophil function (needed to fight fungal infections) and an infection due to Paracoccidioides brasiliensis.

Publisher

Research Square Platform LLC

Reference9 articles.

1. Pahwa R, Modi P, Jialal I Myeloperoxidase Deficiency. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Jun 14]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470278/

2. Myeloperoxidase: Mechanisms, reactions and inhibition as a therapeutic strategy in inflammatory diseases;Davies MJ;Pharmacol Ther,2021

3. Trujillo AB (2020) Paracoccidioidomicosis. Micol Médica Básica 6e [Internet]. New York, NY: McGraw-Hill Education; [cited 2022 Jun 20]. Available from: accessmedicina.up.elogim.com/content.aspx?aid = 1177463781

4. Restrepo-Moreno Á, Tobón-Orozco ÁM, González-Marín Á (2021) Paracoccidioidomicosis. In: Bennett M John E, Dolin M Raphael, Blaser M Martin J, editors. Mand Douglas Bennett Enfermedades Infecc Princ Práctica [Internet]. Novena edición. p. 3211–21. Available from: https://www.clinicalkey.es/#!/content/3-s2.0-B9788491134992002678

5. Human neutrophils susceptibility to Paracoccidioides brasiliensis: an ultrastructural and cytochemical assay;Fernanda Reis Gavazzoni Dias M;Med Mycol,2008

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