Twelve Years of Diagnosis of CNS Mycoses in Oncology Unit: Case Series and Systematic Review
DOI:
10.46551/ruc.v23n2a11Abstract
Objetivo: Elucidar o processo de diagnóstico cirúrgico de Neuromicoses e implicações prognósticas em uma unidade oncológica, entre os anos de 2009 e 2020. Métodos: Trata-se de um estudo retrospectivo em que foram analisados 129 laudos
anatomopatológicos negativos para neoplasia, dos quais quatro casos concluíram etiologia fúngica, sendo três paracoccidioidomicose e um mucormicose. Uma revisão sistemática da literatura foi conduzida para referencial teórico, que levantou 77 casos para comparação. Resultados e Discussão: Os achados apresentados nesse estudo superaram a incidência
mundial documentada de neuroparacoccidioidomicose em mais de 2 vezes. Nessa série, a mucormicose do sistema nervoso central refletiu apresentação típica de doença rinocerebral, com desfecho fatal. Todos os pacientes desse estudo eram HIV negativos, mas provenientes de áreas endêmicas do Centro-Oeste e Sudeste brasileiros, além de possuírem fatores de risco
para infecções fúngicas invasivas e demonstrarem focos de acometimento extracraniano. Considerações finais: A ausência de investigação sobre o comprometimento em outros órgãos, bem como a espera por procedimento neurocirúrgico para o diagnóstico estão associadas a prejuízos à terapia adequada e tempo de hospitalização prolongada, que expõe os pacientes a maior risco de infecções nosocomiais. A subnotificação estatística supõe obstáculo importante ao avanço dos estudos em Neuromicoses, por isso é necessário investir em sistemas nacionais de vigilância e transformar as micoses endêmicas em doenças de notificação compulsória.
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