{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T19:37:31Z","timestamp":1775849851751,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T00:00:00Z","timestamp":1567555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>The acute\u2010subacute form of paracoccidioidomycosis (PCM) is a severe systemic mycosis that affects children and adolescents from endemic regions, leading to generalised lymphadenopathy, fever, weight loss, anaemia, eosinophilia, hypoalbuminemia and hypergammaglobulinemia. The objective of this study is to describe the clinical and laboratorial characteristics of acute\u2010subacute PCM, to determine a mortality risk factor and to propose a test for non\u2010survival hazard related to the disease. Children and adolescents diagnosed with PCM, under 15\u00a0years were included in the study. Their epidemiological, clinical and laboratorial data were obtained from the hospital records. Descriptive analysis, comparison of means, univariate logistic regression, multivariate logistic regression and a ROC curve were performed in order to identify significant information (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). Through a period of 38\u00a0years, 141 children and adolescents were diagnosed with acute\u2010subacute PCM. The main antifungal agent used for the treatment was sulfamethoxazole\u2010trimethoprim (SMX\u2010TMP). The complication rate was 17%, the relapse rate was 7.8% and the mortality rate was 5.7%. A low albumin dosage was identified as a predictor factor for mortality. The cut\u2010off for serum albumin was 2.18\u00a0g\/dL, above which, the survival rate is 99.1%. Thus, simple clinical and laboratorial examinations may lead to the diagnosis of acute\u2010subacute PCM, and the beginning of the treatment is encouraged even before the isolation of the fungus in biological samples, preventing unfavourable outcomes. Patients with an albumin dosage\u00a0\u2264\u00a02.18g\/dL must receive special attention, preferably hospitalised, during the first four weeks of treatment for presenting an elevated mortality hazard.<\/jats:p>","DOI":"10.1111\/myc.12984","type":"journal-article","created":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T20:58:42Z","timestamp":1565729922000},"page":"999-1005","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Acute\u2010subacute paracoccidioidomycosis: A paediatric cohort of 141 patients, exploring clinical characteristics, laboratorial analysis and developing a non\u2010survival predictor"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6400-9926","authenticated-orcid":false,"given":"Mariana Tresoldi das Neves","family":"Romaneli","sequence":"first","affiliation":[{"name":"The State University of Campinas \u2013 Unicamp Campinas SP 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