{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T04:55:45Z","timestamp":1773982545690,"version":"3.50.1"},"reference-count":30,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Inst. Med. trop. S. Paulo"],"published-print":{"date-parts":[[2004,6]]},"abstract":"<jats:p>From February, 1981 to May, 2001, 63 children under 15 y old (ages 2 - 15 y, median = 8 y, mean \u00b1 1 SD = 8 \u00b1 3 y) presenting 70 episodes of Paracoccidioidomycosis were admitted. The main clinical manifestations and laboratory features observed upon admission were: lymph node enlargement (87.1%), fever (75.7%), weakness (48.6%), pallor (41.4%), hepatomegaly (40%), splenomegaly (35.7%), anemia (90%), hypergammaglobulinemia (88.5%), eosinophilia (75.5%) and hypoalbuminemia (72.5%). Moderate to severe malnutrition was detected in 35.7% of the episodes (Gomez's criterion). Radiographic and technetium studies showed bone lesions in 20 of the episodes, most of them being multiple lytic lesions, involving both long (70%) and plain bones (30%). First line treatment consisted of an association of sulfametoxazole-trimethoprin, which was used, exclusively, in 50 episodes. Follow-up of hemoglobin levels, number of eosinophils in the peripheral blood, albumin and gammaglobulin serum levels revealed significant sequential improvement one and six months after hospital admission, being quite useful to evaluate treatment effectiveness. Six patients died (9.3%) and four developed sequelae (6.3%) . In conclusion, the juvenile and disseminated forms can be observed in about 70% of the episodes of PCM occurring in children younger than 15 y old, most of them presenting with a febrile lymphoproliferative syndrome associated to anemia, eosinophilia and hypergammaglobulinemia.<\/jats:p>","DOI":"10.1590\/s0036-46652004000300002","type":"journal-article","created":{"date-parts":[[2005,4,27]],"date-time":"2005-04-27T13:33:04Z","timestamp":1114608784000},"page":"127-131","source":"Crossref","is-referenced-by-count":70,"title":["Paracoccidioidomycosis in children: clinical presentation, follow-up and outcome"],"prefix":"10.1590","volume":"46","author":[{"given":"Ricardo Mendes","family":"Pereira","sequence":"first","affiliation":[{"name":"Universidade Estadual de Campinas, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e1bio","family":"Bucaretchi","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliana de Melo","family":"Barison","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Hessel","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia Teresinha","family":"Tresoldi","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1007\/BF00234089","article-title":"Imported paracoccidioidomycosis: a public health problem in non-endemic areas","volume":"1","author":"AJELLO L.","year":"1985","journal-title":"Europ. J. Epidem."},{"key":"ref2","first-page":"269","article-title":"Paracoccidioidomicose na crian\u00e7a","volume":"21","author":"BARBOSA G.L.","year":"1992","journal-title":"Rev. Pat. trop."},{"key":"ref3","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/00006454-199406000-00009","article-title":"Severe acute paracoccidioidomycosis in children","volume":"13","author":"BENARD G.","year":"1994","journal-title":"Pediat. infect Dis. J."},{"key":"ref4","doi-asserted-by":"crossref","first-page":"390","DOI":"10.4269\/ajtmh.1999.61.390","article-title":"Endemic regions of paracoccidioidomycosis in Brazil: a clinical and epidemiologic study of 584 cases in the southeast region","volume":"61","author":"BLOTTA M.H.S.L","year":"1999","journal-title":"Amer. J. trop. Med. Hyg.","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9637","issn-type":"print"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1128\/CMR.6.2.89","article-title":"Paracoccidioidomycosis: an update","volume":"6","author":"BRUMMER E.","year":"1993","journal-title":"Clin. Microbiol. Rev."},{"key":"ref6","first-page":"194","article-title":"Particularidades cl\u00ednicas da paracoccidioidomicose na crian\u00e7a","volume":"31","author":"CASTRO R.M.","year":"1976","journal-title":"Rev. Hosp. Cl\u00edn. Fac. Med. S. Paulo","ISSN":"https:\/\/id.crossref.org\/issn\/0041-8781","issn-type":"print"},{"key":"ref7","first-page":"198","article-title":"Obstructive jaundice caused by blastomycosis of the lymph nodes around the common bile duct","volume":"25","author":"CHAIB E.","year":"1988","journal-title":"Arq. Gastroent."},{"key":"ref8","first-page":"97","article-title":"Hipotesis sobre el nicho ecol\u00f3gico da Paracoccidioides brasiliensis","volume":"5","author":"CONTI-DIAZ A.","year":"1989","journal-title":"Rev. med. Urug."},{"key":"ref9","first-page":"226","article-title":"Paracoccidioidomicose na crian\u00e7a: relato de dois casos","volume":"60","author":"FARHAT C.K.","year":"1986","journal-title":"J. Pediat."},{"key":"ref10","series-title":". Paracoccidioidomicose. Blastomicose Sul Americana","first-page":"265","volume-title":"Exames complementares","author":"FIORILLO A.M.","year":"1982"},{"key":"ref11","first-page":"31","article-title":"Paracoccidioidomycosis in children in Bel\u00e9m, Par\u00e1 State, Brazil","volume":"32","author":"FONSECA E.R.S.","year":"1999","journal-title":"Rev. Soc. bras. Med. trop.","ISSN":"https:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref12","first-page":"543","article-title":"Desnutrici\u00f3n","volume":"3","author":"GOMEZ F.","year":"1946","journal-title":"Bol. m\u00e9d. Hosp. infant."},{"key":"ref13","first-page":"428","article-title":"La epidemiologia de la paracoccidioidomicosis","volume":"83","author":"GREER D. L.","year":"1977","journal-title":"Bol. Ofic. sanit. panamer.","ISSN":"https:\/\/id.crossref.org\/issn\/0030-0632","issn-type":"print"},{"key":"ref14","first-page":"1","article-title":"NCHS Growth curves for children birth-18 years","volume":"11(165","author":"HAMILL P.V.","year":"1977","journal-title":"United States. Vital Hlth. Statist."},{"key":"ref15","first-page":"92","article-title":"Paracoccidioidomicose na crian\u00e7a: aspectos cl\u00ednicos e laboratoriais em 25 casos","volume":"63","author":"HILDEBRAND T.M","year":"1987","journal-title":"J. Pediat."},{"key":"ref16","first-page":"128","article-title":"Paracoccidioidomycosis in Brazilian children: a critical review (1911 - 1994)","volume":"4","author":"LONDERO A.T.","year":"1997","journal-title":"Arq. bras. Pediat."},{"key":"ref17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/BF00436946","article-title":"Paracoccidioidomycosis in childhood","volume":"82","author":"LONDERO A.T.","year":"1983","journal-title":"A critical review. Mycopathologia"},{"key":"ref18","first-page":"87","article-title":"Aspectos epidemiol\u00f3gicos da paracoccidioidomicose na \u00e1rea end\u00eamica de Botucatu (S\u00e3o Paulo, Brasil)","volume":"25","author":"MARQUES S.A","year":"1983","journal-title":"Rev. Inst. Med. trop. S. Paulo","ISSN":"https:\/\/id.crossref.org\/issn\/0036-4665","issn-type":"print"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1590\/S0365-05962003000200002","article-title":"Paracoccidioidomicose: atualiza\u00e7\u00e3o epidemiol\u00f3gica, cl\u00ednica e terap\u00eautica","volume":"78","author":"MARQUES S.A.","year":"2003","journal-title":"An. bras. Derm.","ISSN":"https:\/\/id.crossref.org\/issn\/0365-0596","issn-type":"print"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1093\/ajcn\/34.1.68","article-title":"Development in impaired cell-mediated immunity in mild to moderate malnutrition","volume":"34","author":"McMURRAY D.N.","year":"1981","journal-title":"Amer. J. clin. Nutr."},{"key":"ref21","series-title":"Paracoccidioidomycosis","first-page":"373","volume-title":"Treatment and control of cure","author":"MENDES R.P.","year":"1994"},{"key":"ref22","first-page":"97","article-title":"Caracter\u00edsticas de la paracoccidioidomicosis infantil: informe de cuatro casos","volume":"10","author":"OCHOA M.T.","year":"1991","journal-title":"Medicina U.P.B.","ISSN":"https:\/\/id.crossref.org\/issn\/0120-4874","issn-type":"print"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1590\/S0037-86822003000400004","article-title":"Paracoccidioidomicose: estudo cl\u00ednico e epidemiol\u00f3gico de 422 casos observados no Estado de Mato Grosso do Sul","volume":"36","author":"PANIAGO A.M.M.","year":"2003","journal-title":"Rev. Soc. bras. Med. trop.","ISSN":"https:\/\/id.crossref.org\/issn\/0037-8682","issn-type":"print"},{"key":"ref24","series-title":"Infectologia pedi\u00e1trica","first-page":"524","volume-title":"Paracoccidioidomicose","author":"REIS J.A.","year":"1999"},{"key":"ref25","series-title":"Textbook of pediatric infectious diseases","first-page":"1928","volume-title":"Paracoccidioidomycosis","author":"RESTREPO A.","year":"1992"},{"key":"ref26","series-title":"Principles and practice of infectious diseases","first-page":"2768","volume-title":"Paracoccidioides brasiliensis","author":"RESTREPO A.","year":"2000"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1128\/AAC.18.1.190","article-title":"In vitro susceptibility testing of Paracoccidioides brasiliensis to sulfonamides","volume":"18","author":"RESTREPO A.","year":"1980","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref28","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1590\/S0036-46651985000600007","article-title":"Paracoccidioidomycosis in children with different skeletal involvement","volume":"27","author":"ROS\u00c1RIO FILHO N.A.","year":"1985","journal-title":"Rev. Inst. Med. trop. S. Paulo","ISSN":"https:\/\/id.crossref.org\/issn\/0036-4665","issn-type":"print"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S0140-6736(71)90267-4","article-title":"Thymolymphatic deficiency and depression of cell mediated immunity in protein-calorie malnutrition","volume":"2","author":"SMYTHE P.M.","year":"1971","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1128\/AAC.21.5.852","article-title":"Synergistic interaction of trimethoprin and sulfamethoxazole on Paracoccidioides brasiliensis","volume":"21","author":"STEVENS D.A.","year":"1982","journal-title":"Antimicrob. Agents Chemother."}],"container-title":["Revista do Instituto de Medicina Tropical de S\u00e3o Paulo"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/rimtsp\/v46n3\/20716.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,2,15]],"date-time":"2019-02-15T15:40:43Z","timestamp":1550245243000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0036-46652004000300002&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,6]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2004,6]]}},"alternative-id":["S0036-46652004000300002"],"URL":"https:\/\/doi.org\/10.1590\/s0036-46652004000300002","relation":{},"ISSN":["0036-4665"],"issn-type":[{"value":"0036-4665","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,6]]}}}