Avaliação do perfil clínico e epidemiológico de pacientes com paracoccidioidomicose em um hospital público

Abstract

Introduction: Paracoccidioidomycosis (PCM) is a systemic disease resulting from infection caused by a dimorphic fungus that is endemic in the Americas, with the highest incidence in Brazil, Venezuela and Colombia. Contamination occurs by inhaling propagules of the mycelial (saprophytic) phase of the pathogen. The disease has the following clinical forms: acute/subacute, chronic and residual. Objective: To evaluate the clinical and epidemiological profile of patients with Paracoccidioidomycosis in a reference center for infectious diseases in the state of Piauí. Methods: This is a retrospective, quantitative-descriptive study. This study was carried out in a hospital specializing in tropical diseases, located in the municipality of Teresina, in the state of Piauí, which provides care to the population through an agreement with the Unified Health System (SUS). A data collection form was used. We included medical records in which the patients had a final diagnosis of PCM, with a hospitalization date between October 2018 and September 2023. Records whose final diagnosis was not PCM and whose information was not complete were excluded. The study in question was submitted to the Research Ethics Committee of the State University of Piauí - UESPI, where it was approved under the Certificate of Presentation and Ethical Appreciation (CAAE): 71167423.4.0000.5209. Results: A total of 2,488 inpatient records were checked between October 2018 and September 2023. Among the records analyzed, 26 diagnostic hypotheses of PCM were identified, 20 of which were confirmed. The most affected gender was male (100%), aged between 30 and 60 (60%), from rural areas (95%), in the state of Piauí (85%), working as farmers (60%). The disease manifested itself mainly in its chronic form (55%), with the extension of the focal and multifocal lesion being equally prevalent (50%), with an onset time of 3 to 6 months (30%), the presence of secretion (60%), and weight loss (90%) of up to 15 kg (33.4%). Discussion: The clinical and epidemiological profile found in the study was consistent with the descriptions of other studies, with the prevalent clinical forms being acute/subacute and chronic, affecting the most impoverished rural populations. PCM is a disease that continues to be neglected by public health, despite being associated with high rates of morbidity and mortality, and remains in the background of health discussion agendas. Conclusion: The data obtained in this study contributes to a better understanding and perception of the epidemiology of PCM in endemic areas, thus demonstrating the need for public health policies that seek better strategies for the prevention, diagnosis and treatment of PCM. Keywords: Paracoccidioidomycosis. Epidemiology. Clinical aspects.