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Open Access 01-12-2018 | Case report

Intestinal paracoccidioidomycosis resembling Crohn’s disease in a teenager: a case report

Authors: Elizete Aparecida Lomazi, Leandro Minatel Vidal de Negreiros, Pedro Vitor Veiga Silva Magalhães, Raquel de Castro Siqueira Togni, Nielce Maria de Paiva, Antonio Fernando Ribeiro, Raquel Franco Leal

Published in: Journal of Medical Case Reports | Issue 1/2018

Abstract

Background

Differential diagnosis of inflammatory bowel disease is often very challenging. Paracoccidioidomycosis is a fungal disease that can mimic manifestations of Crohn’s disease.

Case presentation

We report a case of a 13-year-old Caucasian boy with abdominal pain for 1.5 years associated with nausea, diarrhea, and weight loss of 10 kg. He presented increased C-reactive protein and an increased erythrocyte sedimentation rate. A colonoscopy showed deep serpiginous ulcers throughout his entire colon and rectum, which suggested Crohn’s disease. He received one dose of infliximab, which is an anti-tumor necrosis factor-α, and showed no improvement. After the second dose, he got worse and started to have bloody diarrhea. A new colonoscopy was performed and pathological examination revealed ulcerative chronic inflammation with non-caseating granulomas and fungal structures (budding forms) compatible with Paracoccidioides brasiliensis. He underwent intravenously administered and then orally administered trimethoprim-sulfamethoxazole treatment. Due to drug intolerance, he was treated with amphotericin B and itraconazole, then he showed clinical improvement and mucosal healing with good outcome.

Conclusion

Paracoccidioidomycosis must be part of the differential diagnosis of inflammatory bowel diseases in endemic areas and must be excluded before starting immunosuppressive therapy.

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Title: Intestinal paracoccidioidomycosis resembling Crohn’s disease in a teenager: a case report
Authors: Elizete Aparecida Lomazi
Leandro Minatel Vidal de Negreiros
Pedro Vitor Veiga Silva Magalhães
Raquel de Castro Siqueira Togni
Nielce Maria de Paiva
Antonio Fernando Ribeiro
Raquel Franco Leal
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2018
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-018-1641-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Intestinal paracoccidioidomycosis resembling Crohn’s disease in a teenager: a case report

Abstract

Background

Case presentation

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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