Septic shock, hypercalcemia and hemophagocytic syndrome due to paracoccidioidomycosis in a 3-year-old girl

• Autores: Rodríguez-Portilla, Ricardo, Freundt-Thurne, Angela Parra del Riego, Tokumura-Tokumura, Carmen Carolina, Rojas-Soto, Ninoska Julia, Valdés-Gómez, Jorge
• Formato: artículo
• Fecha de Publicación: 2021
• Institución: Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
• Repositorio: Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
• Lenguaje: español
• OAI Identifier: oai:cmhnaaa_ojs_cmhnaaa.cmhnaaa.org.pe:article/1259
• Enlace del recurso: https://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/1259
• Nivel de acceso: acceso abierto
• Materia: Paracoccidioidomicosis; Choque Séptico; Hipercalcemia; Linfohistiocitosis Hemofagocítica; Preescolar; Paracoccidioidomycosis; Shock; Septic; Hypercalcemia; Lymphohistiocytosis; Hemophagocytic; Child; Preschool

Objetive: Report the case of a girl who presented septic shock, hypercalcemia and hemophagocytic syndrome due to paracoccidioidomycosis. Case report: 3-year-old female patient with 2-month illness characterized by fever, lymphadenopathy, weight loss, abdominal distention, and severe anemia. She arrived in poor general condition, developed septic shock and a hemophagocytic syndrome. The hypercalcemia and dermal lesions were striking. A cervical ganglion biopsy and bone marrow aspirate were performed. In the latter, images compatible with Paracoccidioides were found, which were then confirmed with Grocott's stain. She was treated with amphotericin B and trimethoprim-sulfamethoxazole. The evolution was favorable and serum calcium came back to normal ranges. Conclusion: Complications caused by paracoccidioidomycosis are rare; however, the epidemiological history and bone marrow aspirate should guide the diagnosis and allow prompt treatment.