Case report of a preschool with Generalized Lymph Node Enlargement and diagnosis of Paracoccidioidomycosis

Abstract

Objective: To describe the case of a preschool with suspected paracoccidioidomycosis diagnosed with generalized lymph node enlargement admitted to a teaching hospital in the interior of Rio de Janeiro. Case details: Preschooler, 4 years and 2 months old, started with low fever for three weeks, was treated with Ceftriaxone for fever without focus, but evolved with cervical lymph node enlargement and was hospitalized for investigation of the condition. The patient was discharged from the hospital with a positive mononucleosis test and afebrile. Five days later, the patient started with a high fever and was referred for the completion of the diagnostic investigation. With the available tests, they made a diagnosis of Paracoccidioidomycosis, initiating drug treatment with Amphotericin B Deoxycholate, with regression of the lymph nodes. The patient was discharged from the hospital, prescribed oral Itraconazole for nine to eighteen months, and referred for follow-up at a pediatric outpatient clinic. Final considerations: Paracoccidioidomycosis is a systemic disease, where all organs can be affected, with frequent lymphatic involvement, progressing to generalized lymph node enlargement. Although it is an inflammatory disease, with a satisfactory response to antifungal therapy, it is observed that the disease represents an important public health problem due to its high disabling potential, evolving to severe sequelae or even death if the diagnosis is delayed or the treatment is inadequate.