Universidade estadual de maringá



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Palavras-chave: Paracoccidioidomicose. Tuberculose. Western blot. Diagnóstico diferencial. Erro diagnóstico.
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(Título: Times 14 justificado)

Differential laboratory diagnosis between tuberculosis and paracoccidioidomycosis


(Times 12 centralizado negrito e itálico)

ABSTRACT

Paracoccidioidomycosis (PCM) and tuberculosis (TB) are serious and fatal diseases with important respiratory symptoms; however only TB is routinely investigated. The aim of this study was determine the PCM prevalence in pulmonary symptomatic patients living in Maringá and improve the laboratory diagnosis of PCM. Sputum and blood samples of patients attended at Laboratório de Ensino e Pesquisa em Análises Clínicas – LEPAC/UEM for TB diagnosis were analyzed. The following techniques were performed for all patients: 1) Acid fast smear and culture for mycobacteria; 2) direct mycological exam and special stain Gomori-Grocott methenamine silver to investigate the presence of Paracoccidioides brasiliensis; 3) three serologic techniques for PCM ( Immunodifusion, ELISA and Western blot -WB). The results were shown in two papers. In first, “Paracoccidioidomycosis and tuberculosis: misdiagnosis still persists” is a paracoccidioidomycosis case report of a patient that had symptoms during fifteen years, in spite of never have had a positive Acid fast smear, he received twice empirical treatment for TB with no success. The correct diagnosis occurred only with this study, and attracts attention to the importance to run a parallel investigation between TB and PCM. As a second paper “Western blot (WB) contribution in differential diagnosis between paracoccidioidomycosis and pulmonary tuberculosis”, is a preliminary study showing the contribution of the WB in the differential diagnosis between these diseases. It was proposed a cut-off to minimize cross reaction between both diseases, showing WB with a potential tool to be included in clinical laboratories.



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