LAUSR

Objective The evaluation of therapy response of patients with deep mycosis is a major challenge. The aim of this study was to assess the severity of disease at admission and evaluate treatment response of patients with paracoccidioidomycosis using 67Ga scintigraphy. Subjects and Methods Seventy-three patients with fully active disease were enrolled. A scoring system based on clinicoradiological and serological evaluation and 67Ga scan was devised. Pretherapy 67Ga score of 73 patients was compared with clinicoradiological and serological scores. A subgroup of 23 patients was followed up during treatment, and the rates of improvement of their clinicoradiological, serological, and 67Ga scores during treatment were compared at 3 time points (fully active phase, after clinical improvement, and clinically inactive disease). Results The correlations between scores before therapy were statistically significant. 67Ga score correlated with clinical score (r = 0.47, P < 0.001). Serological score correlated with both 67Ga and clinical scores (r = 0.32, P = 0.006, and r = 0.25, P = 0.034, respectively). Concerning evaluation of therapy response, clinicoradiological, serological, and 67Ga scores decreased significantly after therapy (P < 0.001). Notably, 67Ga score was the single one to become negative in most patients at the end of treatment (20 of 23 patients compared with 7 on clinicoradiological evaluation and 10 on serology, P = 0.003). Conclusions In patients with paracoccidioidomycosis, pretherapy 67Ga scintigraphy correlates with disease severity. Serial 67Ga scans seem to be helpful in evaluating the response to therapy.