Publications by authors named "David Afonso-Joao"

Pithomyces, a dematiaceous fungus, is a common colonizer of dead leaves and stems of many different plants and is associated with facial eczema in some animals. We report a case of invasive fungal pulmonary disease by Pithomyces chartarum in a healthy, nonimmunocompromised patient. We aim to demonstrate our diagnostic and therapeutic approach and focus on the major challenges arising from the lack of scientific evidence regarding infection by this fungus in humans.

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Metaplastic breast carcinoma (MBC) is a rare and aggressive histologic subtype of cancer. Because of its rarity and heterogeneity, the management of these patients is challenging. Here, we present the case of a rapidly progressive MBC with mesenchymal differentiation in a 37-year-old female, treated with trimodal therapy consisting of neoadjuvant chemotherapy with paclitaxel and carboplatin, followed by dose-dense cyclophosphamide and doxorubicin (ddAC), modified radical left mastectomy, and adjuvant radiotherapy.

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Background: The late adverse effects of radiotherapy are caused by microvascular injury or depletion of differentiated cells.

Methods: Here we describe a clinical case of a late and unusual complication related to radiotherapy, in a patient with a history of squamous cell carcinoma of the anal canal.

Results: The patient presented with a large perianal vegetating lesion suspicious of local recurrence, however the biopsy of the lesion did not show malignancy.

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Background: Patients with a penicillin allergy label tend to have worse clinical outcomes and increased healthcare use. Drug provocation tests (DPT) are the gold-standard in the diagnostic workup of penicillin allergy, but safety concerns may hinder their performance. We aimed to assess the frequency of severe reactions following a DPT in patients with reported allergy to penicillins or other β-lactams.

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