Paracoccidioidomycosis

Background

  • Fungal infection caused by Paracoccidioides brasiliensis
  • Found in patients who have resided in Mexico, Central America, or South America
  • Primary infection likely occurs via inhalation

Clinical Features

  • Long asymptomatic period after initial infection common
  • HIV+ patients more likley to have extra-pulmonary dissemination and/or rapid progression of disease
  • SOB, cough
  • Weight loss, malaise, fever
  • Lymphadenopathy
    • May ulcerate and form draining sinuses
  • Mucosal ulcerations
  • Cutaneous papules, which may ulcerate and enlarge
  • +/- destructive ulceration of uvula, epiglottis, and/or vocal cords
  • +/- hepatosplenomegaly

Differential Diagnosis

Evaluation

  • Routine labs usually nonspecific
  • CXR- may show interstitial infiltrates
  • Definitive diagnosis made by visualizing yeast cells in tissue sample, sputum sample, or skin scrapings
  • Serologic tests available in some areas of high endemicity

Management

Disposition

See Also

External Links

References

Authors:

Claire