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Paracoccidioidomycosis
See also in: Pulmonary
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Paracoccidioidomycosis

See also in: Pulmonary
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Contributors: Edith Lederman MD, Noah Craft MD, PhD
Other Resources UpToDate PubMed

Synopsis

Paracoccidioidomycosis, also known as South American blastomycosis, Lutz mycosis, Brazilian blastomycosis, and paracoccidioidal granuloma, is a deep fungal infection caused by the dimorphic fungus Paracoccidioides brasiliensis. It is most commonly found in males living in rural and agricultural areas of Mexico, Central America, and South America, especially Brazil.

The fungus normally is found in soil and is acquired by inhalation. Rarely, it is acquired by direct inoculation into the skin or mucosa from infected plant matter. The disease can manifest in 4 clinical forms: pulmonary, mucocutaneous, lymphatic, and mixed.

Pulmonary infection is the most common and is found in 70%-80% of patients. Disease is localized to the lung in 25% of cases. This is followed by dissemination to the skin and mucosa (around the pharynx, the mouth, and occasionally the anus), lymphatic system (especially cervical nodes), adrenal glands, liver, spleen, central nervous system (brain lesions [abscess, granuloma, nodule, or cyst] or less commonly meningitis), and bones. The clinical course is usually chronic and progressive over months to years, with associated weight loss and chronic cough.

In travelers to endemic areas, the mean time to presentation was 15 years, suggesting a long dormancy before disease presentation.

Codes

ICD10CM:
B41.9 – Paracoccidioidomycosis, unspecified

SNOMEDCT:
59925007 – Paracoccidioidomycosis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The various clinical presentations invoke a great number of diseases to consider in the differential diagnosis.

Mucocutaneous:
Lymphatic:

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 10/02/2017
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Paracoccidioidomycosis
See also in: Pulmonary
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Paracoccidioidomycosis (Adult Form) : Chest pain, Fever, Productive cough, Verrucous scaly plaque, Voice change, Weight loss, Dysphagia, Dyspnea
Clinical image of Paracoccidioidomycosis
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