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Paracoccidioidomycosis - Pulmonary
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Paracoccidioidomycosis - Pulmonary

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Contributors: Susan Voci MD, Sumanth Rajagopal MD, William Bonnez MD
Other Resources UpToDate PubMed

Synopsis

Paracoccidioidomycosis is a chronic fungal infection caused by the dimorphic fungus Paracoccidioides brasiliensis.

It is most commonly found in males living in rural and agricultural areas of Central and South America, especially Mexico and 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. 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, CNS (brain lesions [abscess, granuloma, nodule, or cyst] or less commonly meningitis), and bones.

The clinical presentation includes chronic cough, purulent sputum, chest pain, weight loss, weakness, malaise, dyspnea, and fever. Cutaneous manifestations typically consist of verrucous lesions on the face, particularly around the mouth and nose, and the lower limbs. Oral lesions can be seen on the lips, gingiva, tongue, and palate and tend to be granulomatous or ulcerative. Microstomia can occur. Regardless of organ system involvement, fibroids result upon healing, causing dyspnea cardiopulmonary restriction.

The clinical course is usually chronic and progressive over months to years; 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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Last Updated: 11/03/2014
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Paracoccidioidomycosis - Pulmonary
See also in: Overview
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View all Images (7)
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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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