Paracoccidioidomycosis

Abstract

Paracoccidioidomycosis is an endemic fungal infection of pulmonary origin that disseminates to different sites, notably oral mucous membranes, adrenal glands, reticuloendothelial system, and skin. The disease tends to run a chronic course with acute cases being rare; outbreaks have not been reported. Four clinical presentations are recognized: subclinical infection, progressive disease that can be either chronic (adult-type), or acute/subacute (juvenile-type), and the residual form. This mycosis is restricted to Latin America, and has a striking male predominance. The etiologic agent is a thermally dimorphic fungus, Paracoccidioides brasiliensis, which at 35-37°C assumes a yeast form characterized by a mother cell surrounded by multiple blastoconidia resembling a pilot's wheel. At lower temperatures the fungus grows as a mould that gives rise to conidia. The organism's microniche in nature has not yet been precisely defined. The disease can be successfully treated, but fibrotic sequelae are common.