infectious diseases
Paracoccidioidomycosis
Introduction
Paracoccidioidomycosis is progressive mycosis of the lungs, skin, mucous membranes, lymph nodes, and internal organs caused byParacoccidioides brasiliensis. Symptoms are skin ulcers, adenitis, and pain due to abdominal organ involvement. Diagnosis is clinical and microscopic, confirmed by culture. Treatment is with azoles (eg,itraconazole),amphotericin B, or sulfonamides. (See also Overview of Fungal Infections .) Paracoccidioidomycosis occurs only in discrete foci in South and Central America, most often in men aged 20 to 50, especially coffee growers of Colombia, Venezuela, and Brazil. Although a relatively unusual opportunistic infection, paracoccidioidomycosis sometimes occurs in patients who are immunocompromised but occurs infrequently in those with AIDS. Although specific environmental sources forParacoccidioides brasiliensisremain undefined, it is presumed to exist in soil as a mold, with infection due to inhalation of conidia (spores produced by the mycelial form of the fungus). Conidia convert to invasive yeasts in the lungs and are assumed to spread to other sites via blood and lymphatics. 