New Insights on Pulmonary Paracoccidioidomycosis

Abstract

Paracoccidioidomycosis (PCM) is one of the most relevant systemic endemic mycoses in Latin American countries, especially in South American countries, with endemic and hyperendemic areas. The real burden of PCM may be underestimated because of a lack of compulsory case notification. Recent phylogenetic data revealed that Paracoccidioides brasiliensis comprises several cryptic species including P. brasiliensis and P. lutzii. However, the genetic biodiversity of Paracoccidioides does not affect the clinical manifestations or therapeutic response to therapy. Lung involvement is a common finding, especially in patients experiencing the chronic form of the disease, and, because of its similarities with tuberculosis, clinicians must be alert to the possibility of PCM in patients with chronic respiratory manifestations and epidemiological risk factors for this fungal disease.

Epidemiology of paracoccidioidomycosis in Venezuela: a retrospective study from 1954 to 2019

“…The authors described a new species named Paracoccidioides lutzii that is endemic to Midwestern Brazil, with few cases observed in the Southeast and Ecuador. 7 , 8 , 9 However, the finding of cryptic species within P. brasiliensis drove researchers to explore the evolutionary mechanisms that were responsible for the geographic distribution of four other molecular clades that had been previously characterised in it (S1, PS2, PS3, PS4). Recently, Turissini et al 10 performed a study on 65 isolates of P. brasiliensis to compare nuclear and mitochondrial DNA polymorphisms and in vitro phenotypic variation in isolate morphology.…”

Paracoccidioidomycosis Diagnosed in Europe—A Systematic Literature Review

“…A major issue is the clinical similarity to several other infectious and non-infectious diseases [81]. Paracoccidioidomycosis is commonly misdiagnosed as tuberculosis [83]. The clinical picture of tuberculosis resembles the chronic progressive form of paracoccidioidomycosis [9].…”

Paracoccidioidomycosis due to Paracoccidioides lutzii complicated with adrenal injury and pulmonary arterial hypertension

“…The evolution towards the cure of the patient was accompanied by histological alterations evidenced in a bronchoscopic biopsy, culminating in fibrosis that caused structural alterations in the lungs, pulmonary arterial hypertension and functional pulmonary impairment. Pulmonary sequelae and respiratory dysfunction in paracoccidioidomycosis by P. brasiliensis are not uncommon 13 , as well as pulmonary arterial hypertension 14 . The outcome in the described case shows that it can also occur in the disease caused by P. lutzii.…”