Oral paracoccidioidomycosis: a retrospective study of 95 cases from a single center and literature review

Abstract

Background The ecoepidemiological panorama of paracoccidioidomycosis (PCM) is dynamic and still ongoing in Brazil. In particular, data about the oral lesions of PCM are barely explored. The aim of this study was to report the clinicopathological features of individuals diagnosed with oral PCM lesions at an oral and maxillofacial pathology service in Rio de Janeiro, Brazil, in the light of a literature review. Material and Methods A retrospective study was conducted on oral biopsies obtained from 1958 to 2021. Additionally, electronic searches were conducted in PubMed, Embase, Scopus, Web of Science, Latin American and Caribbean Center on Health Sciences Information, and Brazilian Library of Dentistry to gather information from large case series of oral PCM. Results Ninety-five cases of oral PCM were surveyed. The manifestations were more frequent among males ( n =86/90.5%), middle-aged/older adults ( n =54/58.7%), and white individuals ( n =40/51.9%). The most commonly affected sites were the gingiva/alveolar ridge ( n =40/23.4%) and lip/labial commissure ( n =33/19.3%); however, one ( n =40/42.1%) or multiple sites ( n =55/57.9%) could also be affected. In 90 (94.7%) patients, “mulberry-like” ulcerations/moriform appearance were observed. Data from 21 studies (1,333 cases), mostly Brazilian (90.5%), revealed that men (92.4%; male/female: 11.8:1) and individuals in the fifth and sixth decades of life were the most affected (range: 7-89 years), with the gingiva/alveolar ridge, palate, and lips/labial commissure being the sites most frequently affected. Conclusions The features of oral PCM lesions are similar to those reported in previous studies from Latin America. Clinicians should be aware of the oral manifestations of PCM, with emphasis on the clinicodemographic aspects and differential diagnoses, especially considering the phenomenon of the emergence of reported cases in rural and/or urban areas of Brazil. Key words: Fungal infection, mycoses, neglected diseases, oral manifestations, oral medicine, oral mucosa, paracoccidioidomycosis, south american blastomycosis.

Oral and oropharyngeal mucosal lesions: clinical-epidemiological study of patients attended at a reference center for infectious diseases

“…The oral cavity/oropharynx are commonly affected in PCM. 61 , 62 The PCM OOPML frequency in our study was proportionally higher than that of other studies when considering the duration of the studies, 51 , 62 including that observed in a study carried out in a region with high PCM prevalence. 63 This higher prevalence is likely owing to the fact that our service is a reference center for infectious diseases and conducts the systematic otorhinolaryngological examination of patients referred by other services.…”

Epidemiological aspects and oral implications of Paracoccidioidomycosis infection

“…The epidemiology of oral PCM demonstrates a higher incidence in middle-aged or older male adults [13,14].…”

Paracoccidioidomicose oral

“…No entanto, essa infecção não se limita apenas aos pulmões, pois o fungo pode se disseminar para outros órgãos do corpo, resultando em lesões secundárias e complicações adicionais, inclusive manifestações orais que devem ser notadas pelo cirurgião-dentista numa consulta de rotina. 2 A Paracoccidioidomicose é mais comum em trabalhadores rurais de meia-idade, sendo este o perfil mais comum de pessoas infectadas uma vez que estão frequentemente expostos ao solo onde o fungo reside. A natureza insidiosa dessa infecção torna essencial a conscientização sobre seus sintomas e riscos, bem como a busca por tratamento adequado o mais cedo possível.…”