Paracoccidioidomycosis (South American blastomycosis): A report of an imported case previously diagnosed as tuberculosis

Abstract

A case of paracoccidioidomycosis, previously treated for tuberculosis for two years, is reported. Combined treatment with oral ketoconazole and sulfamethoxypyridazine was successful. The problem of a low index of suspicion among physicians for tropical mycoses, which are very rarely observed in Italy, is discussed.

Gingival Involvement in Oral Paracoccidioidomycosis

“…This fact can make early clinical diagnosis difficult because both patient and clinician may easily overlook a short stay in South or Central America that took place more than a decade before the onset of any signs or symptoms. Such circumstances have been documented for several paracoccidioidomycosis cases that were misdiagnosed and where appropriate treatment was delayed 23,26,27 . The current and anticipated future increases in global travel make it ever more likely that clinicians in non‐endemic areas may have to diagnose such cases.…”

Pulmonary Paracoccidioidomycosis and AIDS

“…From this primary complex, fungus can spread to the kidney, spleen, liver, bone, adrenal glands, and brain by lymphatic or blood circulation. 1,3,5,9,11 Paracoccidioides brasiliensis infection is a rare complication in patients with AIDS. In the last 10 years, less than 50 cases have been published in the medical literature.…”

“…1,2 However, several cases of PCM have been reported in Europe and North America, mainly in patients who were from Latin America or those who have traveled there. 3,4 In Brazil, the association between pulmonary PCM and AIDS is particularly important due to the recent progression of this syndrome in the rural areas of the south of the country, where most of the cases of infection by P. brasiliensis are seen. 2 Despite the importance of the pulmonary PCM in Latin America and even in Europe and North America, there are only a few reports of the high-resolution computed tomographic (HRCT) findings of this infection.…”

Imported paracoccidioidomycosis in Spain

“…The reservoir of P. brasiliensis in nature remains unclear today. The disease starts in the lungs by inhaling dust containing the infecting conidia 3,4 . The clinical picture is ranging from asymptomatic infection to acute‐disseminated and severe disease, depending on the load of spores at the moment of infection, the cell wall composition of the spores and the immunity of the host 2,5 …”