Paracoccidioidomycosis

Paracoccidioidomycosis
Other namesSouth American blastomycosis, Brazilian blastomycosis, Lutz-Splendore-de Almeida disease,
Paracoccidioides histopathology
SpecialtyInfectious disease
SymptomsFever, sepsis, weight loss, large glands, large liver and spleen, mouth ulcers, skin lesions.
TypesMucocutaneous, lymphatic, multi-organ
CausesParacoccidioides brasiliensis
Diagnostic methodSampling of blood, sputum, or skin
Differential diagnosisTuberculosis, leukaemia, lymphoma
TreatmentAntifungal medication
MedicationItraconazole, amphotericin B, trimethoprim/sulfamethoxazole
Deaths200 deaths per year in Brazil

Paracoccidioidomycosis (PCM), also known as South American blastomycosis, is a fungal infection that can occur as a mouth and skin type, lymphangitic type, multi-organ involvement type (particularly lungs), or mixed type. If there are mouth ulcers or skin lesions, the disease is likely to be widespread. There may be no symptoms, or it may present with fever, sepsis, weight loss, large glands, or a large liver and spleen.

The cause is fungi in the genus Paracoccidioides, including Paracoccidioides brasiliensis and Paracoccidioides lutzii, acquired by breathing in fungal spores.

Diagnosis is by sampling of blood, sputum, or skin. The disease can appear similar to tuberculosis, leukaemia, and lymphoma. Treatment is with antifungals, such as itraconazole. For severe disease, treatment is with amphotericin B followed by itraconazole, or trimethoprim/sulfamethoxazole as an alternative.

It is endemic to Central and South America, and is considered a type of neglected tropical disease. In Brazil, the disease causes around 200 deaths per year.