Paracoccidioidomycosis
| Paracoccidioidomycosis | |
|---|---|
 |
|
| Paracoccidioides brasiliensis | |
| Classification and external resources | |
| Specialty | infectious disease |
| ICD-10 | B41 |
| ICD-9-CM | 116.1 |
| DiseasesDB | 29815 |
| eMedicine | med/1731 |
| MeSH | D010229 |
Paracoccidioidomycosis (PCM) (also known as "Brazilian blastomycosis," "South American blastomycosis,","Lutz-Splendore-de Almeida disease" and "paracoccidioidal granuloma") is a fungal infection caused by the fungus Paracoccidioides brasiliensis. Sometimes called South American blastomycosis, paracoccidioidomycosis is caused by a different fungus than that which causes blastomycosis.
P. brasiliensis is a thermally dimorphic fungus distributed in Brazil and South America. The habitat of the infectious agent is not known, but appears to be aquatic. In biopsies, the fungus appears as a polygemulating yeast with a pilot's wheel-like appearance.
Paracoccidioidomycosis is a systemic mycosis caused by the dimorphic fungus Paracoccidioides brasiliensis. Strong evidence indicates this fungus infects the host through the respiratory tract. It frequently involves mucous membranes, lymph nodes, bone, and lungs. Unlike other systemic mycoses, it can cause disease in immunocompetent hosts, although immunosuppression increases the aggressiveness of the fungus. Also uniquely, it rarely causes disease in fertile-age women, probably due to a protective effect of estradiol.
Primary infection is thought to be autolimited and almost asymptomatic as histoplasmosis or coccidioidomycosis (valley fever). In young people, a progressive form of the disease (akin of tuberculous septicemia in tuberculous priminfection) occurs with high prostrating fever, generalized lymphadenopathy, and pulmonary involvement with milliary lesions. This juvenile form has a more severe prognosis even with treatment. The most common form, the so-called adult form of paracoccidioidomycosis, is almost certainly a reactivation of the disease.
Painful lesions with a violaceous hue in lips and oral mucosa are common as is cervical lymphadenitis teeming with polygemulating yeasts in the biopsy. In this form, differential diagnosis must be made with mucocutaneous leishmaniasis, yaws, and TB.
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