Paracoccidiomycosis

Question 1

What’s the most common causaative agent for paracoccidioidomycosis?

Answer 1

Paracoccidioides brasiliensis

Question 2

How is paracoccidioidomycosis diagnosed?

Answer 2

• KOH preparation on wet mount shows characterisitic yeast form
• Culture is difficult and takes 20-30 days

Question 3

What is the geographic distribtuion of paracoccidiodomycosis ?

Answer 3

Central and South America

Question 4

What are clinical clues to the chronic (adult) form of paracoccidioidomycosis?

Answer 4

Chronic (adult) paracoccidiodomycosis
* Endemic area of tropical central/south America
* Middle-aged men in rural areas
* Slowly developing pulmonary symptoms
* Mucocutaneous lesions on face, nasal & oral cavities
* May be misdiagnosed as TB and not respond to treatment
* Reticulonodular infiltrates on CXR

Will mimic TB and other fungal infections (e.g. histoplasmosis)

Question 5

What is the treatment for chronic (adult) paracoccidioidomycosis?

Answer 5

• Itraconazole
• May require liposomal amphotericin B for severe disease

Question 6

What is the treatment for acute (juvenile) paracoccidioidomycosis?

Answer 6

• Itraconazole
• May require liposomal amphotericin B for severe disease

Question 7

What are clinical clues of acute (juveline) paracoccidioidomycosis?

Answer 7

Acute (juvenile) paracoccidioidomycosis
* Rarer (<10% of cases)
* Endemic area of Central/South America
* Children and young adults of both sexes (compared to middle-aged men for the chronic form)
* Rapidly progressive after recent exposure
* Systemic disease of reticuloendethelial system disseminated from the lungs to spleen, lymph nodes, bone marrow, liver
* Mimics leukemia/lymphoma and disseminated TB