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Clinical manifestations and diagnosis of chronic paracoccidioidomycosis

Marcio Nucci, MD
Arnaldo L Colombo, MD
Section Editor
Carol A Kauffman, MD
Deputy Editor
Jennifer Mitty, MD, MPH


Paracoccidioidomycosis is a systemic endemic mycotic disease caused by the thermally dimorphic fungi of the genus Paracoccidioides. Two species are recognized to cause paracoccidioidomycosis: Paracoccidioides brasiliensis and Paracoccidioides lutzii. The fungus has a geographic distribution limited to Central and South America, where paracoccidioidomycosis is the most frequent systemic endemic mycosis.

The clinical manifestations and diagnosis of chronic paracoccidioidomycosis will be reviewed here. The clinical manifestations and diagnosis of acute/subacute paracoccidioidomycosis as well as the mycology, epidemiology, and treatment of paracoccidioidomycosis are discussed separately. (See "Clinical manifestations and diagnosis of acute/subacute paracoccidioidomycosis" and "Mycology and epidemiology of paracoccidioidomycosis" and "Treatment of paracoccidioidomycosis".)


Following inhalation, Paracoccidioides spp typically cause asymptomatic pulmonary infection. If the infection is not contained by the host, the disease may evolve into one of two patterns: the chronic form, which represents reactivation of the primary infection and is most common, or the acute/subacute form [1]. (See "Clinical manifestations and diagnosis of acute/subacute paracoccidioidomycosis".)

Over 90 percent of cases of paracoccidioidomycosis are the chronic form, which may present months or years following the primary infection [2]. It most commonly affects men who work in agriculture, and are between 30 and 60 years of age [3]. (See "Mycology and epidemiology of paracoccidioidomycosis", section on 'Epidemiology'.)

Paracoccidioides spp can disseminate to any part of the body by the hematogenous or lymphatic routes. Thus, as with other systemic endemic fungal infections, any organ can be affected. Signs and symptoms usually progress slowly, and may be related to a single organ or to several organs. (See "Mycology and epidemiology of paracoccidioidomycosis", section on 'Pathogenesis'.)

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Literature review current through: Nov 2017. | This topic last updated: Sep 15, 2016.
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