RT Book, Section A1 Rose, Stacey R. A1 Hamill, Richard J. A2 Papadakis, Maxine A. A2 McPhee, Stephen J. A2 Rabow, Michael W. A2 McQuaid, Kenneth R. SR Print(0) ID 1184175134 T1 Paracoccidioidomycosis (South American Blastomycosis) T2 Current Medical Diagnosis & Treatment 2022 YR 2022 FD 2022 PB McGraw-Hill Education PP New York, NY SN 9781264269389 LK accessmedicine.mhmedical.com/content.aspx?aid=1184175134 RD 2024/03/29 AB Paracoccidioides brasiliensis and Paracoccidioides lutzii infections have been found only in patients who have resided in South or Central America or Mexico. Long asymptomatic periods enable patients to travel far from the endemic areas before developing clinical problems. An acute form of the disease affects predominately younger patients and involves the mononuclear phagocytic system, resulting in progressive lymphadenopathy. A more chronic form affects mostly adult men and predominately involves the lung as well as the skin, mucous membranes, and lymph nodes. Weight loss, pulmonary complaints, or mucosal ulcerations are the most common symptoms. Extensive coalescent ulcerations may eventually result in destruction of the epiglottis, vocal cords, and uvula. Extension to the lips and face may occur. Lymph node enlargement may follow mucocutaneous lesions, eventually ulcerating and forming draining sinuses; in some patients, it is the presenting symptom. Hepatosplenomegaly may be present as well. HIV-infected patients with paracoccidioidomycosis are more likely to have extrapulmonary dissemination and a more rapid clinical disease course.