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Fungal Infections
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Uwe Wollina, Pietro Nenoff, Shyam Verma, Uta-Christina Hipler
Clinical presentation: This is a chronic or subacute granulomatous endemic systemic mycosis, caused by Paracoccidioides brasiliensis and Paracoccidioides lutzii in South America. Risk factors include lymphoma, organ transplantation, and HIV infection. P. brasiliensis affects mucous membranes of the mouth and nose, causing ulceration with subsequent spreading through the lymphatic system. Nodular cutaneous lesions occur that can become necrotic or result in subcutaneous cold abscesses (Figure 8.8).
Endemic mycoses: epidemiology and diagnostic strategies
Published in Expert Review of Anti-infective Therapy, 2020
Andrés Tirado-Sánchez, Gloria M. González, Alexandro Bonifaz
This disease often presents an acute course and is caused by dimorphic fungi, Paracoccidioides brasiliensis, and less frequently Paracoccidioides lutzii, both belonging to the order Onygenales [52]. Other cryptic species include P. americana, P. restrepiensis, and P. venezuelensis [53]. PCM is less frequent than HPL; however, it has increased in recent years. PCM is commonly reported in South American countries: Brazil is most frequent; however, it has also been reported in minor proportions in Argentina, Colombia, Paraguay, Ecuador, Peru, Venezuela, and Mexico [54]. The etiological agent is found in acid soil, contaminated with plant detritus (coffee and sugar cane). The climate of fungus predilection is tropical and humid regions. The disease occurs in all age groups, although it predominates among men (farmers and outdoor workers) of the third and fourth decade of life [54,55]. Children are rarely affected [54]. Infection is often asymptomatic; the clinical expression of PCM depends on three factors: inoculum amount, agent virulence, and host immune response, as occurs in HPL [54]. Clinical manifestations may be acute (affecting children and young adults) or chronic (affecting older adults) [56].