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Paracoccidioidomycosis +par-u-+k@k-+sid-E-+oid-O-+mI-!kO-sis

by Alan M. Sugar, MD

Paracoccidioidomycosis (South American blastomycosis) is infection caused by the fungus Paracoccidioides brasiliensis.

Paracoccidioidomycosis usually involves the skin, mouth, throat, and lymph nodes, although it sometimes appears in the lungs, liver, or spleen. It is very common in South and Central America but rare in the United States. It infects people after they inhale the spores, which grow in the soil. Men aged 20 to 50 are typically affected.


Infected lymph nodes become swollen and may drain pus, but there is little pain. The lymph nodes most commonly infected are those in the neck and under the arms. Painful ulcers may form in the mouth. If the lungs are affected, people may have a cough and difficulty breathing. The liver and spleen may enlarge.

Symptoms last a long time but are rarely fatal.

Diagnosis and Treatment

To diagnose the infection, a doctor takes tissue samples for examination under a microscope and for culture.

The antifungal drug itraconazole is the treatment of choice. Amphotericin B is also effective, but because of its side effects, it is reserved for very severe cases.

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