Inapparent lung involvement in patients with the subacute juvenile type of paracoccidioidomycosis

Abstract

SUMMARYThree patient s wit h th e diagnosi s of subacute juvenile paracoccidioidomycosis who, a t th e tim e o f thei r firs t visit , ha d n o sign s o r symptom s o f lung involvement , were studied . Initiall y th e diagnosi s was confirme d b y th e observatio n o f P . brasiliensis i n biops y material obtaine d fro m clinicall y involved lymphadenopathies .The lung X-rays don e in all patients, did not revea l pathologic changes, althoug h it wa s possibl e t o observ e an d isolat e th e fungu s fro m sputu m sample s obtaine d from th e thre e patients . Thi s fac t reinforce s th e pulmonar y genesi s o f th e mycosi s and proof s th e existenc e o f a pulmonar y primar y infection , eve n i n patient s wit h the juvenile manifestations , in whom th e lun g componen t i s obscured by th e pred o minant lymp h nod e involvement .

Paracoccidioidomycosis: an update.

“…In this particular form of the disease, the lungs are seldom the primary focus as there are no special clinical or radiologic manifestations (165). Even so, a search for the fungus in pulmonary secretions is usually positive, indicating that the lungs are also involved (271). The radiologic pattern is variable, with hypertrophied hilar lymph nodes and infiltrates, mostly basal, predominating (165,317).…”

Oral paracoccidioidomycosis: a retrospective study of 62 Brazilian patients

“…The disease has many clinical forms, particularly lymph node and pulmonary involvements as well as mixed forms (Restrepo et al , 1989), and may present with oral lesions (Lutz, 1908; Restrepo et al , 1970). Oropharyngeal manifestations may be the first presentation, and are fairly common, but few patients have been reported in the English‐language literature (Scully and Almeida, 1992).…”

Cutaneous primary paracoccidioidomycosis

“…They admitted a possible underestimation because sputum bacteriology was not performed in their patients, as it had been in three similar cases reported by Restrepo et al . 39 where latent lung infection was found through its positive results. But, in our case, no internal (lymphatic, abdominal or pulmonary) involvement could be found in the studies performed.…”