Paracoccidioidomycosis disease (Lutz-Splendore-Almeida) - clinical manifestations

Lymphadenitis by Paracoccidioidomycosis Mimetizing Pancreatic Head Cancer

“…Although isolated lymphadenopathy is more common in acute cases of the disease, our patient has epidemiological data on the chronic and most common form of the disease (74 to 96%) with slow and progressive clinical evolution pattern (1,3,9). The clinical condition is commonly associated with significant weight loss (72%), asthenia (65%), mucocutaneous pallor (62%), fever (51%), cough (50%), dysphonia, dysphagia, odynophagia, and in lower frequency, ulcerations in the mouth and throat (9).…”

“…Although isolated lymphadenopathy is more common in acute cases of the disease, our patient has epidemiological data on the chronic and most common form of the disease (74 to 96%) with slow and progressive clinical evolution pattern (1,3,9). The clinical condition is commonly associated with significant weight loss (72%), asthenia (65%), mucocutaneous pallor (62%), fever (51%), cough (50%), dysphonia, dysphagia, odynophagia, and in lower frequency, ulcerations in the mouth and throat (9). The main sites of involvement are the lungs (90%), the skin and mucous membranes, the lymph nodes, with lymph node enlargement (79%), and, less frequently, adrenals (50%), and digestive, bone (20%) and central nervous (25%) systems (1,2,9).…”

“…Brazil is responsible for 80% of PCM cases in Latin America and has a heterogeneous distribution with endemic areas, being considered a neglected disease and a public health problem. (1,2,9). The literature points to an increase in cases in non-endemic areas and countries in recent years, related to the contamination during visits to endemic regions (10,11).…”

“…The clinical condition is commonly associated with significant weight loss (72%), asthenia (65%), mucocutaneous pallor (62%), fever (51%), cough (50%), dysphonia, dysphagia, odynophagia, and in lower frequency, ulcerations in the mouth and throat (9). The main sites of involvement are the lungs (90%), the skin and mucous membranes, the lymph nodes, with lymph node enlargement (79%), and, less frequently, adrenals (50%), and digestive, bone (20%) and central nervous (25%) systems (1,2,9). The chronic PCM lymph node involvement with its enlargement, may present itself with suppurative, and/or cancer-like features (9).…”

Manifestações Bucais Da Paracoccidioidomicose Favorecendo Diagnóstico

“…Na literatura, verifica-se que a infecção inicial pode ser seguida pela disseminação hematogênica do fungo para outros órgãos 8 . Sendo assim, a PCM possui apresentação clínica polimórfica, variando de manifestações restritas à pele e mucosas ao comprometimento sistêmico de múltiplos órgãos, em especial, pulmões e adrenais, com potencial de gerar sequelas incapacitantes até o óbito 14 . No caso relatado, o paciente veio a óbito três meses após o início do tratamento para PCM, pois apresentava uma debilidade sistêmica considerável.…”