Paracoccidioidomycosis with sarcoid-like lesions:a diagnostic challenge

Abstract

Clinical presentation of paracoccidioidomycosis (PCM) can be diverse. Morphology and quantity of skin lesions depends on interactions between host immunity and fungus virulence. Diagnosis can be a challenge considering that this fungus has low virulence and some individuals have immunity to microorganism, which results in well-marked granulomas without visible microorganisms. We report herein a clinical presentation of sarcoid-like PCM, initially diagnosed as tuberculoid leprosy. This rare type of PCM is often mistaken for other types of chronic granulomatous diseases. Diagnosis was confirmed after 4 years when a special stain analysis helped in the identification of the specific etiologic agent.

Avanços e desafios no diagnóstico de paracoccidioidomicose causada pelo complexo de espécies da paracoccidioides: revisão integrativa

“…Kayser, et al, (2019) apresentaram um relato clínico onde a paciente emigrante venezuelana foi inicialmente diagnosticada com sarcoidose devido à combinação de sintomas respiratórios e achados radiológicos e histológicos. A diferenciação entre essas doenças pode ser um desafio devido às semelhanças clínicas e histopatológicas (Abreu, et al, 2017).…”

Chronic progressive pulmonary paracoccidioidomycosis in a female immigrant from Venezuela

“…In fact, the cutaneous multifocal infiltrative subtype of PCM has been explicitly described as sarcoid-like in the literature. 13,14 However, sarcoidosis has a lower prevalence in South America than in Europe or North America. 15,16 Therefore, a history of living in South America is more suggestive for PCM than for sarcoidosis.…”

Paracoccidioidomycosis with sarcoid-like cutaneous lesion: A clinicopathological challenge

“…Paracoccidioidomycosis (PCM) is a systemic mycosis caused by the thermally dimorphic fungus, Paracoccidioides brasiliensis ( P. brasiliensis ) [1] , [2] . This condition is endemic in Brazil, diagnosed more frequently in São Paulo State [7] .…”

“…Transmission occurs through the inhalation route, which in turn, can result in lymphohematogenous dissemination with distant metastatic foci. The main organs affected are the lungs, skin, mucosa, lymph nodes, adrenals, and the nervous system [1] , [2] .…”