Paracoccidioidomycosis with Lymphonodal and Mucous Involvement - Case Report

Abstract

Paracoccidioidomycosis (also known as Lutz disease, Lutz-Splendore-Almeida disease, Brazilian blastomycosis or South American blastomycosis) was first described by Lutz nearly a century ago. This is a systemic fungal infection that can appear in two clinical forms: acute / subacute or chronic. Oral lesions of paracoccidioidomycosis are typically characterized by erythematous and finely granular gingival hyperplasia with petechiae. Additionally, shallow ulcers with microgranulations and pinpoint hemorrhages may involve the lips, jugal mucosa, palate, tonsillar pillars and tongue. Lesions have a mulberry-like surface called "moriform stomatitis". Although common, these lesions are under diagnosed and the late recognition of this disease may lead to rapid progression, and death. We report the case of a young patient with generalized lymphadenopathy, moriform stomatitis and constitutional symptoms (fever, weight loss). We emphasize the importance of the dermatologist in the early identification of the cutaneous-mucous lesions typical of paracoccidioidomycosis and in the establishment of an accurate diagnosis.