DIFFERENTIAL DIAGNOSIS AND MANAGEMENT OF A PATIENT WITH PARACOCCIDIOIDOMYCOSIS

Abstract

Paracoccidioidomycosis (PCM) is a systemic mycosis whose etiologic agent is the thermodimorphic fungus of the genus Paracoccidioides. Differential diagnosis may include oral squamous cell carcinoma (SCC), tuberculosis, histoplasmosis, and Wegener granulomatosis. A 45-year-old male patient was attended in an oral medicine service with complaint of "infection of the tongue." Intraoral examination found deep ulcer of granulomatous bed with raised edges and hard palpation in the lateral tongue and mouth floor with 2 months of evolution. The clinical diagnoses were PCM and SCC. Panoramic radiograph was requested with no alterations. Incisional biopsy was performed, and microscopic evaluation was compatible with PCM. Chest x-ray showed calcified nodules. Culture examination for PCM was negative, and complete blood count revealed eosinophilia. The final diagnosis was PCM, and the patient was referred to a medical service that treated with itraconazole. Currently, the patient is with no lesions and in good health. Paracoccidioidomycosis (PCM) is a systemic mycosis whose etiologic agent is the thermodimorphic fungus of the genus Paracoccidioides. Differential diagnosis may include oral squamous cell carcinoma (SCC), tuberculosis, histoplasmosis, and Wegener granulomatosis. A 45-year-old male patient was attended in an oral medicine service with complaint of "infection of the tongue." Intraoral examination found deep ulcer of granulomatous bed with raised edges and hard palpation in the lateral tongue and mouth floor with 2 months of evolution. The clinical diagnoses were PCM and SCC. Panoramic radiograph was requested with no alterations. Incisional biopsy was performed, and microscopic evaluation was compatible with PCM. Chest x-ray showed calcified nodules. Culture examination for PCM was negative, and complete blood count revealed eosinophilia. The final diagnosis was PCM, and the patient was referred to a medical service that treated with itraconazole. Currently, the patient is with no lesions and in good health.