ORAL PARACOCCIDIOIDOMYCOSIS: A RETROSPECTIVE ANALYSIS OF 94 BRAZILIAN PATIENTS

Abstract

Paracoccidioidomycosis (PCM) is a deep fungal infection caused by Paracoccidioides brasiliensis. PCM is endemic and acquired exclusively in Latin America, with most cases reported in Brazil, Argentina, Colombia, and Venezuela. Objective: To establish a clinical profile of the patients with PCM. Study Design: The authors analyzed retrospectively 94 clinical files of patients with PCM attended at a university stomatology service. Results: Of these patients, 91% were male and 8.5% female, 94.6% were white, and 29.8% were rural workers with mean age of 49.3 years. Eighty-five percent of the patients were smokers and 56.3% were alcohol drinkers. The painful complaint was present in 82% of the patients. Mulberry-like ulcers was the most frequent lesion 87%, healing in 8 weeks in average. The main clinical signs were swelling 88%, bleeding 37%, and erythema 14%. The time until to patient came to the clinic was 14 weeks on average. The most affected sites were tongue 47%, buccal mucosa and palate 41%, and lips 35%. Conclusions: PCM occur predominantly in white men, and the main clinical aspect was painful mulberry-like ulcer on the tongue. The recognition of oral lesions is important because sometimes they are the first manifestation of PCM, frequently preceding even pulmonary lesions. Paracoccidioidomycosis (PCM) is a deep fungal infection caused by Paracoccidioides brasiliensis. PCM is endemic and acquired exclusively in Latin America, with most cases reported in Brazil, Argentina, Colombia, and Venezuela. Objective: To establish a clinical profile of the patients with PCM. Study Design: The authors analyzed retrospectively 94 clinical files of patients with PCM attended at a university stomatology service. Results: Of these patients, 91% were male and 8.5% female, 94.6% were white, and 29.8% were rural workers with mean age of 49.3 years. Eighty-five percent of the patients were smokers and 56.3% were alcohol drinkers. The painful complaint was present in 82% of the patients. Mulberry-like ulcers was the most frequent lesion 87%, healing in 8 weeks in average. The main clinical signs were swelling 88%, bleeding 37%, and erythema 14%. The time until to patient came to the clinic was 14 weeks on average. The most affected sites were tongue 47%, buccal mucosa and palate 41%, and lips 35%. Conclusions: PCM occur predominantly in white men, and the main clinical aspect was painful mulberry-like ulcer on the tongue. The recognition of oral lesions is important because sometimes they are the first manifestation of PCM, frequently preceding even pulmonary lesions.