Abstract
Paracoccidioidomycosis is a systemic disease caused by the dimorphic fungus Paracoccidioides brasiliensis and is most common in Latin America. It has a marked predilection for men. A 76-year-old woman looked for help complaining about "a mouth ulcer, which extended all the way from the tongue to the throat." The patient reported that the lesions had been hurting for 3 months. She also affirmed being a smoker for 30 years. In the extraoral physical exam, a cervical bilateral, sublingual, and submandibular lymphadenopathy was noted. In the intraoral exam ulcerated lesions on the dorsum and apex of the tongue were observed, as well as a nodule in the right pterygomandibular raphe. The diagnostic hypotheses were squamous cell carcinoma and paracoccidioidomycosis. An incisional biopsy was performed and a conclusion of paracoccidioidomycosis diagnostic was reached. The patient underwent treatment under the surveillance of an infectious diseases specialist and has been using systemic antifungal medication since then. Paracoccidioidomycosis is a systemic disease caused by the dimorphic fungus Paracoccidioides brasiliensis and is most common in Latin America. It has a marked predilection for men. A 76-year-old woman looked for help complaining about "a mouth ulcer, which extended all the way from the tongue to the throat." The patient reported that the lesions had been hurting for 3 months. She also affirmed being a smoker for 30 years. In the extraoral physical exam, a cervical bilateral, sublingual, and submandibular lymphadenopathy was noted. In the intraoral exam ulcerated lesions on the dorsum and apex of the tongue were observed, as well as a nodule in the right pterygomandibular raphe. The diagnostic hypotheses were squamous cell carcinoma and paracoccidioidomycosis. An incisional biopsy was performed and a conclusion of paracoccidioidomycosis diagnostic was reached. The patient underwent treatment under the surveillance of an infectious diseases specialist and has been using systemic antifungal medication since then.
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