Paracoccidioidomycosis in pregnancy: an atypical case report

Abstract

A 38-year-old woman was referred to the department of OralPathology at the Universidade Paulista, Goiânia, Brazil, com-plaining of multiple painful ulcers on the gum and upper lipmucosa. The patient was six month pregnant and had reg-ularly attended prenatal visits. The patient had a history ofweight loss due to inability to swallow solid foods in the lasttwo months. Also, the patient complained of drooling. Herpulse and blood pressure were normal.Clinicalexaminationrevealedpalpablelymphnodesinthesubmandibular region. The facial muscles were normal andshowed no visible asymmetry. The intra oral examinationshowed the presence of multiple painful moriform ulcers inthe upper gum, palate and upper lip. The lesion on her lip wassimilar to a granulomatous cheilitis (Fig. 1). The gum lesionswere mulberry-like, with distinctly visible hemorrhagic pin-points on the surface (Fig. 2). The teeth involved had severedegrees of mobility, such as in periodontal disease.Incisional biopsy was performed in the gum, where thehistological sections revealed the presence of granulomatousinflammation, with pseudoepitheliomatous hyperplasia, withthe presence of macrophages, epithelioid cells, multinucle-ated giant cells, histiocytes, as well as lymphocytes (Fig. 3).