Abstract
Paracoccidioidomycosis (PCM) and tuberculosis (TB) are chronic granulomatous diseases. In approximately 70% of all cases of PCM, there is oral involvement, presenting as ulcerations with a granular surface and tiny hemorrhagic areas. In contrast, oral manifestations of TB, consisting of single ulcers with irregular margins and a necrotic base, are uncommon. The combination of PCM and TB is an unusual condition whose diagnosis can represent a challenge to healthcare professionals. A 70-year-old immunocompetent male was referred for evaluation of oral lesions. His medical history revealed a previous diagnosis of pulmonary TB. However, even during treatment for TB, the oral lesions persisted and there was intense pulmonary fibrosis. The physician requested serological testing for Paracoccidioides brasiliensis, which was positive. After incisional biopsy of the oral lesion, histopathological analysis confirmed the diagnosis of PCM. Treatment with itraconazole was started, and the oral lesions showed complete resolution. The patient was still under treatment and no recurrence had been observed.
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