Chronic disseminated paracoccidioidomycosis as a first manifestation of HIV infection

Abstract

Paracoccidioidomycosis (PCM) is a systemic fungal infection endemic in subtropical areas of Central and South America and caused by the dimorphic fungus Paracoccidioides brasiliensis. PCM is a prevalent disease in Latin America, from Mexico (20 degrees northern latitude) to Argentina (35 degrees southern latitude). This distribution includes tropical and subtropical regions and endemic countries with mild temperatures and high and constant humidity throughout the year. Approximately 10 million people are infected by this fungus, however only 2% may develop a disseminated form of the disease. The constant migration from rural to urban areas increases the risk of reactivation of quiescent forms of PCM outside the endemic areas in immunocompetent as well as in immunosupressed patients. The chronic disseminated form of this disease is the most frequent clinical manifestation, characterized by the pulmonary and mucocutaneous involvement. We present the case of an HIV seropositive male with chronic disseminated paracoccidioidomycosis as the first manifestation of retroviral infection. Diagnosis was made based on the epidemiological, clinical, histopathological and microbiological findings.