PARACOCCIDIOIDOMYCOSIS: EPIDEMIOLOGICAL ASPECTS, DIAGNOSIS, AND CLINICAL MANAGEMENT

Abstract

Paracoccidioidomycosis is an endemic systemic mycosis in Latin America, caused by the fungus Paracoccidioides brasiliensis. It primarily affects men in rural areas, with clinical manifestations ranging from asymptomatic forms to severe disease compromising multiple organs, particularly the lungs, skin, and mucous membranes. Infection occurs mainly through the inhalation of fungal conidia present in the soil, leading to primary pulmonary infection that can spread to other parts of the body. Diagnosis is based on clinical findings, laboratory tests, and imaging methods, with histopathology and serological tests being essential for confirming the disease. Treatment involves prolonged use of antifungals such as itraconazole or sulfamethoxazole-trimethoprim, and in severe cases, amphotericin B. The duration of treatment can range from months to years, depending on disease severity and the patient's clinical response. Additionally, there is concern about chronic pulmonary complications and fibrosis, which can significantly impact patients' quality of life. Prevention is challenging due to the widespread environmental distribution of the fungus, but measures such as the use of personal protective equipment by rural workers can reduce infection risk. The significant morbidity associated with the disease underscores the need for effective strategies for early diagnosis and appropriate treatment, as well as investment in research for the development of new therapeutic and immunoprophylactic approaches.