Paracoccidioidomycosis lesions

Diagnosis: Paracoccidioidomycosis lesions

Clinical Presentation

Paracoccidioidomycosis lesions

Clinical History

Submitted by Ellie Goulding MD. Originally posted January 23, 2017.

Treatment

See case discussion.

Differential Diagnosis

• Squamous cell carcinoma • Leishmaniasis • Lymphoma • Sarcoidosis • Wegener granulomatosis (GPA) • Tuberculosis • Histoplasmosis

Key Learnings

• Caused by Paracoccidioides brasiliensis — endemic to Latin America • "Captain's wheel" or "Mickey Mouse ears" — multiple budding yeast (pathognomonic on histology) • Mulberry-like or moriform stomatitis — hemorrhagic, vegetating mucosal lesions • Pulmonary involvement is primary; cutaneous lesions represent hematogenous spread • Most patients: adult males with agricultural exposure in Latin America • Acute/subacute (juvenile) form: lymphadenopathy, hepatosplenomegaly • Chronic (adult) form: pulmonary + mucocutaneous disease

Tags: paracoccidioidomycosis, lesions, ellie goulding md