Paracoccidioidomycosis

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Paracoccidioidomycosis

• A.K.A. South American blastomycosis
• Etiology Paracoccidioides brasilienses
• Epidemiology
• Geographically restricted to South America
• Most common systemic mycosis in Brazil, Columbia
  and Venezuela
• Endemic in most of Central America as well

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Paracoccidioidomycosis

• Epidemiology
• Mode of transmission is inhalation of airborne
  conidia
• Most prevalent among adults over 30 years of age
• Cases in men 15 times greater than in women
• Natives have inherent resistance - recent
  immigrants more often develop severe infections
  than indigenous people

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Paracoccidiodomycosis

• Clinical manifestation
• Most common manifestation is a chronic pulmonary
  condition in adults
• Low grade intermittent fever, weight loss, and
  anorexia
• Cough with expectoration of sputum also common

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Paracoccidioidomycosis

• Laboratory confirmation
• Demonstrating yeast forms in clinical specimen by
  direct microscopic exam
• The yeast ranges in size from 10-30 ?m
• In tissue it causes a granulomatous lesion
  infiltrated peripherally by PMNs
• P. brasiliensis is the only yeast form of
  systemic dimorphic fungi that form multiple buds

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Paracoccidioidomycosis

• Laboratory confirmation
• The large parent cells are usually completely
  surrounded by much smaller daughter cells
  connected by a narrow base
• Classical descriptions usually include the terms
  mariners wheel or Pilots wheel
• The mould is a slow growing, rather non-descript,
  and white to tan

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Paracoccidioides brasiliensis
Wet Mount BHI 37oC
Giemsa Stain Macrophage (intracellular)
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Paracoccidioidomycosis

• Laboratory confirmation
• Microscopically the hyaline mold produces
  non-pigmented, oval, 2 ?m to 4 ?m conidia borne
  singly from short, slender conidiophores
• It is virtually identical the conidia produced by
  the mold form of Blastomyces dermatitidis

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Sporotrichosis

• A.K.A.Rose Gardeners Disease
• Etiology Sporothrix schenckii
• Epidemiology
• Occurs world wide and in all age groups
• More infections are in men due to occupational
  exposure (foresters, gardeners, horticulturists)