Case Report

A Case of Laryngeal Paracoccidioidomycosis Masquerading as Chronic Obstructive Lung Disease

Authors: Antonio G. Tristano, MD, MSc, Lizmer Díaz, MD

Abstract

Paracoccidioidomycosis (South American blastomycosis) is a systemic infection caused by a dimorphic fungus (Paracoccidioides brasiliensis). It is common in the rural areas of Latin America. The majority of the reported cases come from Brazil, Colombia and Venezuela. Paracoccidioidomycosis is the most important systemic mycosis of the tropical Americas and can affect any organ, causing symptomatic or asymptomatic lesions. Paracoccidioidomycosis can mimic other diseases, which must be considered in making the differential diagnosis. Patients get infected by inhaling mycelia found in the natural environment or rarely from traumatic inoculation via mucous membranes. The most common lesions frequently occur in the buccal pharynx mucosa. Others lesions occur in the larynx, adrenal glands, liver, bones, gastrointestinal tract, lungs and nervous system.


Key Points


* Paracoccidioidomycosis of the head and neck is usually associated with high morbidity because patients may present with poor nutritional status due to dysphagia and/or impairment of mastication.


* Other clinical manifestations include hoarseness, odynophagia, sore throat and dyspnea.


* Paracoccidioidomycosis can mimic other diseases, which must be considered in making the differential diagnosis.


* Differential diagnoses include other granulomatous infectious diseases, and cancers of the oropharynx and larynx.


* The absence of clinical suspicion or delay in the diagnosis may dramatically worsen the prognosis.


* Early diagnosis and adequate therapy may prevent extensive tissue destruction. Long-term follow-up is mandatory.

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