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$Title{Paracoccidioidomycosis}
$Subject{Paracoccidioidomycosis South American Blastomycosis
Lutz-Splendore-Almeida Disease Paracoccidioidal Granuloma Lobo Disease}
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Copyright (C) 1986, 1988 National Organization for Rare Disorders, Inc.

159:
Paracoccidioidomycosis

** IMPORTANT **
It is possible that the main title of the article
(Paracoccidioidomycosis) is not the name you expected.  Please check the
SYNONYM listing to find the alternate names and disorder subdivisions covered
by this article.

Synonyms

     South American Blastomycosis
     Lutz-Splendore-Almeida Disease
     Paracoccidioidal Granuloma
     Including:  Lobo Disease

General Discussion

** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only.  It should not be used for diagnostic or treatment
purposes.  If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section.


Paracoccidioidomycosis is an infectious fungal disease involving the
skin, mucous membranes, lymph nodes, and internal organs.  The disease occurs
primarily in South and Central America.  It usually affects men between the
ages of 20 and 50 years.  The disease is fatal if not treated, but several
effective therapeutic drugs exist.

Symptoms

Paracoccidioidomycosis occurs in four clinical forms, depending on the
affected individual's immunological reaction to the pathogenic organism, and
the extent to which the organism becomes systemic.  The four forms are:

     l.  Mucocutaneous Paracoccidioidomycosis
     2.  Lymphatic Paracoccidioidomycosis
     3.  Visceral Paracoccidioidomycosis
     4.  Pulmonary Paracoccidioidomycosis

The four forms may occur simultaneously, only one may occur, or one may
give way to another as the disease progresses.  The pathogen spreads from one
part of the body to another primarily via the lymph and blood.

Mucocutaneous Paracoccidioidomycosis affects the skin, mucous membranes,
and the borders between the two, particularly on the face, mouth (including
the gums, tongue, palate, tonsils), and nose.  Small ulcers with tiny
yellowish areas containing the fungus gradually expand over the area
involved, while nearby lymph nodes enlarge and adhere to the undersurface of
the skin causing some pain.  As cells of the lymph nodes are destroyed, they
discharge a puss-like fluid through the skin.

In the lymphatic form of Paracoccidioidomycosis, larger lymph nodes are
involved in addition to those described above.  The nodes in the mesentery
(membrane connecting and supporting the abdominal organs), the neck, and the
armpits are greatly, although generally painlessly, enlarged.

The spleen, liver, pancreas, kidneys, intestines, and rarely, the brain,
are involved in Visceral Paracoccidiodomycosis.

In Pulmonary Paracoccidioidomycosis, the patient has a cough, often with
bloody sputum, difficulty breathing, fever, fatigue, weight loss, and an
overall feeling of discomfort.

Causes

Paracoccidioidomycosis is caused by the fungus Paracoccidioides brasiliensis.
(This fungus used to be known as Blastomyces brasiliensis.)

Affected Population

Paracoccidiodomycosis occurs only in Central and South America, and is
especially prevalent in the coffee growing regions of Brazil.  It affects men
about 10 times as often as women.  Most affected men are between 20 and 50
years of age.

Related Disorders

Paracoccidioidomycosis is a systemic fungal disease, of which there are many
other examples.  The organism causing this disorder used to be classified in
the same group as that responsible for Blastomycosis.  Thus, Blastomycosis
was known as North American Blastomycosis, while Paracoccidioidomycosis was
known as South American Blastomycosis.

Therapies:  Standard

Amphotericin B is the antifungal treatment of choice for
Paracoccidiodomycosis, and is usually effective.  In patients who do not
tolerate this drug, sulfonamides suppress symptoms and progress of the
disease, but do not eliminate the pathogen.

Therapies:  Investigational

Ketoconazole is currently under investigation for the treatment of
Paracoccidiodomycosis and other systemic fungal infections.

This disease entry is based upon medical information available through
September 1989.  Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate.  Please check with the agencies listed in the Resources section for
the most current information about this disorder.

Resources

For more information on Paracoccidiomycosis, please contact:

     National Organization for Rare Disorders (NORD)
     P.O. Box 8923
     New Fairfield, CT  06812-1783
     (203) 746-6518

     Centers for Disease Control (CDC)
     1600 Clifton Road, NE
     Atlanta, GA  30333
     (404) 639-3534

     NIH/National Institute of Allergy and Infectious Diseases (NIAID)
     9000 Rockville Pike
     Bethesda, MD  20892
     (301) 496-5717

References

CECIL TEXTBOOK OF MEDICINE, 18th ed.:  James B. Wyngaarden, and Lloyd H.
Smith, Jr., Eds.:  W. B. Saunders Co., 1988.  Pp. 1843-4.

THE MERCK MANUAL 15th ed:  R. Berkow, et al:  eds; Merck, Sharp & Dohme
Research Laboratories, 1987.  P. 143.