View source for Paracoccidioides brasiliensis

= Microbiology =

* Dimorphic fungus with four phylogenetic lineages
* Disease is caused by ''P. brasiliensis'' and ''P. lutzii'' (newly discovered)
* '''Mariner's wheel''' of budding conidia

= Epidemiology =

* South and Central America, with Brazil being the largest endemic country
* Has been isolated from the feces of bats (''Artibeus lituratus'') and from internal organs of the nine-banded armadillo

= Clinical Presentation =

* Usually self-limited pulmonary infection
* Can cause acute/subacute pulmonary infection in children, adolescents, and immunocompromised individuals
** Fever, weight loss, lymphadenopathy, and hepatosplenomegaly
** Half have skin and mucosal lesions
* Can cause chronic disease in adults
** Pulmonary infiltrates on CXR
** Adrenal lesions with insufficiency are common
* However, may remain latent following infection, and reactivate later as pulmonary or disseminated disease

= Diagnosis =

* Serology
** Antibodies
** Antigen

= Management =

* Itraconazole 200 to 400 mg/day for 9 to 12 months
* If severe, consider amphotericin 1mg/kg/day
* ?Septra

{{DISPLAYTITLE:''Paracoccidioides brasiliensis''}}
[[Category:Fungi]]