Esophageal and Pulmonary Involvement Caused by Paracoccidioidomycosis in Immunocompromised Patient: Case Report

Abstract

Paracoccidioidomycosis (PCM) is a fungal infection endemic to South America. It predominantly affects men, depending on their work field: farmers and agriculturists. Paracoccidioidomycosis is caused by the aspiration of the fungus in its micellar form and manifests in three conditions: acute, subacute, and chronic; the latter is more frequent in adults, whose treatment will depend on azoles, amphotericin B, and sulfonamides. This case concerns a 57-year-old Colombian man, a farmer with no pathological history who showed dysphagia for solids that progressed to liquids, sialorrhea, and weight loss for two months. He underwent upper GI endoscopy, and whitish lesions were observed; thus, he was biopsied, displaying yeasts in multiple gemmations compatible with paracoccidioidomycosis. In turn, a chest CT scan showed generalized interstitial parenchymal involvement. Subsequently, he was treated with itraconazole, showing improvement and resolution in his clinical picture. Since the pathology described is endemic in South America and can be disseminated in immunocompromised patients. Given the broad infection spectrum, consideration should be given to patients with risk factors, symptomatology, and findings in extension studies suggesting this disease to provide timely and specific treatment.