Paracoccidioidomycosis: Global Vision of a Forgotten Endemic Mycosis

Purpose of ReviewThis review aims to evaluate the disease globally from its immunopathogenesis to clinical manifestations and treatment. We would like to call attention to an infectious disease, restricted to some countries in Latin America and with serious sequelae mainly at the pulmonary level.Recent FindingsParacoccidioidomycosis is a systemic fungal infection caused by a complex of thermal dimorphic fungi named Paracoccidioides brasiliensis and P. lutzii. It is the second most prevalent endemic mycosis in Latin America and is usually restricted to this geographical area. It is characterized by a primary pulmonary infection from where it disseminates to the oropharyngeal mucosa, lymph nodes, skin, and other organs. There are a great number of people infected but just a few develop clinical manifestations. Azoles are used for the treatment of the disease. Itraconazole is preferred in mild to moderate disease, and amphotericin B products are reserved for patients with severe or disseminated disease.SummaryThere are new clinical, epidemiological, and laboratory aspects that allow an opportune diagnosis of this disease. Also, we would like to advance in the knowledge of the immunopathogenic process initiated by the fungal infection, to find mechanisms that prevent infection and the development of the fibrosis produced by it.