🍄 Chapter 287 · Paracoccidioidomycosis (South American Blastomycosis)

Nelson Textbook of Pediatrics 22nd Edition | Paracoccidioides brasiliensis. Endemic in Latin America (Brazil, Colombia, Venezuela, Argentina). Juvenile (acute/subacute) form: reticuloendothelial system (lymphadenopathy, hepatosplenomegaly, bone marrow involvement, fever, weight loss). Adult (chronic) form: pulmonary (dyspnea, cough, hemoptysis), oral/nasal mucosal ulcers (moriform stomatitis – 'mulberry-like'), skin, adrenal involvement. Diagnosis: 'pilot's wheel' budding (multiple buds around parent cell). Treatment: itraconazole (first-line), TMP-SMX, amphotericin B for severe.