[Clinical problems in medical mycology: Problem number 49]

The case of a 22 year-old pregnant woman, suffering an infectious disease with skin lesions on the head, is presented. The patient referred a systemic mycosis 5 years before, treated with oral antifungal, with good clinical response. The mycological study of the skin clinical samples showed multiple budding yeast like elements consistent with Paracoccidioides, and the same organism was isolated in cultures. Physical examination and images studies did not show other location of the mycosis. The patient was treated with oral cotrimoxazole during pregnancy and lactation; afterwards this treatment was stopped and replaced by itraconazole by oral route at a daily dose of 200mg due to the poor clinical response observed with the first treatment. A rapid and favorable evolution was seen with the latter.