Paracoccidioidomycosis: Current Status and Future Trends.

Area of Science:

• Mycology
• Infectious Diseases
• Tropical Medicine

Background:

• Paracoccidioidomycosis (PCM) is a systemic neglected tropical mycosis endemic to Latin America, particularly Brazil.
• The classical agent, *Paracoccidioides brasiliensis sensu stricto*, was previously considered monotypic.
• Molecular taxonomy has identified several cryptic species within the *Paracoccidioides* genus.

Purpose of the Study:

• To provide a comprehensive review of PCM, encompassing immunopathology, diagnostics, clinical manifestations, and treatment.
• To highlight challenges in *Paracoccidioides* species identification and patient management.
• To integrate recent taxonomic developments into the understanding and clinical approach to PCM.

Main Methods:

• Literature review of immunopathology, laboratory diagnosis, clinical aspects, and treatment of PCM.
• Analysis of classical and molecular diagnostic techniques for *Paracoccidioides* identification.
• Synthesis of clinical management strategies considering disease severity and patient factors.

Main Results:

• Molecular assays are crucial for accurate species-level identification of *Paracoccidioides*, complementing classical methods.
• Multiple cryptic species exist, impacting diagnosis and potentially treatment.
• Relapses can occur years after apparent cure, underscoring the need for long-term follow-up.

Conclusions:

• Accurate species identification through molecular methods is essential for effective PCM management.
• Treatment strategies must be individualized based on clinical presentation, severity, and patient-specific factors.
• Ongoing research and improved diagnostic and follow-up protocols are needed to address challenges in PCM control.