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Oral paracoccidioidomycosis. A study of 36 South American patients
M R Sposto1, C Scully, O P de Almeida
1Department of Oral Diagnosis, Faculty of Odontology, UNESP, Araraquara, Brazil.
Abstract:
Paracoccidioidomycosis (South American blastomycosis) is an uncommon, progressive systemic mycosis, virtually only seen in persons who have visited Latin America. Reports of oral lesions are extremely rare in the English-language literature. Thirty-six adults with oral lesions as the first sign of paracoccidioidomycosis are described; this appears to be the largest series in the dental literature. All had chronic proliferative mulberry-like ulcerated oral lesions; the diagnosis was confirmed histologically. The gingiva or alveolar process was the typical site, but lesions were also seen particularly on the palate and lip. Most of the patients proved to have detectable pulmonary involvement. Patients with lesions in the oropharynx, tongue, or floor of mouth all had confirmed pulmonary lesions.
Insights
Paracoccidioidomycosis, a rare fungal infection, can manifest as chronic oral lesions, often as the initial symptom. This study details 36 cases, highlighting typical oral sites and frequent pulmonary involvement in affected adults.
Area of Science:
- Mycology
- Infectious Diseases
- Oral Medicine
Background:
- Paracoccidioidomycosis (South American blastomycosis) is a systemic fungal infection endemic to Latin America.
- Oral manifestations are infrequently reported in English-language literature, making them a diagnostic challenge.
Purpose of the Study:
- To describe the clinical characteristics of oral lesions as the primary presentation of paracoccidioidomycosis.
- To analyze the frequency and location of oral lesions and associated pulmonary involvement in a series of adult patients.
Main Methods:
- Retrospective case series of 36 adult patients presenting with oral lesions as the first sign of paracoccidioidomycosis.
- Histological confirmation of diagnosis and assessment of oral lesion characteristics, location, and pulmonary status.
Main Results:
- Thirty-six adult patients with chronic, mulberry-like, ulcerated oral lesions were identified.
- The gingiva and alveolar process were the most common sites, followed by the palate and lip.
- Pulmonary involvement was detected in most patients, particularly those with oropharyngeal, tongue, or floor of mouth lesions.
Conclusions:
- Oral lesions can be the initial and most prominent sign of paracoccidioidomycosis.
- Dental practitioners should consider paracoccidioidomycosis in the differential diagnosis of chronic oral ulcerations, especially in patients with a history of travel to Latin America.
- Systemic and pulmonary involvement frequently co-exist with oral manifestations.