Infectious Diseases and Microbiology -Paracoccidioidomycosis (Paracoccidioides brasiliensis)

Infectious Diseases and Microbiology -Paracoccidioidomycosis (Paracoccidioides brasiliensis) 

When contaminated soil is disturbed, aerosolized conidia from Paracoccidioides brasiliensis are inhaled, which results in the disease paracoccidioidomycosis. The disease paracoccidioidomycosis is only seen in South and Central America. Males are nine times more likely than females to develop symptoms and a progressive case of paracoccidioidomycosis due to the estrogen-mediated suppression of mycelial-to-yeast conversion in vivo.

Infections with no symptoms are frequent. The signs of symptomatic infections are similar to those of histoplasmosis and blastomycosis, and they manifest as primary and chronic pneumonia with fever, coughing, sputum production, and chest pain. Although it is uncommon, submandibular lymphadenopathy and oral, nasal, and facial nodular ulcerative lesions are the typical symptoms of disseminated extrapulmonary illness.

Conidia that have been inhaled grow into pathogenic yeast in the lungs. Male clinical illness predisposition is explained by the inhibition of mold-to-yeast phase conversion in the presence of estrogen by a fungal, cytoplasmic, estrogen-binding protein. Recuperation following infection is mostly determined by cell-mediated immunity.

When clinical specimens such as sputum, bronchoalveolar lavage, and tissue are examined under a microscope in a KOH preparation for diagnosis, a distinctive yeast with several buds arranged in a "pilot wheel" shape is revealed.
For confirmation, thermal dimorphism can be demonstrated by culture.
The recommended medications for the treatment of paracoccidioidomycosis are itraconazole and amphotericin B.
 One way to prevent an outbreak is to stay away from endemic regions.

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