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Paracoccidioides brasiliensis
Etiology
Paracoccidioidomycosis (South American or Brazilian blastomycosis, Lutz-Splendore-Almeida disease) is the most common systemic mycosis in Latin America. It is a fungal infection that is endemic in South America, with cases reported in Central America and Mexico. Brazil accounts for more than 80% of all reported cases. The etiologic agent, Paracoccidioides brasiliensis, is a thermally dimorphic fungus found in the environment in the mycelial (mold) form and in tissues as yeast.
Epidemiology
P. brasiliensis is a soil-inhabiting microorganism and is ecologically unique to Central and South America. Endemic outbreaks occur mainly in the tropical rain forests of Brazil, with cases scattered in Argentina, Colombia, and Venezuela. There is an increased incidence in areas with moderately high altitude, with high humidity and rainfall, and where coffee and tobacco are grown. Armadillos appear to be a natural reservoir for P. brasiliensis. The most common route of infection is by inhalation of conidia. The disease is not usually thought to be contagious, and person-to-person transmission has not been confirmed. Paracoccidioidomycosis is more common among boys after puberty because of the role of estrogen in preventing the transition of conidia to the yeast form. Children account for <10% of the total number of cases.
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