Paracoccidioidomycosis cases by Paracoccidioides lutzii in southeastern Brazil

Background and objective Paracoccidioidomycosis (PCM) is a systemic fungal disease caused by the thermodimorphic fungi P aracoccidioides spp . Their distribution is highly variable. Paracoccidioides lutzii is predominantly found in North and Middle-West Brazil and Ecuador. This study evaluated the clinicopathological characteristics of 10 patients diagnosed with PCM caused by P. lutzii in a reference center located in southeastern Brazil. Design Double immunodiffusion assay (DID) was used to investigate 35 patients’ sera with negative serology for P. brasiliensis against a P. lutzii CFA (cell-free antigen). Results Out of the 35 retested patients, 10 (28.6%) were positive for P. lutzii CFA. Four patients did not report any displacement to P. lutzii endemic areas. Our results reinforce the importance of using different antigens when testing patients with clinical manifestations of PCM and negative serological tests for P. brasiliensis , primarily in cases of the report of displacement to or former residence in P. lutzii endemic regions. Conclusions The availability of tests for different Paracoccidioides species antigens is fundamental for reaching an adequate diagnosis, patient follow-up, and definition of prognosis.