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Paracoccidioidomycosis (South American Blastomycosis)
A Study of 39 Cases Observed in Medellín, Colombia
A study designed to determine the various clinical, epidemiologic, and diagnostic aspects of paracoccidioidomycosis was undertaken. Clinical studies revealed that most of the patients had pulmonary involvement either as the only manifestation of the disease (46.1%) or in combination with other manifestations (47.3%). Mucous-membrane lesions were second in importance (51.0%). More than 90.0% of the patients were over 30 years of age, all but one were males, and more than 80.0% worked in occupations related to contact with soil. It was found that 69.4% of the cases originated in the subtropical forest. Methods such as biopsies, direct (KOH) mounts, and cultures proved to be reliable diagnostic tools as they allowed observation, or isolation, or both, of Paracoccidiodes brasiliensis in more than 80.0% of the cases. Serologic procedures (complement-fixation [CF] and agar-gel immunodiffusion tests) were also found to be valuable diagnostic methods. At the time of admission, 79.4% of the patients had a positive CF test, and 92.3% gave precipitin bands. The results of the serologic tests were of great help in case-finding.