Paracoccidioidomycosis Epidemiological Features of a 1,000-Cases Series from a Hyperendemic Area on the Southeast of Brazil

Fernando Bellissimo-Rodrigues Social Medicine Department and Infectious Diseases Division/Internal Medicine Department, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Sao Paulo, Brasil

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Alcyone Artioli Machado Social Medicine Department and Infectious Diseases Division/Internal Medicine Department, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Sao Paulo, Brasil

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Roberto Martinez Social Medicine Department and Infectious Diseases Division/Internal Medicine Department, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, Sao Paulo, Brasil

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Paracoccidioidomycosis has been known for over 100 years, and until now, there were only few estimates of the disease's incidence. We aim to analyze 1,000 cases treated between 1960 and 1999 at Ribeirão Preto city, São Paulo, Brazil, where the disease's incidence range detected was 1.6 to 3.7 cases per 100,000 habitants per year (mean = 2.7 cases/year). We observed a male to female ratio of 6:1 and an age distribution from 3 to 85 years. The acute/subacute form of the disease accounted for 25.4% of cases. Most of the patients (93.5%) had lived or worked in rural areas before the disease development. Smoking and alcoholism were reported by 64.7% and 37.2% of patients, respectively. Comorbidities identified included tuberculosis (8.3%), Chagas' disease (8.6%), and human immunodeficiency virus/acquired immunodeficiency syndrome (4.2%). The present study revealed an area in Brazil where paracoccidioidomycosis is hyperendemic (has the highest reported incidence of this disease); this endemic area is probably caused by geological and climatic conditions as well as intensive agriculture.

Author Notes

*Address correspondence to Fernando Bellissimo-Rodrigues, Avenida dos Bandeirantes, 3900, Campus Universitário—Monte Alegre, CEP: 14048-900, Ribeirão Preto, São Paulo, Brazil. E-mail: fbellissimo@fmrp.usp.br

Financial support: This work was partially supported by Fundação para o Apoio ao Ensino, Pesquisa e Assistência (FAEPA) do HC FMRP-USP.

Authors' addresses: Fernando Bellissimo-Rodrigues, Alcyone Artioli Machado, and Roberto Martinez, Avenida dos Bandeirantes, 3900, Campus Universitário-Monte Alegre, postal code 14048-900, Ribeirão Preto, São Paulo, Brazil, E-mails: fbellissimo@fmrp.usp.br, aldebaran@netsite.com.br, and rmartine@fmrp.usp.br.

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