Paracoccidioidomycosis: an unusual presentation in a young girl disclosing an unnoted HIV-infection

Abstract

The association of paracoccidioidomycosis with AIDS is apparently less frequent than expected. The authors present an unusual case of paracoccidioidomycosis in a 13-year-old female student which was later found to be the first opportunistic infection in the course of the patient's HIV-infection. The clinical presentation followed an accidental incised wound on the palmar region initially described as a ‘sporotrichotic-chancre’. After good response under sulfamethoxazole-trimethoprin, the patient relapsed and presented an associated oral candidiasis. HIV-infection was documented and additional investigation showed CD4⁺ T-cells=22/mm³, CD8⁺=280 cell/mm³ and viral load=4,043 log. This case report presents an uncommon dermatological-clinical picture in the youngest patient in which such association has been reported to date.

Keywords:

• paracoccidioidomycosis
• AIDS
• co-infection
• opportunistic fungal infection
• cutaneous lesions

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This paper was first published online on Early Online on 22 April 2009.