title: Pulmonary paracoccidioidomycosis: radiology and clinical-epidemiological evaluation.
abstract: BACKGROUND
  The purpose of this study was to compare respiratory signs and symptoms between patients with and without chest X-ray abnormalities in order to establish the meaning of radiographic findings in pulmonary PCM diagnosis.
  
  
  METHODS
  The epidemiological, clinical and radiological lung findings of 44 patients with paracoccidioidomycosis (PCM) were evaluated. Patients were divided into two groups of 23 and 21 individuals according to the presence (group 1) or absence (group 2) of chest X-ray abnormalities, respectively, and their clinical data was analyzed with the aid of statistical tools.
  
  
  RESULTS
  As a general rule, patients were rural workers, young adult males and smokers - group 1 and 2, respectively: males (91.3% and 66.7%); mean age (44.4 and 27.9 year-old); smoking (34.7% and 71.4 %); acute/subacute presentation (38.1% and 21.7%); chronic presentation (61.9% and 78.3%). The most frequent respiratory manifestations were - group 1 and 2, respectively: cough (25% and 11.4%) and dyspnea (22.7% and 6.8%). No statistical difference was observed in pulmonary signs and symptoms between patients with or without radiographic abnormalities. The most frequent radiological finding was nodular (23.8%) or nodular-fibrous (19%), bilateral (90.5%) and diffuse infiltrates (85.7%).
  
  
  CONCLUSIONS
  Absence of statistical difference in pulmonary signs and symptoms between these two groups of patients with PCM indicates clinical-radiological dissociation. A simplified classification of radiological lung PCM findings is suggested, based on correlation of these data and current literature review.
authors.affiliation: Radiology Unit, Sao Paulo Cancer Institute, Sao Paulo, SP, Brazil. ricardomcfreitas@gmail.com
authors.forename: Ricardo Miguel Costa de
authors.initials: RM
authors.lastname: Freitas
authors.forename: Renata
authors.initials: R
authors.lastname: Prado
authors.forename: Fábio Luis Silva do
authors.initials: FL
authors.lastname: Prado
authors.forename: Ivie Braga de
authors.initials: IB
authors.lastname: Paula
authors.forename: Marco Túlio Alves
authors.initials: MT
authors.lastname: Figueiredo
authors.forename: Cid Sérgio
authors.initials: CS
authors.lastname: Ferreira
authors.forename: Eugenio Marcos Andrade
authors.initials: EM
authors.lastname: Goulart
authors.forename: Enio Roberto Pietra
authors.initials: ER
authors.lastname: Pedroso
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000000981:diagnostic imaging*; D011859:Radiography; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult