Difficulty in diagnosing oral paracoccidioidomycosis after topical nystatin usage.
Paracoccidioidomycosis (PCM) is caused by a dimorphic fungus called Paracoccidioides brasiliensis and is a disseminated, systemic disorder that involves the lungs and other organs but presents characteristic oral lesions as the prominent feature. This article reports an unusual case of a 56-year-old man who had symptomatic granulomatous lesions in the oral cavity. The patient had received a nystatin-based treatment that masked the presence of fungi and made the diagnosis of PCM difficult. Although nystatin is normally used to treat oral fungal infections such as candidiasis, its topical usage is not appropriate for management of PCM. Once the patient received the correct treatment, he demonstrated a full recovery.
Department of Oral Pathology, University of Sao Paulo, SP, Brazil.
Felipe Fornias
FF
Sperandio
Fernanda Salgueiredo
FS
Giudice
Ana Patricia Carneiro Goncalves Bezerra
AP
Coelho
Suzana Cantanhede Orsini Machado
SC
de Sousa
Marilia Triervelier
MT
Martins
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001706:Biopsy; D002180:Candidiasis, Oral / Q000188:drug therapy*; D003937:Diagnosis, Differential; D004177:Dipyrone / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000382:microbiology*; D009761:Nystatin / Q000627:therapeutic use*; D010229:Paracoccidioidomycosis / Q000175:diagnosis*
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000935:Antifungal Agents; D009761:Nystatin; D017964:Itraconazole; D004177:Dipyrone