title: Concomitant pulmonary paracoccidioidomycosis and pulmonary histoplasmosis: a rare case.
abstract: The incidence of pulmonary fungal infections is very low in Uruguay, and such infections typically affect immunocompromised patients. We report the case of an immunocompetent patient presenting with a two-month history of cough, dyspnea, and fever. The patient resided in a rural area. Imaging tests revealed extensive pneumonitis and pulmonary fibrosis. On the basis of direct mycological examination, culture, and serological testing, we made a diagnosis of concomitant histoplasmosis and paracoccidioidomycosis. The patient presented arterial hypotension that was diagnostic of adrenocortical insufficiency. Although the pulmonary fibrosis and pneumonia were irreversible, the clinical condition of the patient improved after antifungal treatment. This was an exceptional case of two pulmonary fungal infections occurring simultaneously in the same patient.
authors.affiliation: Faculty of Medicine, School of Medicine, University of the Republic of Uruguay, Montevideo, Uruguay. torres.esteche@gmail.com
authors.forename: Veronica
authors.initials: V
authors.lastname: Torres Esteche
authors.forename: Zaida
authors.initials: Z
authors.lastname: Arteta
authors.forename: Gabriela
authors.initials: G
authors.lastname: Torres
authors.forename: Andrea
authors.initials: A
authors.lastname: Vaucher
authors.forename: Elbio
authors.initials: E
authors.lastname: Gezuele
authors.forename: Raquel
authors.initials: R
authors.lastname: Balleste
mesh_terms: D060085:Coinfection / Q000175:diagnosis*; D006660:Histoplasmosis / Q000175:diagnosis*; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000175:diagnosis*; D014583:Uruguay