title: Prostatic paracoccidioidomycosis with a fatal outcome: a case report.
abstract: BACKGROUND
  Paracoccidioidomycosis is a systemic mycosis in Latin America that can affect various organs. Few case reports of paracoccidioidomycosis affecting the prostate are found in the literature.
  
  
  METHODS
  We present the case of a 79-year-old Caucasian man with a six-month history of irritative symptoms of the prostate (urgency, frequency and nocturia) and difficulty initiating urination that progressed to urinary retention and the use of a urinary catheter. The anatomopathological analysis of the transurethral resection of the prostate revealed chronic granulomatous prostatitis of fungal etiology (paracoccidioidomycosis) with extensive necrosis. The patient began treatment with itraconazole at a dose of 100mg/day for six months. Radiography of the thorax revealed bilaterally diffuse nodular reticular interstitial lesions. The patient progressed to respiratory failure and was sent to the intensive care unit, but suffered a cardiopulmonary arrest and was pronounced dead.
  
  
  CONCLUSIONS
  Due to the high incidence of paracoccidioidomycosis in countries like Brazil, urologists should suspect blastomycosis in all patients with symptoms of lower urinary obstruction with chronic abacterial prostatitis. Considering that paracoccidioidomycosis has the potential to affect various organs, following diagnosis, the treatment must be initiated as soon as possible.
authors.affiliation: Urology Department, São José do Rio Preto Medical School, Av, Brigadeiro Faria Lima 5416, 15090-000, São José do Rio Preto, SP, Brazil. pedro.arruda@sbu.org.br.
authors.forename: Pedro Francisco Ferraz
authors.initials: PF
authors.lastname: de Arruda
authors.forename: Márcio
authors.initials: M
authors.lastname: Gatti
authors.forename: José Germano Ferraz
authors.initials: JG
authors.lastname: de Arruda
authors.forename: Daniel Cernach
authors.initials: DC
authors.lastname: Ayres
authors.forename: Eduardo Maciel
authors.initials: EM
authors.lastname: Narvaes
authors.forename: Laísa Ferraz
authors.initials: LF
authors.lastname: de Arruda
authors.forename: Moacir Fernandes
authors.initials: MF
authors.lastname: de Godoy