title: [Disseminated juvenile paracoccidioidomycosis diagnosed in a girl in an urban area].
abstract: BACKGROUND
  Paracoccidioidomycosis is one of the most prevalent systemic fungal infections in Latin American countries. The incidence rate has been increasing and its detection has gotten increasingly common in travelers or immigrants from endemic areas. It is characterized by respiratory symptoms, lymphadenopathies and skin lesions, which gradually progress and subsequently lead to death in some untreated chronic disease cases.
  
  
  OBJECTIVE
  To describe the clinical approach and diagnosis of an exotic tropical pathology in an urban area.
  
  
  METHODS
  Case description and extended literature review. We made a case report of urban paracoccidioidomycosis in a young patient, with a clinical syndrome of fever for a month, widespread nodal involvement, cutaneous manifestations and weight loss. During the physical examination, hepatosplenomegaly and a febrile episode were evidenced, whose diagnosis was difficult. Management started with itraconazole and trimethoprim sulfamethoxazole, with subsequent cessation of spiking fevers and significant improvement of the skin lesions. We performed a comprehensive literature review, with search criteria performed in PubMed and adapted for different databases. The review was conducted based on the studies found in Medline, LILACS, SciELO and Cochrane Library, from 1966 up to this moment. Studies were selected by the authors based on their relevance and scientific contribution to the discussion of this case.
  
  
  CONCLUSIONS
  There are few cases of paracoccidiomycosis in the pediatric population despite the endemicity of this entity in Latin America. An increasing population influx from endemic areas makes suspecting of this disease a must.
authors: Departamento de Pediatría, Clínica Universitaria Colombia, Bogotá, D.C, Colombia.
authors: Angélica
authors: A
authors: Ballesteros
authors: Departamento de Pediatría, Clínica Universitaria Colombia, Bogotá, D.C, Colombia.
authors: Sandra
authors: S
authors: Beltrán
authors: Departamento de Pediatría, Clínica Universitaria Colombia, Bogotá, D.C, Colombia.
authors: Jaime
authors: J
authors: Patiño
authors: Departamento de Pediatría, Clínica Universitaria Colombia, Bogotá, D.C, Colombia.
authors: Cynthia
authors: C
authors: Bernal
authors: Departamento de Pediatría, Clínica Universitaria Colombia, Bogotá, D.C, Colombia.
authors: Rocío
authors: R
authors: Orduz
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D010229:Paracoccidioidomycosis / Q000175:diagnosis* / Q000188:drug therapy; D014504:Urban Health