UNUSUAL ORAL MANIFESTATION OF PARACOCCIDIOIDOMYCOSIS MIMICKING ORAL SYPHILIS

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology Vol. 134; no. 3; p. e155
• Main Authors: Gonçalves, Douglas Rodrigues, Loureiro, Felippe José Almeida, Rodrigues, Wictor Nogueira, Bittencourt, Raquel, Martins, Manoela Domingues, Carrard, Vinicius Coelho, Martins, Marco Antonio Trevizani
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-09-2022
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2022.01.400

A 38-year-old White man, rural dweller, presented to the stomatology service reporting a painful nodule with ulcerated areas in the buccal mucosa on the right side extending to the upper and lower lips about 1 year ago. He reported mouth opening limitation and difficulty eating. Facial asymmetry was also noticed in the extraoral examination. Some oral infectious diseases were considered as diagnostic hypotheses. Laboratory exams and partial biopsy were conducted. Serological tests were compatible with syphilis and microscopic features were inconclusive. Treatment with penicillin G benzathine intramuscular and dipyrone was prescribed. The patient returned 3 months later for follow-up examination without regression of signs and symptoms. A new biopsy was performed, and microscopic features confirmed oral paracoccidioidomycosis. The patient was referred to an infectologist and pneumologist. Treatment with itraconazole 100 mg was performed. Partial remission of oral lesions was observed after 2 months.