DISSEMINATED PARACOCCIDIOIDOMYCOSIS WITH INVOLVEMENT OF THE CENTRAL NERVOUS SYSTEM, TESTICULAR, LUNGS AND ADRENAL: REPORT OF A DIAGNOSTIC CHALLENGE

Abstract

In this case report will be described an atypical case of paracoccidioidomycosis. Paracoccidioidomycosis is a disease of high prevalence in the state of Mato Grosso the etiological agent Paracoccidioides brasiliensis is a dimorphic fungus that inhabits soils infecting farmers between the second and third decade of life. Its symptom in the most prevalent form begin to manifest between the fourth and fifth decade of life. Because it is a granulomatous disease, it can have multiple clinical facets. On this, a patient with disseminated form will be reported manifesting the disease not by the most common forms: pulmonary and cutaneous. But yes, with adrenal insufficiency, cerebral and testicular form. As the aetiology was not known, since it was not possible to isolate the agent in various materials. The cerebral form led the patient to be treated for neurotoxoplasmosis and neurotuberculosis empirically. Nevertheless it was from an right testicular expansive lesion which led to orchiectomy being identified the pathogen in the anatomopathological. Thus, due to the peculiarity of the case and by the high incidence of this condition we should add cerebral paracoccidioidomycosis in possible diagnoses when there are multiple brain lesions with ring reinforcement.