PARACOCCIDIOIDOMICOSE TEGUMENTAR CUTANEOMUCOSA: A IMPORTÂNCIA DA ODONTOLOGIA NO DIAGNÓSTICO E CUIDADO INTEGRAL DO PACIENTE.

Abstract

Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis in Brazil, representing a serious public health issue due to its disabling potential. This report describes a case of PCM diagnosed through the extension project “Clinical and Histopathological Diagnosis of Oral Diseases.” A 54-year-old man, residing in a rural area, a smoker (4 corn-husk cigarettes/day for 45 years), and a daily consumer of distilled beverages, sought care reporting pain while eating. The patient had experienced dental mobility for five months, progressing to painful lesions in the oral cavity, along with weight loss and productive cough for one month. Physical examination revealed extensive moriform lesions on the lips, buccal mucosa, gingiva, palate, and oropharynx, in addition to pain during mouth opening and poor oral condition. The diagnostic hypothesis was chronic multifocal PCM, confirmed by incisional biopsy of the lip and chest radiography. Histopathological examination showed epithelium with acanthosis, exocytosis, and micro-abscesses, as well as chronic inflammatory infiltrate and multinucleated giant cells containing budding fungal yeasts. Radiography revealed extensive nodular infiltrate. The patient was referred to the Infectious Diseases Clinic at Maria Aparecida Pedrossian University Hospital (Humap-UFMS/Ebserh) and started treatment with itraconazole (2 capsules/day). After three months, there was a significant improvement in the oral lesions and pain; however, the patient continued to report dyspnea with moderate exertion and remained under follow-up. After ten months, the patient returned to work activities, showed significant improvement in dyspnea, weight gain, was pain-free, and achieved complete remission of the oral lesions, being referred for oral rehabilitation. This case highlights the importance of early diagnosis and collaboration between dental surgeons and other healthcare professionals to ensure comprehensive patient care.