Seven months ago, patient started to present pain in the epigastric region and right / left scapular regions, associated with fever, chills, dyspnea and weight loss. At that time, he was hospitalized two times, with resolution of fever. Five days later he started a mucus-purulent yellowish cough. He reports that in 2012 he lived and worked in plantations, having a habit of using grass as toothpick. At that time he presented oral lesions suggestive of fungal lesions. He was treated for paracoccidiomycosis with Itraconazole without completing therapeutic regimen.
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Nodular opacities with bilateral random distribution, more evident in the bases.
Although the imaging features are nonspecific and have broad differentials, the strong epidemiological facts and the clinical presentation favors paracoccidioidomycosis over other conditions.
- Gazzoni FF, Severo LC, Marchiori E, Irion KL, Guimarães MD, Godoy MC, Sartori AP, Hochhegger B. Fungal diseases mimicking primary lung cancer: radiologic-pathologic correlation. Mycoses. 57 (4): 197-208.