Fig.20-A1
Paracoccidioidomycosis

A merchant from Mérida / Venezuela noted a tumor-like, ulcerated skin lesion at his left plantar surface which had grown slowly during some months. The doctor who was consulted made a smear from the ulcer surface without staining it. The result will be shown in Fig. 20-A2.

Fig.20-A2
Paracoccidioidomycosis

In this smear a structure was found which resembled the steering wheel form of a budding Paracoccidioides brasiliensis cell, however, it could represent air bubbles.

Fig.20-A3
Paracoccidioidomycosis

In the culture of the material taken from the ulcer surface did grow colonies of Paracoccidioides brasiliensis.

Fig.20-A4
Paracoccidioidomycosis

The patient suddenly accused pain at his left lower extremity. In the x-ray examination of the fibula a localized defect was detected which represented a osteomyelitis caused by this fungus. This confirmed a marked haematogenous dissemination of P. brasiliensis.

Fig.20-A5
Paracoccidioidomycosis

In an enlarged axillary lymph node also was found a fungal infection with P. brasiliensis which had produced necrotic and caseating foci.