Historical series of paracoccidioidomycosis ocular cases (1923-2025): emphasis on molecular diagnosis of P. lutzii in Midwestern Brazil.
Nathan Pereira Lopes de Siqueira, Vitoria Lucchesi Ribeiro, Giovana Volpato Pazin et al.
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Case in brief
A 53-year-old male logger from Mato Grosso, Brazil, presented with right periorbital edema, eyelid ulceration, and nasal lesions, initially misdiagnosed as leishmaniasis. Diagnosis of ocular paracoccidioidomycosis caused by P. lutzii was confirmed through fungal culture and duplex PCR. Chest CT showed interstitial lesions and adrenal enlargement. Treatment with itraconazole led to clinical cure after 12 months.
What made this case unusual
This case is notable as it is the first documented instance of ocular paracoccidioidomycosis specifically caused by P. lutzii.
Diagnostic / clinical pearl
Clinicians should consider paracoccidioidomycosis in patients with ocular symptoms in endemic regions, especially when initial diagnoses like leishmaniasis are made.
Why it matters
This case highlights the importance of molecular diagnostics in accurately identifying fungal species in atypical presentations, which can prevent misdiagnosis and improve patient outcomes.