Paracoccidioidomycosis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Paracoccidioidomycosis?
An infectious disease doctor, a doctor who treats infections caused by germs such as fungi, usually leads care for paracoccidioidomycosis. A lung doctor (pulmonologist) or a skin doctor (dermatologist) may help when the lungs or skin are affected. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is paracoccidioidomycosis?
Paracoccidioidomycosis is a rare infection caused by a fungus called Paracoccidioides. A fungus is a living thing like a mold or a yeast. The fungus lives in the environment in parts of Mexico, Central America, and South America. Most cases are in Brazil, Venezuela, Colombia, and Argentina. The infection is also known as South American blastomycosis.
Many people who are infected with the fungus never develop symptoms. People who do get sick usually have symptoms in their lungs or skin. The disease is likely rare in the United States.
Symptoms
Symptoms can start several weeks, months, or even years after a person is first exposed to the fungus.
The CDC lists these symptoms:
- Cough.
- Fever.
- Fatigue, which means feeling very tired.
- Weight loss.
- Swollen lymph nodes, which are small glands that help the body fight germs.
- Sores in the mouth and throat.
- Skin sores.
- An enlarged liver and spleen.
In adults, the infection usually affects the lungs and causes sores in the mouth and throat. Children are more likely to have swollen lymph nodes and skin sores.
When the lungs are affected, a person may also have trouble breathing and chest pain. The infection can also reach the liver, spleen, and intestines. The adrenal glands may be especially open to infection. Long-lasting adrenal infection may cause low levels of adrenal hormones.
Causes and who gets it
People get paracoccidioidomycosis after breathing in the fungus from the environment. The fungus is thought to live in soil as a mold. It has been found in soil near armadillo burrows. The disease does not spread from person to person.
Anyone who lives in or visits places where the fungus lives can get the disease. It is most common among men who work outdoors and in agriculture. Many people who are exposed do not get sick. Among children, boys and girls have the same risks.
The disease sometimes occurs in people whose immune systems are weak, including people with AIDS. It can happen in the United States in people who have visited or moved from South and Central America.
How doctors diagnose it
Doctors use a person's symptoms, lab tests, and imaging tests, such as a chest X-ray, to diagnose paracoccidioidomycosis. A doctor will often do a biopsy, which means taking a small sample from the body part that is affected. The sample goes to a lab for a fungal culture or to be looked at under a microscope. Doctors may also look at sputum or pus from the infected person.
A blood test can also help. However, blood tests cannot tell an active infection from a past one.
Treatment
Paracoccidioidomycosis is treated with antifungal medicines, which are medicines that kill fungi. Examples are itraconazole and amphotericin B.
An antibiotic called trimethoprim/sulfamethoxazole can also help treat the infection, even though antibiotics are made to kill bacteria and not fungi. Patients usually need treatment for about one year. Without treatment, life-threatening problems can occur.
When to see a doctor
See a doctor if you have a cough, fever, weight loss, swollen lymph nodes, or sores in the mouth, throat, or skin. Tell the doctor if you live in or have visited Mexico, Central America, or South America.
Call 911 or go to the emergency room if you have severe trouble breathing, chest pain or discomfort lasting two minutes or more, fainting, or a sudden change in thinking or behavior.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can ask about your symptoms and travel history, order first tests, and coordinate care with an infectious disease doctor and a lab. They can also help with follow-up during the long treatment.
Common questions
Can paracoccidioidomycosis spread from person to person?
No, paracoccidioidomycosis does not spread from person to person. People get it by breathing in the fungus from the environment.
How long does treatment for paracoccidioidomycosis last?
Patients usually need treatment for about one year. Your doctor will decide the exact plan.
Who is most likely to get paracoccidioidomycosis?
Men who work outdoors and in agriculture are most likely to get it. Anyone who lives in or visits the areas where the fungus lives can get it.
Is paracoccidioidomycosis life threatening?
It can be life threatening if it is not treated. Scientists estimate that less than 5% of patients with the disease die from it.
Sources
- Centers for Disease Control and Prevention - Paracoccidioidomycosis Basics
- National Organization for Rare Disorders (NORD) - Paracoccidioidomycosis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
