South American blastomycosis
Paracoccidioidomycosis refers to the endemic disease produced by N/A(L):Paracoccidioides brasiliensis. The infection is found beginning at about 23 degrees North latitude in Mexico and extends southwards to Argentina. It is not seen in Chile and the Caribbean Islands. The ecologic niche for P. brasiliensis remains obscure and the fungus has only been isolated four times from soil [328, 2107]. Inhalation of conidia is presumably the route of acquisition. Primary infection is asymptomatic in most cases. The fungus can remain dormant for years within lymph nodes to appear later probably in relation to some type of immunodeficiency [756, 1430, 1896]. Interestingly, paracoccidiodomycosis affects primarily men (Men/women ratio 15:1) and people older than 30. A juvenile form with a peculiar poor prognosis occurs rarely.