[South American blastomycosis (paracoccidioidomycosis) in Switzerland. Clinical course and morphological findings in a case following long-term therapy].

The clinical course and morphological findings are reported of visceral paracoccidioidomycosis or South American blastomycosis with lung involvement in a 47-year-old male after specific antimycotic treatment for 11 years. The patient had been infected during a stay in São Paulo, Brazil, from 1950 to 1954. The diagnosis was established in 1959 after his return to St. Gall, Switzerland, in tissue from buccal mucosa and cervical lymph node biopsy and in fungus cultures. The patient was treated with Fungizone (amphotericin B) and with the sulfonamide Fanasil. He died in 1970 from acute right heart failure. Autopsy revealed multiple encapsulated mycotic foci in both lungs, together with healed foci and pulmonary fibrosis. Histological examination showed a large amount of Paracoccidioides brasiliensis in the mycotic foci, but cultural proof was no longer possible. In the buccal mucosa and lymph nodes, only fungus-free scars were observed. There are only a few effective antimycotic agents. With a thorough knowledge of their side effects and dosage modalities, it is possible to achieve highly satisfactory results.