Paracoccidioidomycosis in the immunosuppressed host: report of a case and review of the literature.

A case of reactivated paracoccidioidomycosis in an immunosuppressed host is described, the first association of this disease with renal transplantation. His presentation and clinical course was similar to the general experience with this mycosis. his response to ketoconazole was delayed when compared with that in non-immunosuppressed patients. Ketoconazole produced a dramatic resolution of all symptoms within 7 months. Serial determinations of paracoccidioides complement fixing antibodies showed falling titers, accurately reflecting his clinical status. Comparisons are made with other endemic mycoses in immunosuppressed patients. More cases of paracoccidioidomycosis in immunosuppressed patients can be expected to occur as immunosuppressive therapy becomes more common in areas endemic for Paracoccidioides brasiliensis, and with current trends in migration and travel.