Resumen

TORRES FRANCO, Camila Luján  y  RAMOS ALFONZO, Alejandra Noemí. Perianal ulcer as a manifestation of systemic paracoccidioidomycosis. Rev. virtual Soc. Parag. Med. Int. [online]. 2026, vol.13, n.1, e13142615.  Epub 17-Mar-2026. ISSN 2312-3893.  https://doi.org/10.18004/rvspmi/2312-3893/2026.e13142615.

Paracoccidioidomycosis (PCM) is a systemic mycosis endemic to Latin America, caused by thermo-dimorphic fungi of the genus Paracoccidioides, which predominantly affects adult males with a history of exposure to rural areas. Its clinical manifestations are variable and depend on the form of presentation and dissemination of the agent, with anorectal involvement being uncommon.

We present the case of a 54-year-old male patient who consulted for a chronic painful perianal ulcer of one year's evolution, associated with significant weight loss and progressive respiratory symptoms. Complementary studies revealed cavitary pulmonary involvement, laryngeal lesions, intestinal involvement, and neurological involvement. Microbiological and anatomopathological studies of the perianal lesion confirmed the diagnosis of systemic PCM. During the course of the disease, the patient developed complications associated with antifungal treatment, including acute renal injury and infectious encephalitis, which led to multiple therapeutic adjustments until clinical improvement was achieved with voriconazole.

This case highlights the importance of considering PCM in the differential diagnosis of chronic perianal ulcers in patients from endemic areas, as well as the need for an individualized and multidisciplinary therapeutic approach in the face of atypical clinical presentations and complex evolution.

Palabras clave : paracoccidioidomycosis; ulcer; diseases of the anus; invasive fungal infections; endemic diseases.

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