ABSTRACT
The pathogenesis of the initial pulmonary lesions are interpreted as being similar to those of the primary complex in tuberculosis; like the latter disease, the lesions may either heal or progress, spreading to other organs. Lung involvement in paracoccidioidomycosis is very frequent. In a series of 338 cases, 82% of the patients presented lung involvement. Pulmonary paracoccidiodomycosis, in its initial phase, is usually either asymptomatic or oligosymptomatic. The pulmonary lesions are characterized by localized alveolar or insterstitial granulomas and, functionally, the spirographic tests are normal. The patients may be asymptomatic or present respiratory symptoms so mild clinical signs of lung involement may be inapparent. Clinical and functional studies have revealed that the evolution of pulmonary paracoccidioidomycosis is associated with an obstructive or mixed form of pulmonary insufficiency, characterized particularly by dyspnea and cough.
