It is not seen in Chile and the Caribbean Islands. Inhalation of conidia is presumably the route of acquisition. Primary infection is asymptomatic in most cases. The adult form usually manifests with painful ulcerated lesions in the mouth. Cavitary lesions may also be found.
Hilar adenopathy is usually absent.
The prognosis of paracoccidioidomycosis is good when treated, however treatment regimens are very long and relapse is frequent. P. brasiliensis has the peculiarity among the fungi of responding to treatment with sulfa drugs. However regimens with these agents require maintenance treatment for up to 5 years. Amphotericin B is not curative by itself and should be given with sulfas or azoles. The azole antifungals have provided a significant advance in the treatment of paracoccidioidomycosis.