Multisystemic paracoccidioidomycosis with rare retinal and central nervous system involvement: a case report

Abstract

We report a rare case of disseminated paracoccidioidomycosis in an immunocompetent 41-year-old woman presenting with granulomatous skin lesions, neurological involvement, and subretinal fibrosis leading to exudative retinal detachment and permanent vision loss. Diagnosis was confirmed by direct microscopy, histopathology, and serology. The patient was treated with liposomal amphotericin B followed by trimethoprim-sulfamethoxazole, showing significant clinical improvement. This case highlights an atypical presentation of paracoccidioidomycosis with ocular and central nervous system involvement, emphasizing the need to consider the disease in differential diagnoses even in unusual forms, especially in endemic regions.