01849nas a2200349   4500000000100000008004100001260001700042653002200059653001900081653003300100653001100133653001700144653001500161653000900176653001600185653001800201653002100219653002700240100001300267700001400280700001300294700001300307700001500320700001800335700001400353700001300367245007300380300001100453490000700464520101400471022001401485       2000                            d  c2000 Mar-Apr10aAntifungal Agents10aBiopsy, Needle10aDrug Administration Schedule10aHumans10aItraconazole10aKnee Joint10aMale10aMiddle Aged10aOsteomyelitis10aParacoccidioides10aParacoccidioidomycosis1 aBorgia G1 aReynaud L1 aCerini R1 aCiampi R1 aSchioppa O1 aDello Russo M1 aGentile I1 aPiazza M00aA case of paracoccidioidomycosis: experience with long-term therapy.  a119-200 v283 a<p>We describe long-term therapy for paracoccidioidomycosis occurring in a 61-year-old house-painter from Venezuela. The diagnostic examinations made in South America had shown pulmonary granulomatous lesions and an osteolytic pattern of the left knee that had been considered suspect of malignant disease with an indication for limb amputation. With the aid of fine needle aspiration biopsy (FNAB) and culture examination we diagnosed an osteomyelitis by Paracoccidioides brasiliensis and initiated therapy with itraconazole, 400 mg per day, reduced to 200 mg per day after 2 months. At the end of 2 years of drug therapy, we observed complete regression of the pulmonary lesions and of the osteolytic area of the left knee. Moreover, we have periodically observed our patient to verify his clinical development and he is still in good health. We suggest that this pathology be considered in differential diagnosis of leprosy, tuberculosis, leishmaniasis, and systemic mycoses, even in non-endemic areas.</p>  a0300-8126