Paracoccidioidomycosis (South American blastomycosis) is caused by Paracoccidioides brasiliensis, a dimorphic fungus acquired by inhalation from environmental sources. Acute infection occurs in young or immunocompromised pts and manifests as disseminated infection of the reticuloendothelial system. Chronic infection accounts for 90% of cases and presents primarily as progressive pulmonary disease with occasional ulcerative and nodular mucocutaneous lesions in the nose and mouth. Diagnosis relies on culture of the organism. Itraconazole (100-200 mg/d for 6-12 months) is effective, but AmB may be required for seriously ill pts.