Coinfection of paracoccidioidomycosis and mucocutaneous leishmaniasis: a case report and systematic review.
6 affiliations
- 1Department of Medical Clinics, Hospital Universitario Mayor Méderi, Universidad del Rosario, Bogotá, Colombia.
- 2Department of Internal Medicine, Fundación Cardioinfantil, Bogotá, Colombia.
- 3Department of Medicine, Division of Health Sciences, Universidad del Norte, Barranquilla, Colombia.
- 4ADOM Salud IPS, Bogotá, Colombia.
- 5Research Department, Hospital Universitario Mayor Méderi, Universidad del Rosario, Bogotá, Colombia.
- 6Infectious Diseases and Tropical Medicine Institute, Hospital Universitario Mayor Méderi, Universidad del Rosario, Bogotá D.C, Colombia.
Abstract
Background
Systemic mycoses and neglected tropical diseases, such as paracoccidioidomycosis (PCM) and leishmaniasis, remain major public health concerns in endemic regions of Latin America. Their coinfection is exceptionally rare and scarcely reported although these infections share overlapping ecological niches and risk factors across multiple endemic countries, including Colombia.Methods
We report the first documented case of coinfection by PCM and mucocutaneous leishmaniasis in an elderly male agricultural worker from a tropical endemic region in Colombia. The patient presented with upper gastrointestinal bleeding, chronic respiratory symptoms, long-standing nasal and oral mucocutaneous lesions, and severe malnutrition. A systematic literature review was also conducted following PRISMA guidelines to identify all previously reported cases of PCM-leishmaniasis coinfection up to April 2026. The review protocol was registered in Open Science Framework (https://doi.org/10.17605/OSF.IO/9T5GM).Results
Histopathological examination established pulmonary PCM, and additional nasal and oral lesions biopsies confirmed mucocutaneous leishmaniasis with granulomatous PCM involvement. The systematic review identified 381 records, from which only two previously published cases were eligible; three cases were analyzed together with the index case. All patients were adult males from endemic areas with relevant environmental exposure and no evidence of a recognized immunosuppressive disorder or immunosuppressive therapy. The clinical manifestations were highly heterogeneous, ranging from localized mucocutaneous involvement to disseminated disease with pulmonary and laryngeal compromise. Notably, the Colombian case expanded the known clinical spectrum by including upper gastrointestinal bleeding and severe malnutrition. In all cases, the diagnosis relied on histopathological confirmation, and treatment with amphotericin B followed by itraconazole resulted in favorable clinical outcomes.Conclusion
PCM-leishmaniasis coinfection is a rare but clinically significant entity that poses important diagnostic challenges, particularly in endemic settings. This case highlights the diagnostic challenges posed by overlapping clinical presentations and underscores the importance of maintaining a high index of suspicion and performing comprehensive diagnostic evaluations in patients from regions where both infections may coexist.
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BibTeX
@article{bayona2026coinfection,
title = {{Coinfection of paracoccidioidomycosis and mucocutaneous leishmaniasis: a case report and systematic review.}},
author = {Paula Valentina Bayona and Iván Salcedo and Luis Alejandro Charry and Brayan Bayona and Tomás Martín and Luisa Fernanda Murcia and Paula Ximena Pavia},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1892049},
url = {https://europepmc.org/article/MED/42922997},
note = {CC BY},
}
RIS
TY - JOUR
TI - Coinfection of paracoccidioidomycosis and mucocutaneous leishmaniasis: a case report and systematic review.
AU - Paula Valentina Bayona
AU - Iván Salcedo
AU - Luis Alejandro Charry
AU - Brayan Bayona
AU - Tomás Martín
AU - Luisa Fernanda Murcia
AU - Paula Ximena Pavia
PY - 2026
DA - 2026/10/08
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1892049
UR - https://europepmc.org/article/MED/42922997
AB - Background Systemic mycoses and neglected tropical diseases, such as paracoccidioidomycosis (PCM) and leishmaniasis, remain major public health concerns in endemic regions of Latin America. Their coinfection is exceptionally rare and scarcely reported although these infections share overlapping ecological niches and risk factors across multiple endemic countries, including Colombia.Methods We report the first documented case of coinfection by PCM and mucocutaneous leishmaniasis in an elderly male agricultural worker from a tropical endemic region in Colombia. The patient presented with upper gastrointestinal bleeding, chronic respiratory symptoms, long-standing nasal and oral mucocutaneous lesions, and severe malnutrition. A systematic literature review was also conducted following PRISMA guidelines to identify all previously reported cases of PCM-leishmaniasis coinfection up to April 2026. The review protocol was registered in Open Science Framework (https://doi.org/10.17605/OSF.IO/9T5GM).Results Histopathological examination established pulmonary PCM, and additional nasal and oral lesions biopsies confirmed mucocutaneous leishmaniasis with granulomatous PCM involvement. The systematic review identified 381 records, from which only two previously published cases were eligible; three cases were analyzed together with the index case. All patients were adult males from endemic areas with relevant environmental exposure and no evidence of a recognized immunosuppressive disorder or immunosuppressive therapy. The clinical manifestations were highly heterogeneous, ranging from localized mucocutaneous involvement to disseminated disease with pulmonary and laryngeal compromise. Notably, the Colombian case expanded the known clinical spectrum by including upper gastrointestinal bleeding and severe malnutrition. In all cases, the diagnosis relied on histopathological confirmation, and treatment with amphotericin B followed by itraconazole resulted in favorable clinical outcomes.Conclusion PCM-leishmaniasis coinfection is a rare but clinically significant entity that poses important diagnostic challenges, particularly in endemic settings. This case highlights the diagnostic challenges posed by overlapping clinical presentations and underscores the importance of maintaining a high index of suspicion and performing comprehensive diagnostic evaluations in patients from regions where both infections may coexist.
SN - 2296-858X
ER -