Paracoccidioidomycosis: an epidemic in the Republic of Paraguay, the center of South America

The investigation done on the frequency or incidence of Paracoccidioidomycosis in the Republic of Paraguay, with the cases appeared and registered in the Institute of Pathology of Asuncion, presents an incidence rate of 0.46 per 100,000 in the total population; 0.52 per 100,000 in the population at risk. Considering the exposed masculine population the rate is 1.03 per 100,000 and for the feminine 0.02 per 100,000. The age group most affected is within the 50-54 year range with 3.54 per 100,000, the highest rate of all the groups studied. These are the incidence in a strongly exposed population which is controlled and well known. The period of 10 years (1960/69) which has been chosen for this investigation, shows a frequency of the mixed type (lymphatic-visceral or lymphoma-type) which reaches 25% of the total, and a low frequency for the pulmonary form which reaches a mere 12.5%. The mucocutaneous lesion with the involvement of the regional lymph nodes is the dominating form. Considering three consecutive 5 year periods between 1960 to 1974, no cases with proved pulmonary involvement were found until 1964; from 1965 to 1969 the percentage of pulmonary lesions in all the cases considered was 23.0% and from 1970 to 1974 reached to 38.4%. However, mucocutaneous and the lymphatic-visceral or mixed forms do not show significant variations. The rats are small and represent the incidence of this mycosis. It is suggested that a failure of the immunologic system would be found in those affected by the disease and there would be a strong resistence in the majority of the population exposed or within the endemic area of the infection.