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***chiclero = a person who extracts gum from wild or cultivated trees
==Paracoccidiodomycosis=====pathogen===*''Paracoccidioides brasiliensis''*soil-transmitted fungus*dimorphic fungus**mould <28℃**yeast >37℃ ===epidemiology===*confined to Latin America, esp. Brazil 80%*male vs female 14:1**most patients from tobacco/coffee crops**female hormone inhibit the transformation to yeast ===disease===*pneumonia**cough, sputum, hemoptysis, fever, weight loss*mimic pulmonary tuberculosis not only in history but also in imaging*skin and mucous membrane lesion**ulcer, painful**teeth loss*bone erosion ===diagnosis===*KOH microscopy of oral mucosa, skin lesion, sputum**Mickey Mouse or ship pilot wheel appearance of yeast form*histopathology**epithelioid granulomas**microabscess ===treatment===*co-trimoxazole*itraconazole ==Histoplasmosis==
