Because the fungus Paracoccidioides brasiliensis can remain dormant for long periods of time, declaring that a patient with paracoccidioidomycosis has been cured by therapy is difficult. A patient may need to be followed for many years before a cure can be declared with absolute confidence.


Patient selection: completion of an adequate course of antifungal therapy


Elements of apparent cure - all of the following:

(1) clinical cure

(2) mycologic cure

(3) radiologic cure

(4) serologic cure


Features of clinical cure:

(1) absence of signs and symptoms related to infection

(2) healing of all mucocutaneous lesions

(3) resolution of lymphadenopathy

(4) reversal of weight loss


Features of mycologic cure:

(1) negative studies after a complete evaluation


Features of serologic cure:

(1) negative serologic tests or a titer <= 1:2 for at least 2 years after stopping therapy (reversal of existing titers take 6-9 months)


Features of radiologic cure:

(1) gradual resolution of infectious nodules with shrinkage and scarring over time

(2) neither enlargement of existing lesions nor appearance of new lesions


It takes a year or two before a patient can be declared apparently cured. Ongoing monitoring is needed to determine if this is a correct assumption. This is because of the capacity of the fungus to lie dormant for long periods of time.


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