Disseminated paracoccidioidomycosis: correlation between clinical and in vitro resistance to ketoconazole and trimethoprim sulphamethoxazole.

The present study relates to a case of subacute multifocal paracoccidioidomycosis where the upper intestinal tract is involved. The involvement of the upper digestive tract is uncommon. The recommended therapeutic treatment plans and the difficulty in the treatment of paracoccidioidomycosis are discussed in association with susceptibility tests to antifungal drugs in vitro. This is the first report available in the literature showing, in parallel, clinical and in vitro resistance to ketoconazole and trimethoprim sulphamethoxazole, studied during the course of the disease.