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The agents of paracoccidioidomycosis, historically identified as  Paracoccidioides brasiliensis , are in fact different phylogenetic species. This study aims to evaluate associations between  Paracoccidioides  phylogenetic species and corresponding clinical data.    Methods   Paracoccidioides  strains from INI/Fiocruz patients (1998–2016) were recovered. Socio-demographic, epidemiological, clinical, serological, therapeutic and prognostic data of the patients were collected to evaluate possible associations of these variables with the fungal species identified through partial sequencing of the ADP-ribosylation factor ( arf ) and the 43-kDa-glycoprotein ( gp43 ) genes.    Results  Fifty-four fungal strains were recovered from 47 patients, most (72.3%) infected in Rio de Janeiro state, Brazil. Forty-one cases were caused by  Paracoccidioides brasiliensis  and six by  Paracoccidioides americana  (former PS2).  P .  brasiliensis  was responsible for severe lymph abdominal forms, whereas patients infected with  P .  americana  presented a high rate of adrenal involvement. However, no statistically significant associations were found for all variables studied.  P .  americana  presented 100% reactivity to immunodiffusion, even when tested against antigens from other species, while negative results were observed in 9 (20%) cases caused by  P .  brasiliensis , despite being tested against a homologous antigen.    Conclusions   P .  brasiliensis  and  P .  americana  are sympatric and share similar clinical features and habitat, where they may compete for similar hosts.

Clinical features and genetic background of the sympatric species Paracoccidioides brasiliensis and Paracoccidioides americana