Paracoccidioidomycosis may manifest as An acute / subacute form that usually affects patients < 30 years and manifests as disseminated disease (involving the lymph nodes, liver, spleen, and bone marrow) An adult form that results from reactivation and that can cause chronic pulmonary disease with pulmonary fibrosis, emphysema, and bullae Diagnosis of Paracoccidioidomycosis Culture and / or histopathology Clinical findings suggest the diagnosis of paracoccidioidomycosis.