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However, by revisiting these classifications, case reports, or case series from which the authors based their own, we found many patients who did not fit in either the 1987 classification or in the correspondent natural history\/pathogenesis view. In this report, the concepts of paracoccidioidomycosis infection, primary pulmonary paracoccidioidomycosis (PP-PCM), and other subclinical forms of PCM are reassessed. A classification is proposed to encompass all these subtle but distinct outcomes. I suggest a continuum between the PP-PCM and the overt chronic form of disease, and not the current view of quiescent foci, frozen in time and suddenly reactivated for unknown reasons. Failure to fully resolve the infection in its initial stages is a conceivable hypothesis for the chronic form. The proposed clinical classification might offer new insights to better characterize and manage PCM patients.<\/jats:p>","DOI":"10.1093\/ofid\/ofaa624","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T17:40:33Z","timestamp":1608313233000},"source":"Crossref","is-referenced-by-count":18,"title":["Pathogenesis and Classification of Paracocidioidomycosis: New Insights From Old Good Stuff"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-3602","authenticated-orcid":false,"given":"Gil","family":"Benard","sequence":"first","affiliation":[{"name":"Laboratory of Medical Investigation Units 53 and 56, Division of Clinical Dermatology, Clinics Hospital, and Laboratory of Medical Mycology, Institute of Tropical Medicine, School of Medicine University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"2021031009043873100_CIT0001","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1590\/S0037-86821987000200012","article-title":"Paracoccidioidomycosis: a recently proposed classification of its clinical forms","volume":"20","author":"Franco","year":"1987","journal-title":"Rev Soc Bras Med Trop"},{"key":"2021031009043873100_CIT0002","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s11046-007-9065-0","article-title":"An overview of the immunopathology of human paracoccidioidomycosis","volume":"165","author":"Benard","year":"2008","journal-title":"Mycopathologia"},{"key":"2021031009043873100_CIT0003","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.jinf.2013.07.019","article-title":"Characterization of the immune response in human paracoccidioidomycosis","volume":"67","author":"de Castro","year":"2013","journal-title":"J Infect"},{"key":"2021031009043873100_CIT0004","doi-asserted-by":"crossref","first-page":"224","DOI":"10.2174\/1874285801711010224","article-title":"Paracoccidioidomycosis: current perspectives from Brazil","volume":"11","author":"Mendes","year":"2017","journal-title":"Open Microbiol J"},{"key":"2021031009043873100_CIT0005","doi-asserted-by":"crossref","DOI":"10.1016\/B978-0-12-819990-9.00001-9","article-title":"Paracoccidioidomycosis","volume-title":"Encyclopedia of Mycology","author":"Taborda","year":"2020"},{"key":"2021031009043873100_CIT0006","first-page":"70","article-title":"Treatment for early, uncomplicated coccidioidomycosis: what is success?","volume":"15","author":"Galgiani","year":"2008","journal-title":"Clin Infect Dis"},{"key":"2021031009043873100_CIT0007","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1086\/595687","article-title":"Factors and outcomes associated with the decision to treat primary pulmonary coccidioidomycosis","volume":"48","author":"Ampel","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2021031009043873100_CIT0008","doi-asserted-by":"crossref","first-page":"983","DOI":"10.3201\/eid2006.131842","article-title":"Characteristics of patients with mild to moderate primary pulmonary coccidioidomycosis","volume":"20","author":"Blair","year":"2014","journal-title":"Emerg Inf Dis"},{"key":"2021031009043873100_CIT0009","first-page":"245","article-title":"[Contribui\u00e7\u00e3o ao estudo da blastomicose infec\u00e7\u00e3o.]","volume":"1","author":"Lacaz","year":"1959","journal-title":"Rev Inst Med Trop S\u00e3o Paulo"},{"key":"2021031009043873100_CIT0010","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1590\/S0034-89101974000200004","article-title":"[Inqu\u00e9rito sobre blastomicose sul-americana pela intradermo rea\u00e7\u00e3o em uma comunidade rural do munic\u00edpio de Botucatu, SP (Brasil)]","volume":"8","author":"Carandina","year":"1974","journal-title":"Revista Sa\u00fade P\u00fablica"},{"key":"2021031009043873100_CIT0011","first-page":"271","article-title":"Infection vs disease in paracoccidioidomycosis","author":"Furtado","year":"1972"},{"key":"2021031009043873100_CIT0012","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/BF00437027","article-title":"Spontaneous regression of pulmonary paracoccidioidomycosis. 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