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The middle\u2010west region of Brazil has shown the highest number of PCM by <jats:italic>Paracoccidioides<\/jats:italic> <jats:italic>lutzii<\/jats:italic> (<jats:italic>P lutzii<\/jats:italic>) cases. Differentiating cases of severe PCM from non\u2010severe ones should be a concern at the bedside. Diagnosis of severe PCM by <jats:italic>P lutzii<\/jats:italic> is based on the subjectivity of clinical manifestations, which can result in a delay in starting its treatment and, consequently evolution to severe sequelae. There is not laboratory biomarker available to support the early diagnosis of severe PCM that is feasible for all the realities that coexist in Brazil.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to investigate the usefulness of laboratory biomarkers as erythrocyte sedimentation rate (ESR), C\u2010reactive protein (CRP) and neutrophil\/lymphocyte ratio (NLR) in the diagnosis of severe PCM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients\/Methods<\/jats:title><jats:p>ESR, CRP and NLR were analysed for 44 patients with PCM <jats:italic>by P lutzii<\/jats:italic> and a Receiver Operation Characteristic (ROC) curve were generated to identify the NLR cut\u2010off point and point out the presence of severe PCM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen (36.4%) had severe PCM and 28 (63.6%) had non\u2010severe PCM. The mean NLR was higher and statistically significant among patients with severe PCM than among those with non\u2010severe PCM. The area under the ROC curve was 0.859 for the diagnosis of severe PCM. The cut\u2010off point for NLR for the diagnosis of severe PCM was 3.318 (sensitivity of 100%, specificity of 77%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>According to results, it is plausible to conclude that NLR represents a potential biomarker for the diagnosis of severe PCM.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13282","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T09:27:32Z","timestamp":1617874052000},"page":"874-881","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Paracoccidioidomycosis due to <i>P lutzii<\/i>: The importance of neutrophil\/lymphocyte ratio in the symptomatic and asymptomatic phases in severe cases"],"prefix":"10.1111","volume":"64","author":[{"given":"Andreia Ferreira","family":"Nery","sequence":"first","affiliation":[{"name":"Internal Medicine Department Faculty of Medicine Federal University of Mato Grosso 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