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The majority of PCM cases occur in large areas in Brazil, comprising the South, Southeast and Midwest regions, with the latter demonstrating a higher incidence of the species <jats:italic>Paracoccidioides lutzii<\/jats:italic>.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology and main findings<\/jats:title>\n<jats:p>This study presents clinical, molecular and serological data of thirteen new PCM cases during 2016 to 2019 from the state of Mato Grosso do Sul, located in the Midwest region, Brazil. From these thirteen cases, sixteen clinical isolates were obtained and their genomic DNAs were subjected to genotyping by <jats:italic>tub1<\/jats:italic> -PCR-RFLP. Results showed <jats:italic>Paracoccidioides brasiliensis sensu stricto<\/jats:italic> (S1) (11\/16; 68.8%), <jats:italic>Paracoccidioides restrepiensis<\/jats:italic> (PS3) (4\/16; 25.0%) and <jats:italic>P<\/jats:italic>. <jats:italic>lutzii<\/jats:italic> (1\/16; 6.2%) as <jats:italic>Paracoccidiodes<\/jats:italic> species. Therefore, in order to understand whether the type of phylogenetic species that are circulating in the state influence the reactivity profile of serological tests, we performed double agar gel immunodiffusion (DID), using exoantigens from genotyped strains found in this series of PCM cases. Overall, our DID tests have been false negative in about 30% of confirmed PCM cases. All patients were male, most with current or previous rural activity, with ages ranging from 17 to 59 years, with 11 patients (84.6%) over 40 years of age. No clinical or epidemiological differences were found between <jats:italic>Paracoccidioides<\/jats:italic> species. However, it is important to note that the only case of <jats:italic>P<\/jats:italic>. <jats:italic>lutzii<\/jats:italic> died as an outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study suggests <jats:italic>P<\/jats:italic>. <jats:italic>brasiliensis sensu stricto<\/jats:italic> (S1) as the predominant species, showing its wide geographic distribution in Brazil. Furthermore, our findings revealed, for the first time, the occurrence of <jats:italic>P<\/jats:italic>. <jats:italic>restrepiensis<\/jats:italic> (PS3) in the state of Mato Grosso do Sul, Brazil. Despite our setbacks, it would be interesting to provide the complete sequencing of these clinical isolates to complement the molecular information presented.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0009317","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T18:57:10Z","timestamp":1617821830000},"page":"e0009317","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["An update on the occurrence of Paracoccidioides species in the Midwest region, Brazil: Molecular epidemiology, clinical aspects and serological profile of patients from Mato Grosso do Sul State"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1177-2092","authenticated-orcid":true,"given":"Karine","family":"Mattos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3306-3118","authenticated-orcid":true,"given":"Tiago Alexandre","family":"Cocio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0095-2215","authenticated-orcid":true,"given":"Edil\u00e2nia Gomes Ara\u00fajo","family":"Chaves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9914-8771","authenticated-orcid":true,"given":"Clayton Luiz","family":"Borges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0035-2439","authenticated-orcid":true,"given":"James","family":"Venturini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0575-2263","authenticated-orcid":true,"given":"L\u00eddia Raquel","family":"de Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinaldo Poncio","family":"Mendes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8925-7712","authenticated-orcid":true,"given":"Anamaria Mello Miranda","family":"Paniago","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4181-142X","authenticated-orcid":true,"given":"Simone Schneider","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,7]]},"reference":[{"issue":"Suppl 19","key":"pntd.0009317.ref001","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1590\/S0036-46652015000700003","article-title":"THE POWER OF THE SMALL: THE EXAMPLE OF Paracoccidioides brasiliensis CONIDIA","volume":"57","author":"A Restrepo","year":"2015","journal-title":"Rev Inst Med Trop Sao Paulo"},{"issue":"1","key":"pntd.0009317.ref002","article-title":"New Trends in Paracoccidioidomycosis Epidemiology","volume":"3","author":"R. 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