Location: Latin America

Pathology: Budding yeast of Paracoccidoides with "captain's wheel" formation

Clinical presentation: Similar to blastomycosis- Acute pneumonia- Painful nasal, pharyngeal, and laryngeal mucosal ulcerations- Cervical lymphadenopathy- Can disseminate to skin/bones (including verrucous skin lesions)

Treatment: Itraconazole or amphotericin B for systemic disease.