PMC3152968_01
Clinical picture with arrows showing (a) chronic foot ulcer, (b) clear palate ulcer, and (c) mouth ulcer.
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fig1
Physical examination revealed a wasted patient with pale skin and upper palate, nose, mouth, and right foot ulcers (Figure 1).
Colonoscopy showing (a) Intense inflammatory stenotic ulcer and (b) giant exudative colonic ulcer.
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fig2
Colonoscopy revealed multiple deep and large patchy exudative ulcers from rectum to cecum alternating with areas of normal mucosa (Figure 2).
100x. Direct microscopic examination with typical double-wall Paracoccidioides brasiliensis.
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fig3
Direct microscopic examination revealed several double wall fungi with multiple gemmulation compatible with paracoccidioidomycosis (Figure 3). 
H&E 80x. Arrows showing intra- and extracellular small yeast of  Histoplasma capsulatum.
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fig4
Histopathology demonstrated acute infectious colitis with multiple granulomas rich in epithelioid cells and oval budding yeast cells consistent with Histoplasma capsulatum (Figure 4).
H&E 80x. Arrows showing intracellular Paracoccidioides brasiliensis.
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fig5
Paracoccidioides was found at a different site (Figure 5). Palate, nose, foot ulcer, sputum, and urine samples were positive for Paracoccidioides.