What is the most common presenting complaint of paracoccidioidomycosis?

The lung is the primary site of infection. However, respiratory complaints are the least common presenting symptom. Painful mucosal ulcerations involving the mouth and nose are the most common findings. Patients may also have enlarged cervical lymph nodes and verrucous, crusted, edematous facial lesions. Hematogenous dissemination may also cause disease in the adrenals, spleen, liver, gastrointestinal tract, and central nervous system (CNS).

Almeida OP, Jacks J: Paracoccidioidomycosis of the mouth: an emerging deep mycosis, Crit Rev Oral Biol Med 14:377–383, 2003.