paracoccidioidomycosis is a potentially severe disease that may lead to death. specific skin lesions are common and suitable for early diagnosis. dissemination to the reticuloendothelial system is the main characteristic of the acute and subacute clinical forms. pleural exudate and ascitis are rare in paracoccidioidomycosis. in the present case, these followed an acute hemorrhagic pancreatitis. amphotericin b and proper hospital care are crucial for the recovery of severe cases.