Paracoccidioidomycosis is a fungal disease of systemic involvement that can invade any organ and is of high mortality if it is not diagnosed in a timely manner. We present the case of a farmer male with a history of diabetes mellitus, who previously develops lingual ulcers and subsequently presents severe lung disease associated with septic shock, without response to antituberculous and antibacterial treatment. The bronchial secretion smear shows evidence of yeasts in multiple budding, compatible with Paracoccidioidomycosis. The patient had a satisfactory recovery to the administration of amphotericin B deoxycholate.