We report a rare case of chronic paracoccidioidomycosis(PCM) in a woman with Crohn disease in the setting oftreatment with azathioprine and mesalazine. Serumtests for antigens to Paracoccidioides brasiliensis,Histoplasma capsulatum, and Aspergillus fumigatuswere negative. An incisional biopsy of an oral lesionwith periodic acid-schiff and Grocott-methenaminesilverstains revealed chronic granulomatousinflammation with multinucleated giant cells withParacoccidioides brasiliensis within the cytoplasm,confirming the diagnosis of PCM.