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Thambugala KM, Daranagama DA, Tennakoon DS, Jayatunga DPW, Hongsanan S, Xie N. Humans vs. Fungi: An Overview of Fungal Pathogens against Humans. Pathogens 2024; 13:426. [PMID: 38787278 PMCID: PMC11124197 DOI: 10.3390/pathogens13050426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
Human fungal diseases are infections caused by any fungus that invades human tissues, causing superficial, subcutaneous, or systemic diseases. Fungal infections that enter various human tissues and organs pose a significant threat to millions of individuals with weakened immune systems globally. Over recent decades, the reported cases of invasive fungal infections have increased substantially and research progress in this field has also been rapidly boosted. This review provides a comprehensive list of human fungal pathogens extracted from over 850 recent case reports, and a summary of the relevant disease conditions and their origins. Details of 281 human fungal pathogens belonging to 12 classes and 104 genera in the divisions ascomycota, basidiomycota, entomophthoromycota, and mucoromycota are listed. Among these, Aspergillus stands out as the genus with the greatest potential of infecting humans, comprising 16 species known to infect humans. Additionally, three other genera, Curvularia, Exophiala, and Trichophyton, are recognized as significant genera, each comprising 10 or more known human pathogenic species. A phylogenetic analysis based on partial sequences of the 28S nrRNA gene (LSU) of human fungal pathogens was performed to show their phylogenetic relationships and clarify their taxonomies. In addition, this review summarizes the recent advancements in fungal disease diagnosis and therapeutics.
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Affiliation(s)
- Kasun M. Thambugala
- Genetics and Molecular Biology Unit, Faculty of Applied Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda 10250, Sri Lanka; (K.M.T.); (D.P.W.J.)
- Center for Biotechnology, Department of Zoology, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
- Center for Plant Materials and Herbal Products Research, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
| | - Dinushani A. Daranagama
- Department of Plant and Molecular Biology, Faculty of Science, University of Kelaniya, Kelaniya 11300, Sri Lanka;
| | - Danushka S. Tennakoon
- Bioengineering and Technological Research Centre for Edible and Medicinal Fungi, Jiangxi Agricultural University, Nanchang 330045, China;
| | - Dona Pamoda W. Jayatunga
- Genetics and Molecular Biology Unit, Faculty of Applied Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda 10250, Sri Lanka; (K.M.T.); (D.P.W.J.)
- Center for Biotechnology, Department of Zoology, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
- Center for Plant Materials and Herbal Products Research, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
| | - Sinang Hongsanan
- Shenzhen Key Laboratory of Microbial Genetic Engineering, College of Life Science and Oceanography, Shenzhen University, Shenzhen 518060, China
| | - Ning Xie
- Shenzhen Key Laboratory of Microbial Genetic Engineering, College of Life Science and Oceanography, Shenzhen University, Shenzhen 518060, China
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Tarannum N, Pooja K, Jakhar S, Mavi A. Nanoparticles assisted intra and transdermic delivery of antifungal ointment: an updated review. DISCOVER NANO 2024; 19:11. [PMID: 38195832 PMCID: PMC10776542 DOI: 10.1186/s11671-023-03932-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
This review paper highlights the trans-dermic delivery of nanoparticles (NPs) based antifungal ointments with the help of nanotechnology. It also describes the novel trans-dermal approach utilizing various nanoparticles which enables an efficient delivery to the target site. This current review gives an overview about past research and developments as well as the current nanoparticle-based ointments. This review also presents data regarding types, causes of infection, and different pathogens within their infection site. It also gives information about antifungal ointments with their activity and side effects of antifungal medicines. Additionally, this review also focuses on the future aspects of the topical administration of nanoparticle-based antifungal ointments. These nanoparticles can encapsulate multiple antifungal drugs as a combination therapy targeting different aspects of fungal infection. Nanoparticles can be designed in such a way that they can specifically target fungal cells and do not affect healthy cells. Nanoparticle based antifungal ointments exhibit outstanding potential to treat fungal diseases. As further research and advancements evolve in nanotechnology, we expect more development of nanoparticle-based antifungal formulations shortly. This paper discusses all the past and future applications, recent trends, and developments in the various field and also shows its bright prospective in the upcoming years.
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Affiliation(s)
- Nazia Tarannum
- Department of Chemistry, Chaudhary Charan Singh University, Meerut, 250004, Uttar Pradesh, India.
| | - Km Pooja
- Department of Chemistry, Chaudhary Charan Singh University, Meerut, 250004, Uttar Pradesh, India
| | - Shivani Jakhar
- Department of Chemistry, Chaudhary Charan Singh University, Meerut, 250004, Uttar Pradesh, India
| | - Anshika Mavi
- Department of Chemistry, Chaudhary Charan Singh University, Meerut, 250004, Uttar Pradesh, India
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de Freitas VLT, Rocha FMM, Ribeiro EN, Lindoso JAL, Bittencourt AA, Pivetta DNAG, Benard G, de Freitas-Xavier RS. Seasonality of sporotrichosis in Brazil: A modelled analysis of the epidemic in São Paulo, 2011-2020. Mycoses 2023. [PMID: 37198141 DOI: 10.1111/myc.13594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Sporotrichosis is an endemic subcutaneous mycosis classically caused by the Sporothrix schenckii species complex. Recently, sporotrichosis has emerged in Brazil as a cat-transmitted epidemic caused by a new species, Sporothrix brasiliensis. OBJECTIVES To survey the clinical-epidemiological profile of all sporotrichosis cases diagnosed between 2011 and 2020 at a reference hospital in São Paulo metropolitan area and evaluate the annual distribution of cases in relation to seasonality. METHODS Patients' demographic and clinical-epidemiological data were surveyed. A generalized linear model was fitted to relate the quarterly number of sporotrichosis cases detected between 2015 and 2019 with precipitation and temperature series. Prediction of the number of cases from 2011 to 2014 was attempted based on the fitted model without the trend component that appears from 2015. RESULTS Among 271 suspected cases admitted during 2011-2020, 254 were confirmed by fungal isolation and/or clinical-epidemiological criteria. We observed that 2015 onwards the number of cases regularly increased during Autumn and Winter, the driest and coldest stations of the year. We verified that temperature series affected the number of cases (p = .005) because an increase of 1°C in the temperature series was associated with a 14.24% decrease in the average cases number, with the average number of cases increasing by 10.96% (p < .0001) every quarter, corresponding to an annual increase of 52%. Between 2011 and 2014, the predicted number of sporotrichosis cases averaged 10-12 per year, with 33%-38% occurring in the winter. CONCLUSION We hypothesize that sporotrichosis seasonality is associated with the felines' oestrus cycle, which may provide alternative, cat-directed approaches to the sporotrichosis epidemic control.
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Affiliation(s)
| | | | - Emanoella Nogueira Ribeiro
- Medical Mycology Laboratory (LIM 53/HCFMUSP) and Institute Tropical Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - José Angelo Laulleta Lindoso
- Laboratory of Protozoology (LIM 49/HCFMUSP), Institute of Tropical Medicine, Medical School, University of São Paulo, São Paulo, Brazil
- Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil
| | | | | | - Gil Benard
- Medical Mycology Laboratory (LIM 53/HCFMUSP) and Institute Tropical Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Antifungal Activity of Amphiphilic Perylene Bisimides. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27206890. [PMID: 36296485 PMCID: PMC9609932 DOI: 10.3390/molecules27206890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
Perylene-based compounds, either naturally occurring or synthetic, have shown interesting biological activities. In this study, we report on the broad-spectrum antifungal properties of two lead amphiphilic perylene bisimides, compounds 4 and 5, which were synthesized from perylene-3,4,9,10-tetracarboxylic dianhydride by condensation with spermine and an ammonium salt formation. The antifungal activity was evaluated using a collection of fungal strains and clinical isolates from patients with onychomycosis or sporotrichosis. Both molecules displayed an interesting antifungal profile with MIC values in the range of 2–25 μM, being as active as several reference drugs, even more potent in some particular strains. The ammonium trifluoroacetate salt 5 showed the highest activity with a MIC value of 2.1 μM for all tested Candida spp., two Cryptococcus spp., two Fusarium spp., and one Neoscytalidium spp. strain. Therefore, these amphiphilic molecules with the perylene moiety and cationic ammonium side chains represent important structural features for the development of novel antifungals.
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Konkay K, Golajapu R, Chaganti PD, Janani B, Haque MZ. Cytopathological study of cutaneous and subcutaneous mycosis presenting as soft-tissue swellings: A 5-year retrospective study from a tertiary care center in South India. Cytojournal 2022; 19:54. [PMID: 36324857 PMCID: PMC9610122 DOI: 10.25259/cytojournal_30_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives Cutaneous and subcutaneous mycosis can mimic skin and soft-tissue neoplasms clinically and pose diagnostic challenge to pathologists on cytology. Since there are a limited number of studies on this topic from South India and etiological agents vary with geographic region, in this paper, we present clinical and cytological features of the same the objective of this study is to review and evaluate clinical and cytological features of subcutaneous and cutaneous mycosis with histopathological correlation wherever available. Materials and Methods This was an observational and retrospective study of 5-year duration. All cases diagnosed as mycosis on cytology were retrieved from pathology records. Cytology slides along with special stains for fungus were reviewed. Review of histopathology slides and culture correlation was done whenever available. Statistical analysis was done using frequencies and percentages. Results There were 39 cases during the study period (male - 34 and female - 5). On aspiration, all cases yielded pus; microscopy revealed necrotic debris in 39 cases, inflammatory infiltrate in 39 cases, epithelioid granulomas with multinucleated giant cells in 25 cases, and negative staining hyphal forms in 37 cases. Special stains for fungus showed septate hyphal forms suggestive of Aspergillus species in 34 cases, and yeast and pseudo hyphal forms of candida species in one case. A broad category as fungal infection without subtyping was given in four cases. Culture did not yield growth but fungus was identified on KOH mounts. Histopathology showed fungus in 13 of 14 cases done. Conclusion Subcutaneous mycosis should be suspected when aspiration yields pus and appropriate special stains must be done. Aspergillus species was the most common etiological agent in our study.
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Affiliation(s)
- Kaumudi Konkay
- Department of Pathology, Guntur Medical College, Guntur, Andhra Pradesh, India.,Corresponding author: Kaumudi Konkay, Department of Pathology, Guntur Medical College, Guntur, Andhra Pradesh, India.
| | - Rajeswari Golajapu
- Department of Pathology, Guntur Medical College, Guntur, Andhra Pradesh, India
| | | | - B. Janani
- Department of Pathology, Guntur Medical College, Guntur, Andhra Pradesh, India
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Schaff AR, Ferguson S, Phair K, Ferris R, Goe A. Eumycetoma and disseminated phaeohyphomycosis in a Sumatran tiger. J Vet Diagn Invest 2021; 33:1197-1201. [PMID: 34382452 DOI: 10.1177/10406387211038920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 16-y-old female Sumatran tiger (Panthera tigris sumatrae) was evaluated for hyporexia. Examination revealed chronic kidney disease and a large subcutaneous axillary mass with draining tracts that contained numerous small black grains. Histologic examination revealed the presence of intralesional fungal hyphae. Persistent hyporexia and pyogranulomatous disease, as well as progressive cachexia and azotemia occurred despite treatment, and euthanasia was performed. Disseminated phaeohyphomycosis was diagnosed on postmortem examination, additionally affecting various lymph nodes, the nasal cavity, mesenteric adipose tissue, abdominal aorta, pericardium, and kidney. Fungal culture from a deep-tissue sample isolated a pure growth of Curvularia sp., a dematiaceous opportunistic fungus able to cause eumycetomas and/or phaeohyphomycosis. Phaeohyphomycosis is a rare but emerging condition, not previously reported as disseminated disease in an exotic carnivore, to our knowledge. Aggressive systemic antifungal treatment was unsuccessful, likely complicated by diagnostic challenges and concurrent renal disease. The presence of a swelling with abundant grains exiting draining tracts should direct clinicians to the diagnosis of a mycetoma, warranting early and aggressive treatment.
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Affiliation(s)
- Amanda R Schaff
- Department of Pathology and Population Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ, USA.,BluePearl Veterinary Partners Scottsdale, Scottsdale, AZ, USA
| | - Sylvia Ferguson
- Department of Pathology and Population Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ, USA
| | - Kristen Phair
- Phoenix Zoo, Phoenix, AZ, USA.,San Diego Zoo Wildlife Alliance, San Diego, CA, USA
| | - Rachel Ferris
- Phoenix Zoo, Phoenix, AZ, USA.,University of California-Davis, School of Veterinary Medicine, Davis, CA, USA
| | - Alexandra Goe
- Department of Pathology and Population Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ, USA
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Krauth DS, Barlow BT, Berjohn CM. Fungal osteomyelitis and septic arthritis in an immune competent man: The first report of invasive osteoarticular infection due to Scedosporium dehoogii. Med Mycol Case Rep 2021; 33:14-17. [PMID: 34258180 PMCID: PMC8253999 DOI: 10.1016/j.mmcr.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/22/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022] Open
Abstract
Invasive osteoarticular infections (IOI) due to Scedosporium spp. are rare in the immune competent patient, but have been associated with direct inoculation from antecedent trauma. Here we describe a case of IOI due to Scedosporium dehoogii in a previously healthy man. The clinical presentation and the diagnosis and treatment is discussed. To our knowledge, this is the first reported case of IOI caused by S. dehoogii.
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Affiliation(s)
- Daniel S Krauth
- Division of Infectious Diseases, Naval Medical Center, San Diego, 92134, United States.,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, 20814, United States
| | - Brian T Barlow
- Department of Orthopaedic Surgery, Naval Medical Center, San Diego, 92134, United States.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, 20814, United States
| | - Catherine M Berjohn
- Division of Infectious Diseases, Naval Medical Center, San Diego, 92134, United States.,Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, 20814, United States
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8
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Garg A, Sharma GS, Goyal AK, Ghosh G, Si SC, Rath G. Recent advances in topical carriers of anti-fungal agents. Heliyon 2020; 6:e04663. [PMID: 32904164 PMCID: PMC7452444 DOI: 10.1016/j.heliyon.2020.e04663] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 11/22/2019] [Accepted: 08/05/2020] [Indexed: 12/19/2022] Open
Abstract
Fungal skin infections are the most common global issue for skin health. Fungal infections are often treated by topical or systemic anti-fungal therapy. Topical fungal therapy is usually preferred because of their targeted therapy and fewer side effects. Advanced topical carriers because of their distinct structural and functional features, overcome biopharmaceutical challenges associated with conventional drug delivery systems like poor retention and low bioavailability. Literature evidence indicated topical nanocarriers loaded with anti-fungal agents display superior therapeutic response with minimum toxicity. Nanocarriers often used for topical anti-fungal medication includes Solid-Lipid nanoparticles, Microemulsions, Liposomes, Niosomes, Microsponge, Nanogel, Nanoemulsion, Micelles etc. This review summarizes recent advances in novel strategies employed in topical carriers to improve the therapeutic performance of anti-fungal drugs.
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Affiliation(s)
- Abhinava Garg
- Department of Pharmaceutics, I.S.F.College of Pharmacy, Moga, Punjab, India
| | - Ganti S. Sharma
- Department of Pharmaceutics, I.S.F.College of Pharmacy, Moga, Punjab, India
| | - Amit K. Goyal
- School of Chemical Sciences and. Pharmacy, Central University of Rajasthan, India
| | - Goutam Ghosh
- Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Sudam Chandra Si
- Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Goutam Rath
- Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
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9
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Shen XC, Dai XN, Xie ZM, Li P, Lu S, Li JH, Zhang Y, Ye XD. A Case of Chromoblastomycosis Caused by Fonsecaea pedrosoi Successfully Treated by Oral Itraconazole Together with Terbinafine. Dermatol Ther (Heidelb) 2020; 10:321-327. [PMID: 32086748 PMCID: PMC7090106 DOI: 10.1007/s13555-020-00358-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Indexed: 12/03/2022] Open
Abstract
Patients with chromoblastomycosis (CBM) usually have a history of local skin damage related to outdoor activities, mainly manifested as chronic refractory proliferative pathologic changes. We report a case of a 56-year-old man with CBM, identified as Fonsecaea pedrosoi infection by fungal culture and gene sequencing. This patient was successfully treated with a regimen of oral itraconazole (ITZ) and terbinafine lasting 7 months. Through in vitro drug sensitivity tests, minimum inhibitory concentrations of amphotericin, ITZ, and terbinafine were 1 μg/ml, 0.25 μg/ml, and 1 μg/ml, respectively. In this case, terbinafine was found to be more effective than ITZ.
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Affiliation(s)
- Xu-Cheng Shen
- Department of Dermatology, Dermatology Institute of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510182, China
| | - Xiang-Nong Dai
- Department of Dermatology, Dermatology Institute of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510182, China
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, 510095, China
| | - Zhi-Min Xie
- Department of Dermatology, Dermatology Institute of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510182, China
| | - Ping Li
- Department of Dermatology, Dermatology Institute of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510182, China
| | - Sha Lu
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Jia-Hao Li
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Yi Zhang
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, 510095, China
| | - Xing-Dong Ye
- Department of Dermatology, Dermatology Institute of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 510182, China.
- Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, 510095, China.
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Rojas-García OC, García-Martínez JM, Carrión-Álvarez D. [Chromoblastomycosis in Mexico. A forgotten disease]. SALUD PUBLICA DE MEXICO 2019; 61:3. [PMID: 30753765 DOI: 10.21149/9459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
[No disponible]
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Affiliation(s)
- Olga Carolina Rojas-García
- Departamento de Ciencias Básicas, Vicerrectoría de Ciencias de la Salud, Universidad de Monterrey. San Pedro Garza García, Nuevo León, México
| | - Joyce Marie García-Martínez
- Departamento de Ciencias Básicas, Vicerrectoría de Ciencias de la Salud, Universidad de Monterrey. San Pedro Garza García, Nuevo León, México
| | - Diego Carrión-Álvarez
- Departamento de Ciencias Básicas, Vicerrectoría de Ciencias de la Salud, Universidad de Monterrey. San Pedro Garza García, Nuevo León, México
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Ramirez-Garcia A, Pellon A, Rementeria A, Buldain I, Barreto-Bergter E, Rollin-Pinheiro R, de Meirelles JV, Xisto MIDS, Ranque S, Havlicek V, Vandeputte P, Govic YL, Bouchara JP, Giraud S, Chen S, Rainer J, Alastruey-Izquierdo A, Martin-Gomez MT, López-Soria LM, Peman J, Schwarz C, Bernhardt A, Tintelnot K, Capilla J, Martin-Vicente A, Cano-Lira J, Nagl M, Lackner M, Irinyi L, Meyer W, de Hoog S, Hernando FL. Scedosporium and Lomentospora: an updated overview of underrated opportunists. Med Mycol 2018. [PMID: 29538735 DOI: 10.1093/mmy/myx113] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Species of Scedosporium and Lomentospora are considered as emerging opportunists, affecting immunosuppressed and otherwise debilitated patients, although classically they are known from causing trauma-associated infections in healthy individuals. Clinical manifestations range from local infection to pulmonary colonization and severe invasive disease, in which mortality rates may be over 80%. These unacceptably high rates are due to the clinical status of patients, diagnostic difficulties, and to intrinsic antifungal resistance of these fungi. In consequence, several consortia have been founded to increase research efforts on these orphan fungi. The current review presents recent findings and summarizes the most relevant points, including the Scedosporium/Lomentospora taxonomy, environmental distribution, epidemiology, pathology, virulence factors, immunology, diagnostic methods, and therapeutic strategies.
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Affiliation(s)
- Andoni Ramirez-Garcia
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Aize Pellon
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Aitor Rementeria
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Idoia Buldain
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | | | | | | | | | - Stephane Ranque
- Laboratoire de Parasitologie-Mycologie, AP-HM / CHU Timone, Marseille, France
| | - Vladimir Havlicek
- Institute of Microbiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Patrick Vandeputte
- Laboratoire de Parasitologie-Mycologie, CHU, Angers, France.,Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Angers, France
| | - Yohann Le Govic
- Laboratoire de Parasitologie-Mycologie, CHU, Angers, France.,Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Angers, France
| | - Jean-Philippe Bouchara
- Laboratoire de Parasitologie-Mycologie, CHU, Angers, France.,Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Angers, France
| | - Sandrine Giraud
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Angers, France
| | - Sharon Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, Westmead Hospital, The University of Sydney, New South Wales, Australia
| | - Johannes Rainer
- Institute of Microbiology, Leopold-Franzens University Innsbruck, Austria
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology. Instituto de Salud Carlos III. Majadahonda, Madrid, Spain
| | | | | | - Javier Peman
- Microbiology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Carsten Schwarz
- Cystic Fibrosis Centre Berlin/Charité-Universitätsmedizin Berlin, Germany
| | - Anne Bernhardt
- Mycotic and Parasitic Agents and Mycobacteria, Robert Koch Institute, Berlin, Germany
| | - Kathrin Tintelnot
- Mycotic and Parasitic Agents and Mycobacteria, Robert Koch Institute, Berlin, Germany
| | - Javier Capilla
- Mycology Unit, Medical School and IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Adela Martin-Vicente
- Mycology Unit, Medical School and IISPV, Universitat Rovira i Virgili, Reus, Spain.,Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN USA
| | - Jose Cano-Lira
- Mycology Unit, Medical School and IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Markus Nagl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michaela Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Laszlo Irinyi
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School - Westmead Hospital, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School, Sydney Medical School - Westmead Hospital, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Sybren de Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Fernando L Hernando
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain
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12
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Najafzadeh MJ, Gerrits van den Ende AHG, Vicente VA, Dolatabadi S, Sun J, de Hoog GS. Identification of chromoblastomycosis agents by PCR based reverse line blot (PCR-RLB) hybridization assay. Microb Pathog 2018; 125:43-47. [PMID: 30194974 DOI: 10.1016/j.micpath.2018.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 08/27/2018] [Accepted: 09/01/2018] [Indexed: 11/16/2022]
Abstract
Chromoblastomycosis is one of the most prevalent implantation fungal infections caused by melanized fungi, affecting individuals with certain risk factors with high morbidity due to its recalcitrant nature. It is difficult to identify the etiological agents and thus a suitable reproductive molecular identification method applicable in developing countries has been investigated. We report the identification of four different fungal causative agents of chromoblastomycosis by reverse line blotting hybridization (RLB) based on biotin-labeled PCR products and amine labeled probes to hybridize. Sixty five reference strains, including type strains, i.e. Fonsecaea pedrosoi, F. monophora, F. nubica, and Phialophora verrucosa, obtained from the CBS-KNAW were included in this study. Internal transcribed spacer 1 (ITS1) regions of relevant species were aligned and adjusted using BIONUMERICS v. 4.61 in order to design four specific probes to identify informative nucleotide polymorphisms. The final identification of these species by RLB assay was concordant with ITS sequencing and showed 100% specificity with no cross hybridization, able to identify all tested strains. The time and cost were less compare to other routine identification methods such as sequencing. This assay allows sensitive and specific simultaneous detection and identification of a different fungal species.
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Affiliation(s)
- M J Najafzadeh
- Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Cancer Molecular Pathology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - V A Vicente
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Basic Pathology, Federal University of Paraná, Brazil
| | - S Dolatabadi
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands; Faculty of Engineering, Sabzevar University of New Technology, Sabzevar, Iran.
| | - J Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - G S de Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands; Center of Expertise in Mycology Radboudumc / CWZ, Nijmegen, the Netherlands.
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13
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Le TA, Nguyen KL, Pham MH, Vi TT, Do NA. Case Report: A Case of Chromoblastomycosis Caused by Fonsecaea pedrosoi in Vietnam. Mycopathologia 2018; 184:115-119. [PMID: 29974323 DOI: 10.1007/s11046-018-0284-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 06/27/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissues caused by different melanized fungi. The disease occurs worldwide, particularly in tropical and subtropical regions but not reported in Vietnam. A 47-year-old women was admitted to hospital 103, Hanoi, Vietnam, with a 10-year lasting lesion on backside of her right shank. Diagnosis of chromoblastomycosis was made after discovery of a muriform cell in histopathological examination. A black, slow-growth fungus was isolated and identified as Fonsecaea pedrosoi after molecular analysis. After 1-month treatment with itraconazole, the lesion has significant improvement. CONCLUSION This is the first case of chromoblastomycosis caused by Fonsecaea pedrosoi reported in Vietnam.
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Affiliation(s)
- Tran-Anh Le
- Department of Parasitology, Vietnam Military Medical University (VMMU), Phung Hung Street, Ha Dong Town, Hanoi, Vietnam.
| | - Khac-Luc Nguyen
- Department of Parasitology, Vietnam Military Medical University (VMMU), Phung Hung Street, Ha Dong Town, Hanoi, Vietnam
| | - My-Hang Pham
- Department of Dermatological Disease, Hospital 103, Vietnam Military Medical University (VMMU), Hanoi, Vietnam
| | - Thuat-Thang Vi
- Department of Pathology, Hospital 103, Vietnam Military Medical University (VMMU), Hanoi, Vietnam
| | - Ngoc-Anh Do
- Department of Parasitology, Vietnam Military Medical University (VMMU), Phung Hung Street, Ha Dong Town, Hanoi, Vietnam
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14
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Coelho RA, Brito-Santos F, Figueiredo-Carvalho MHG, Silva JVDS, Gutierrez-Galhardo MC, do Valle ACF, Zancopé-Oliveira RM, Trilles L, Meyer W, Freitas DFS, Almeida-Paes R. Molecular identification and antifungal susceptibility profiles of clinical strains of Fonsecaea spp. isolated from patients with chromoblastomycosis in Rio de Janeiro, Brazil. PLoS Negl Trop Dis 2018; 12:e0006675. [PMID: 30048450 PMCID: PMC6080783 DOI: 10.1371/journal.pntd.0006675] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/07/2018] [Accepted: 07/09/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Chromoblastomycosis (CBM) is a difficult-to-treat chronic subcutaneous mycosis. In Brazil, the main agent of this disease is Fonsecaea pedrosoi, which is phenotypically very similar to other Fonsecaea species, differing only genetically. The correct species identification is relevant since different species may differ in their epidemiologic aspects, clinical presentation, and treatment response. METHODOLOGY/PRINCIPAL FINDINGS Partial sequencing of the internal transcribed spacer (ITS) was used to identify twenty clinical isolates of Fonsecaea spp. Their in vitro antifungal susceptibility was determined using the broth microdilution method, according to the M38-A2 protocol. Amphotericin B (AMB), flucytosine (5FC), terbinafine (TRB), fluconazole (FLC), itraconazole (ITC), ketoconazole (KTC), posaconazole (POS), voriconazole (VRC), ravuconazole (RVC), caspofungin (CAS), and micafungin (MFG) were tested. The association between ITC/TRB, AMB/5FC, and ITC/CAS was studied by the checkerboard method to check synergism. The available patients' data were correlated with the obtained laboratory results. Fonsecaea monophora (n = 10), F. pedrosoi (n = 5), and F. nubica (n = 5) were identified as CBM' agents in the study. TRB and VRC were the drugs with the best in vitro activity with minimal inhibitory concentrations (MIC) lower than 0.25 mg/L. On the other hand, FLC, 5FC, AMB, and MFG showed high MICs. The AMB/5FC combination was synergistic for three F. monophora strains while the others were indifferent. Patients had moderate or severe CBM, and ITC therapy was not sufficient for complete cure in most of the cases, requiring adjuvant surgical approaches. CONCLUSIONS/SIGNIFICANCE F. monophora, the second most frequent Fonsecaea species in South America, predominated in patients raised and born in Rio de Janeiro, Brazil, without cerebral involvement in these cases. TRB, VRC, and the AMB/5FC combination should be further investigated as a treatment option for CBM.
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Affiliation(s)
- Rowena Alves Coelho
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Fábio Brito-Santos
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | | | - Juliana Vitoria dos Santos Silva
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Maria Clara Gutierrez-Galhardo
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Antonio Carlos Francesconi do Valle
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Luciana Trilles
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School-Sydney Medical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead Institute for Medical Research, Sydney, Australia
| | - Dayvison Francis Saraiva Freitas
- Laboratory of Clinical Research in Infectious Dermatology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Rodrigo Almeida-Paes
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil
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15
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de Brito AC, Bittencourt MDJS. Chromoblastomycosis: an etiological, epidemiological, clinical, diagnostic, and treatment update. An Bras Dermatol 2018; 93:495-506. [PMID: 30066754 PMCID: PMC6063100 DOI: 10.1590/abd1806-4841.20187321] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 09/24/2017] [Indexed: 01/19/2023] Open
Abstract
Chromoblastomycosis is a chronic, granulomatous, suppurative mycosis of the skin and subcutaneous tissue caused by traumatic inoculation of dematiaceous fungi of the family Herpotrichiellaceae. The species Fonsecaea pedrosoi and Cladophialophora carrionii are prevalent in regions where the disease is endemic. Chromoblastomycosis lesions are polymorphous: verrucous, nodular, tumoral, plaque-like, and atrophic. It is an occupational disease that predominates in tropical and subtropical regions, but there have been several reports of cases in temperate regions. The disease mainly affects current or former farm workers, mostly males, and often leaving disabling sequelae. This mycosis is still a therapeutic challenge due to frequent recurrence of lesions. Patients with extensive lesions require a combination of pharmacological and physical therapies. The article provides an update of epidemiological, clinical, diagnostic, and therapeutic features.
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Affiliation(s)
- Arival Cardoso de Brito
- Dermatology Course, Universidade Federal do Pará,
Belém (PA), Brazil
- Medical Residency in Dermatology, Universidade Federal do
Pará, Belém (PA), Brazil
- Dermatopathology Laboratory, Universidade Federal do Pará,
Belém (PA), Brazil
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16
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Batista-Duharte A, Téllez-Martínez D, Aparecida Jellmayer J, Leandro Portuondo Fuentes D, Campos Polesi M, Martins Baviera A, Zeppone Carlos I. Repeated Exposition to Mercury (II) Chloride Enhances Susceptibility to S. schenckii sensu stricto Infection in Mice. J Fungi (Basel) 2018; 4:jof4020064. [PMID: 29799450 PMCID: PMC6023541 DOI: 10.3390/jof4020064] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 01/18/2023] Open
Abstract
Sporotrichosis is a subcutaneous mycosis that has re-emerged in several tropical and subtropical regions over the last decades. Growing findings suggest that the interplay of host, pathogen, and environment has a determinant effect on the diversity, local distribution, and virulence of Sporothrix schenckii sensu lato, the etiologic agent. Among the environmental factors, we have studied the potential role of repeated exposures to mercury (Hg), a known immunotoxic xenobiotic that is widely used in gold mining regions where sporotrichosis outbreaks are frequently reported. In this study, male Swiss mice received subcutaneous injections of either 300 or 1200 µg/kg of mercury (II) chloride (HgCl2) for 14 days, three times a week. A control group was injected with the vehicle Phosphate Buffered Saline (PBS). Treatment with HgCl2 impaired several immunologic parameters that are involved in host response to Sporothrix infection, such as the production of TNFα, IL-1, and nitric oxide by macrophages, and Th1/Th2/Th17 populations and their respective cytokines. The consequences of these effects on the host resistance to S. schenckii infection were subsequently evaluated. Hg-exposed mice exhibited a higher fungal load in the fungal inoculation site associated to systemic dissemination to spleen and liver on 14 days post-infection and a higher production of specific IgG1 and mild reduction of IgG2a. These findings suggest that repeated exposition to Hg enhances susceptibility to S. schenckii infection in mice and can be a factor associated to sporotrichosis outbreaks in endemic and highly Hg-polluted areas.
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Affiliation(s)
- Alexander Batista-Duharte
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú km 1, Araraquara 14800-903, Brazil.
| | - Damiana Téllez-Martínez
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú km 1, Araraquara 14800-903, Brazil.
| | - Juliana Aparecida Jellmayer
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú km 1, Araraquara 14800-903, Brazil.
| | - Deivys Leandro Portuondo Fuentes
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú km 1, Araraquara 14800-903, Brazil.
| | - Marisa Campos Polesi
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú km 1, Araraquara 14800-903, Brazil.
| | - Amanda Martins Baviera
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú km 1, Araraquara 14800-903, Brazil.
| | - Iracilda Zeppone Carlos
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú km 1, Araraquara 14800-903, Brazil.
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17
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Kang RB, Simonson DC, Stoner SE, Hughes SR, Agger WA. The Clinical Presentation of Subcutaneous Phaeohyphomycosis: A Case Series from Yetebon, Ethiopia. Clin Med Res 2017; 15:88-92. [PMID: 29018005 PMCID: PMC5849443 DOI: 10.3121/cmr.2017.1377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/06/2017] [Accepted: 10/03/2017] [Indexed: 11/18/2022]
Abstract
Subcutaneous phaeohyphomycosis is a chronic fungal infection usually found on the lower extremity and feet of agricultural workers in the tropics. It can present with various skin manifestations, verrucous to nodular plaques, and is caused by multiple species of fungi. Laboratory confirmation requires skin samples for pathology and fungal cultures. Cure, often difficult in resource-poor countries, requires months of antifungal therapy. We describe the cases of three men from Ethiopia who were seen and are being treated by American doctors who traveled there on a medical mission.
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Affiliation(s)
- Rachel B Kang
- Department of Medical Education, Gundersen Medical Foundation, La Crosse, Wisconsin, USA
| | - Devin C Simonson
- Department of Podiatry, Gundersen Health System; La Crosse, Wisconsin, USA
| | - Sarah E Stoner
- Department of Microbiology, Gundersen Health System, La Crosse, Wisconsin, USA
| | - Sarah R Hughes
- Department of Pathology, Gundersen Health System, La Crosse, Wisconsin, USA
| | - William A Agger
- Department of Medical Education, Gundersen Medical Foundation, La Crosse, Wisconsin, USA
- Infectious Disease Section, Gundersen Health System, La Crosse, Wisconsin, USA
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18
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Abstract
Chromoblastomycosis (CBM), also known as chromomycosis, is one of the most prevalent implantation fungal infections, being the most common of the gamut of mycoses caused by melanized or brown-pigmented fungi. CBM is mainly a tropical or subtropical disease that may affect individuals with certain risk factors around the world. The following characteristics are associated with this disease: (i) traumatic inoculation by implantation from an environmental source, leading to an initial cutaneous lesion at the inoculation site; (ii) chronic and progressive cutaneous and subcutaneous tissular involvement associated with fibrotic and granulomatous reactions associated with microabscesses and often with tissue proliferation; (iii) a nonprotective T helper type 2 (Th2) immune response with ineffective humoral involvement; and (iv) the presence of muriform (sclerotic) cells embedded in the affected tissue. CBM lesions are clinically polymorphic and are commonly misdiagnosed as various other infectious and noninfectious diseases. In its more severe clinical forms, CBM may cause an incapacity for labor due to fibrotic sequelae and also due to a series of clinical complications, and if not recognized at an early stage, this disease can be refractory to antifungal therapy.
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19
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Queiroz-Telles F, Fahal AH, Falci DR, Caceres DH, Chiller T, Pasqualotto AC. Neglected endemic mycoses. THE LANCET. INFECTIOUS DISEASES 2017; 17:e367-e377. [PMID: 28774696 DOI: 10.1016/s1473-3099(17)30306-7] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/19/2016] [Accepted: 03/23/2017] [Indexed: 01/18/2023]
Abstract
Fungi often infect mammalian hosts via the respiratory route, but traumatic transcutaneous implantation is also an important source of infections. Environmental exposure to spores of pathogenic fungi can result in subclinical and unrecognised syndromes, allergic manifestations, and even overt disease. After traumatic cutaneous inoculation, several fungi can cause neglected mycoses such as sporotrichosis, chromoblastomycosis, mycetoma, entomophthoramycosis, and lacaziosis. Most of these diseases have a subacute to chronic course and they can become recalcitrant to therapy and lead to physical disabilities, including inability to work, physical deformities, and amputations. For many years, paracoccidioidomycosis was considered the most prevalent endemic systemic mycosis in the Americas, but this situation might be changing with recognition of the worldwide presence of Histoplasma capsulatum. Both paracoccidioidomycosis and histoplasmosis can mimic several infectious and non-infectious medical conditions and lead to death if not recognised early and treated. Cutaneous implantation and systemic mycoses are neglected diseases that affect millions of individuals worldwide, especially in low-income countries where their management is suboptimum because challenges in diagnosis and therapeutic options are substantial issues.
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Affiliation(s)
| | | | - Diego R Falci
- Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Centro Universitário La Salle, Canoas, Brazil
| | - Diego H Caceres
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alessandro C Pasqualotto
- Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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20
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Subcutaneous Mycotic Cyst Caused by Roussoella percutanea in a UK Renal Transplant Patient. Mycopathologia 2017; 182:721-725. [DOI: 10.1007/s11046-017-0121-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 01/30/2017] [Indexed: 11/28/2022]
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21
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Abstract
Mycetoma is a localized chronic, suppurative, and deforming granulomatous infection seen in tropical and subtropical areas. It is a disorder of subcutaneous tissue, skin and bones, mainly of feet, characterized by a triad of localized swelling, underlying sinus tracts, and production of grains or granules. Etiological classification divides it into eumycetoma caused by fungus, and actinomycetoma caused by bacteria. Since the treatment of these two etiologies is entirely different, a definite diagnosis after histopathological and microbiological examination is mandatory, though difficult. Serological test exists but is not so reliable; however, molecular techniques to identify relevant antigens have shown promise. The disease is notoriously difficult to treat. Eumycetoma may be unresponsive to standard antifungal therapy. Actinomycetoma responds to antibiotic therapy, but prolonged treatment is necessary. This review focuses on the etiopathogenesis, clinical features, laboratory diagnosis, and treatment of mycetoma.
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Affiliation(s)
- Vineet Relhan
- Department of Dermatology, Maulana Azad Medical College, New Delhi, India
| | - Khushbu Mahajan
- Department of Dermatology, NDMC Medical College and Hindu Rao Hospital, New Delhi, India
| | - Pooja Agarwal
- Department of Dermatology, AMC Medical College, Ahmedabad, Gujarat, India
| | - Vijay Kumar Garg
- Department of Dermatology, Maulana Azad Medical College, New Delhi, India
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22
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Bhat RM, Monteiro RC, Bala N, Dandakeri S, Martis J, Kamath GH, Kambil SM, Asha Vadakayil R. Subcutaneous mycoses in coastal Karnataka in south India. Int J Dermatol 2015; 55:70-8. [PMID: 26267755 DOI: 10.1111/ijd.12943] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 10/27/2014] [Accepted: 12/03/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Subcutaneous mycoses are chronic, localized infections of the skin and subcutaneous tissue which occur following traumatic implantation of the etiological agent. The causative organisms are soil saprophytes of regional epidemiology with varying ability to adapt to the tissue environment and elicit disease. OBJECTIVES This study was conducted to evaluate the various types of subcutaneous mycoses, including actinomycotic mycetomas, in south coastal Karnataka, India. METHODS Between January 2005 and January 2013, a total of 25 patients were diagnosed with subcutaneous mycoses based on a detailed clinical history and presentation, histopathology, and culture of organisms. RESULTS Chromoblastomycosis was the infection most commonly seen (n = 16 patients, 64%), followed by mycetoma (n = 4, 16%), sporotrichosis (n = 4, 16%), and rhinoentomophthoromycosis (n = 1, 4%). The extremities were the most common site of involvement, with the lower limb being most affected (64%). Males were more commonly afflicted (64%) than females (36%). Most patients were agricultural workers, although preceding trauma was noted in only three patients. The majority of patients responded well to therapy and were disease-free on follow-up. CONCLUSIONS Subcutaneous mycoses are a rare group of disorders. Chromoblastomycosis is the most frequent subcutaneous fungal infection in south India. Morphologically, chromomoblastomycoses present as verrucous, ulcerative, nodular, or eczematous lesions. Clinical diagnosis is important as culture is often negative. The incidence of infection is higher among rubber tappers. It is important to clinically differentiate chromoblastomycosis from tuberculosis verrucosa cutis. Most of the subcutaneous mycoses respond well to treatment, with the exception of rhinoentomophthoromycosis, which is a rare form of deep mycosis with associated mutilation. Eumycetomas are not observed in this part of India.
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Affiliation(s)
- Ramesh M Bhat
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Rochelle C Monteiro
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Nandakishore Bala
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Sukumar Dandakeri
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Jacintha Martis
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Ganesh H Kamath
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Srinath M Kambil
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Ramay Asha Vadakayil
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
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Phaeohyphomycosis Caused by a Novel Species, Pseudochaetosphaeronema martinelli. J Clin Microbiol 2015; 53:2927-34. [PMID: 26135866 DOI: 10.1128/jcm.01456-15] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 06/24/2015] [Indexed: 11/20/2022] Open
Abstract
Among the opportunistic mycoses that are emerging in patients with immunosuppression or severe underlying illness, many isolates lack of characteristic sporulation and until recently could not be identified. Clinical signs are mostly nonspecific and therefore such infections have often been disregarded. In the present paper we describe a novel, nonsporulating fungal species causing subcutaneous phaeohyphomycosis in two patients of different origin. One is a 73-year-old female from Martinique who suffered from rheumatoid arthritis, while the other case concerns a 72-year-old male from Mexico who had a history of type 2 diabetes mellitus. Sequencing of the partial ribosomal operon revealed that in both cases a member of the order Pleosporales was concerned which could not be affiliated to any family within this order. Multilocus analysis revealed that the fungus was related to another, unaffiliated agent of human mycetoma, Pseudochaetosphaeronema larense, and therefore the name Pseudochaetosphaeronema martinelli was introduced.
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24
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Mufti ST, Aljhdali H. Mycetoma at a tertiary care hospital in Saudi Arabia: correlation of histopathological and clinical findings. Asian Pac J Trop Biomed 2015. [DOI: 10.1016/s2221-1691(15)30353-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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25
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Brás S, Sabino R, Laureano A, Simões H, Fernandes C, Marques-Pinto G, Cardoso J, Veríssimo C. Cutaneous infection by different Alternaria species in a liver transplant recipient. Med Mycol Case Rep 2015; 8:1-4. [PMID: 25750855 PMCID: PMC4348454 DOI: 10.1016/j.mmcr.2015.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 01/26/2015] [Accepted: 01/27/2015] [Indexed: 12/02/2022] Open
Abstract
Fungal invasive infections are rare in general population but are an emergent cause of infection in the immunocompromized population, especially in the solid organ transplant recipients. Herein the authors report a clinical case of a liver transplanted patient suffering a cutaneous co-existent infection with A. alternata as well as A. infectoria. To our knowledge this is the first case of cutaneous concomitant infection due to those two species reported not only in Portugal but also worldwide. The patient was treated with surgical excision of the lesions and oral itraconazol without relapse.
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Affiliation(s)
- Susana Brás
- Departement of Dermatology and Venereology, Curry Cabral Hospital - Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Raquel Sabino
- Laboratório Nacional de Referência de Infecções Parasitárias e Fúngicas, Departamento de Doenças Infecciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - André Laureano
- Departement of Dermatology and Venereology, Curry Cabral Hospital - Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Helena Simões
- Laboratório Nacional de Referência de Infecções Parasitárias e Fúngicas, Departamento de Doenças Infecciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Cândida Fernandes
- Departement of Dermatology and Venereology, Curry Cabral Hospital - Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Gabriela Marques-Pinto
- Departement of Dermatology and Venereology, Curry Cabral Hospital - Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Jorge Cardoso
- Departement of Dermatology and Venereology, Curry Cabral Hospital - Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - Cristina Veríssimo
- Laboratório Nacional de Referência de Infecções Parasitárias e Fúngicas, Departamento de Doenças Infecciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
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Cateau E, Cante V, Garcia Hermoso D, Rodier MH. Case of Fonsecaea nubica chromoblastomycosis from the French territory of Mayotte. JMM Case Rep 2014; 1:e004218. [PMID: 28663818 PMCID: PMC5415939 DOI: 10.1099/jmmcr.0.004218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 10/06/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Fonsecaea nubica is a newly described species in the genus Fonsecaea. CASE PRESENTATION We describe here a clinical case of chromoblastomycosis in a 66-year-old man who presented a 3-year history of leg lesions. F. nubica was identified by morphological and molecular methods. Four months of treatment with itraconazole (300 mg daily) significantly improved the lesions. CONCLUSION To the best of our knowledge, this case represents the first clinical case of F. nubica described in France. Particular attention should be paid to microscopic examination for fungal cultures in order to avoid confusion with a contaminating fungus. Moreover, recurrent, wide and deep biopsies should be performed to monitor the evolution of the lesions.
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Affiliation(s)
- Estelle Cateau
- Laboratoire de Parasitologie et Mycologie Medicale, CHU de Poitiers, 2 rue de la Miletrie, BP 577 86021 Poitiers, France
| | - Vincent Cante
- Service de Dermatologie, CHU de Poitiers, 2 rue de la Miletrie, BP 577 86021 Poitiers, France
| | - Dea Garcia Hermoso
- Unité de Mycologie Moléculaire, Centre National Mycoses Invasives et Antifongiques, Institut Pasteur, Paris, France.,CNRS URA3012, Paris, France
| | - Marie-Helene Rodier
- Laboratoire de Parasitologie et Mycologie Medicale, CHU de Poitiers, 2 rue de la Miletrie, BP 577 86021 Poitiers, France
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Silva AADL, Criado PR, Nunes RS, da Silva WLF, Kanashiro-Galo L, Duarte MIS, Sotto MN, Pagliari C. In situ immune response in human chromoblastomycosis--a possible role for regulatory and Th17 T cells. PLoS Negl Trop Dis 2014; 8:e3162. [PMID: 25233082 PMCID: PMC4169370 DOI: 10.1371/journal.pntd.0003162] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 08/04/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Chromoblastomycosis is a chronic fungal infection that affects skin and subcutaneous tissue. Lesions can be classified in tumorous, verrucous, cicatricial and plaque type. The cellular immune response in the severe form of the disease seems to correlate with a Th2 pattern of cytokines. The humoral immune response also seems to play a role. We intended to explore the populations of regulatory T cells and the Th17 pattern. METHODOLOGY Twenty-three biopsies of verrucous form were obtained from patients with clinical, culture and histopathological diagnostic of chromoblastomycosis, without treatment. It was performed an immunohistochemistry method to detect Foxp3, CD25, TGF-β, IL-6, IL-17 and IL-23. PRINCIPAL FINDINGS IL-17 was the only cytokine with high expression in CBM when compared to normal skin. The expression of Treg cells, TGF- β, IL-6 and IL-23 were similar to normal skin. CONCLUSIONS/SIGNIFICANCE The constitution of a local immune response with high expression of IL-17 and low expression of other cytokines could be at least in part, an attempt to help the immune system against fungal infection. On the other hand, high levels of local immune response mediated by Th17 profile could overcome the role of Treg cells. The inefficient immunomodulation as a consequence of the unbalance by Treg/Th17 cells seems to corroborate with the less effective immune response against fungi.
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Affiliation(s)
- Aline Alves de Lima Silva
- Laboratório da Disciplina de Patologia de Moléstias Transmissíveis/Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Dermatopatologia/Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Ricardo Criado
- Laboratório de Dermatopatologia/Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo Spina Nunes
- Laboratório de Dermatopatologia/Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Wellington Luiz Ferreira da Silva
- Laboratório da Disciplina de Patologia de Moléstias Transmissíveis/Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Dermatopatologia/Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luciane Kanashiro-Galo
- Laboratório da Disciplina de Patologia de Moléstias Transmissíveis/Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maria Irma Seixas Duarte
- Laboratório da Disciplina de Patologia de Moléstias Transmissíveis/Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mirian N. Sotto
- Laboratório da Disciplina de Patologia de Moléstias Transmissíveis/Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Dermatopatologia/Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Carla Pagliari
- Laboratório da Disciplina de Patologia de Moléstias Transmissíveis/Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Dermatopatologia/Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Mishra K, Das S, Goyal S, Gupta C, Rai G, Ansari MA, Saha R, Singal A. Subcutaneous mycoses caused by Rhytidhysteron species in an immunocompetent patient. Med Mycol Case Rep 2014; 5:32-4. [PMID: 25180152 PMCID: PMC4147701 DOI: 10.1016/j.mmcr.2014.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 07/04/2014] [Accepted: 07/04/2014] [Indexed: 11/24/2022] Open
Abstract
Subcutaneous mycoses are chronic fungal infections of the skin and subcutaneous tissues caused by variety of fungal agents and usually occur following trauma with vegetative matter. We report a case of subcutaneous mycoses caused by rare fungus belonging to the genus Rhytidhysteron, in an immunocompetent male who presented with a subcutaneous nodule on left foot. This unusual species was identified and confirmed by molecular methods.
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Affiliation(s)
- K Mishra
- Department of Pathology, University College of Medical Sciences, Delhi 110095, India
| | - S Das
- Department of Microbiology, University College of Medical Sciences, Delhi 110095, India
| | - S Goyal
- Department of Pathology, University College of Medical Sciences, Delhi 110095, India
| | - C Gupta
- Department of Microbiology, University College of Medical Sciences, Delhi 110095, India
| | - G Rai
- Department of Microbiology, University College of Medical Sciences, Delhi 110095, India
| | - M A Ansari
- Department of Microbiology, University College of Medical Sciences, Delhi 110095, India
| | - R Saha
- Department of Microbiology, University College of Medical Sciences, Delhi 110095, India
| | - A Singal
- Department of Dermatology, University College of Medical Sciences, Delhi 110095, India
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Ahmed SA, Stevens DA, van de Sande WWJ, Meis JF, de Hoog GS. Roussoella percutanea, a novel opportunistic pathogen causing subcutaneous mycoses. Med Mycol 2014; 52:689-98. [PMID: 24969729 DOI: 10.1093/mmy/myu035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We report the isolation of a novel agent of subcutaneous mycosis from a 45-year-old Indian male immigrant in the United States. Phylogenetic analysis of partial small ribosomal subunit and large ribosomal subunit, internal transcribed spacer, partial translation elongation factor (TEF1), and RNA polymerase second largest subunit (rPB2) loci revealed that the strain was identical to another isolate previously reported as "Madurella mycetomatis." Both strains clustered in the order Pleosporales, nested in the family Arthopyreniaceae/Roussoellaceae. The fungus differed from known species and hence a new taxon, Roussoella percutanea, is introduced, typified by a strain that showed delayed production of pycnidial conidiomata. Antifungal susceptibility testing suggested that the new species is resistant to echinocandins and flucytosine, with variable results with azoles and amphotericin B.
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Affiliation(s)
- Sarah A Ahmed
- Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan Centraalbureau voor Schimmelcultures KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, The Netherlands
| | - David A Stevens
- California Institute for Medical Research, San Jose, and Division of Infectious Diseases, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Wendy W J van de Sande
- Erasmus MC, Department of Medical Microbiology and Infectious Diseases, Rotterdam, The Netherlands
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - G S de Hoog
- Centraalbureau voor Schimmelcultures KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, The Netherlands Peking University Health Science Center, Research Center for Medical Mycology, Beijing, China; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China; Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China; Basic Pathology Department, Federal University of Paraná State, Curitiba, Paraná, Brazil; King Abdulaziz University, Jeddah, Saudi Arabia
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Verma GK, Verma S, Singh G, Shanker V, Tegta GR, Minhas S, Sharma V, Thakur J. A case of extensive chromoblastomycosis from North India. Braz J Microbiol 2014; 45:275-7. [PMID: 24948945 PMCID: PMC4059311 DOI: 10.1590/s1517-83822014005000025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 04/04/2013] [Indexed: 01/19/2023] Open
Abstract
A case of extensive chromoblastomycosis of the right leg and thigh with verruciform to nodular lesions evolving rapidly over five years duration is reported. The diagnosis was confirmed by visualizing pathognomonic pigmented muriform bodies with unique septate hyphae and mycological culture yielding Fonsecaea pedrosoi.
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Affiliation(s)
| | - Santwana Verma
- Departament of Microbiology Indira Gandhi Medical College Shimla India
| | - Gagandeep Singh
- Departament of Medical Microbiology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Vinay Shanker
- Departament of Dermatology Indira Gandhi Medical College Shimla India
| | - Geeta Ram Tegta
- Departament of Dermatology Indira Gandhi Medical College Shimla India
| | - Smridhi Minhas
- Departament of Dermatology Indira Gandhi Medical College Shimla India
| | - Vineeta Sharma
- Departament of Microbiology Indira Gandhi Medical College Shimla India
| | - Jatin Thakur
- Departament of Dermatology Indira Gandhi Medical College Shimla India
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Revisiting the clinical and histopathological aspects of patients with chromoblastomycosis from the Brazilian Amazon region. Arch Med Res 2013; 44:302-6. [PMID: 23684532 DOI: 10.1016/j.arcmed.2013.04.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 04/15/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Chromoblastomycosis is a chronic fungal infection caused by species of the family Dematiaceae. Fonsecaea pedrosoi is the most common etiological agent. The objective of this study was to describe the epidemiological and mycological profile of patients with chromoblastomycosis from the Amazon region of Brazil and to correlate the clinical forms with the histopathological findings and severity criteria. METHODS Sixty-five patients were submitted to mycological (direct, culture, and microculture) and histopathological (hematoxylin-eosin staining) examination. Severity of the disease was classified according to the criteria proposed by Carrión in 1950. RESULTS Most patients were males (93.8%) and laborers (89.2%). There was a predominance of verrucous lesions (55.4%), which were mainly found on the lower limbs (81.5%). Two major types of tissue reaction were observed: a granulomatous reaction characterized by the formation of suppurative granulomas rich in fungal cells, which were almost always seen in verrucous lesions, and a reaction characterized by the formation of tuberculoid granulomas with few parasites, which were mainly found in well-delimited erythematous plaque-like and cicatricial lesions (p = 0.0001). A peculiar type of organized mycotic granuloma was observed in 20 subjects. Suppurative granulomas were more frequently detected in severe lesions (p = 0.0189) and in lesions with a duration of >10 years (p = 0.0408). CONCLUSIONS These results suggest that verrucous lesions present a less competent inflammatory tissue response than patients who develop a well-formed tuberculoid reaction. The latter is associated with a more effective immune response as observed in the limited clinical forms of chromoblastomycosis.
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Queiroz-Telles F, Santos DWCL. Chromoblastomycosis in the Clinical Practice. CURRENT FUNGAL INFECTION REPORTS 2012. [DOI: 10.1007/s12281-012-0116-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rangel LP, Moreira OC, Livramento GN, Britto C, Alviano DS, Alviano CS, Ferreira-Pereira A. Putative role of an ABC transporter in Fonsecaea pedrosoi multidrug resistance. Int J Antimicrob Agents 2012; 40:409-15. [PMID: 22999764 DOI: 10.1016/j.ijantimicag.2012.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 07/10/2012] [Accepted: 07/16/2012] [Indexed: 10/27/2022]
Abstract
Fonsecaea pedrosoi, a dematiaceous fungus, is the main agent responsible for chromoblastomycosis, a chronic and progressive mycosis of the skin and subcutaneous tissues. This disease can cause different types of lesions depending on the immune status of the host. Its treatment is complicated by the toxicity of available antifungal agents as well as drug resistance. In this work, an ATP-binding cassette (ABC) transporter in this fungus was characterised, with the degree of expression related to the drug resistance of two strains (a patient isolated strain and a laboratory strain). A 150 kDa protein was detected by western blotting. The ATPase activity of membrane preparations was also evaluated. The F. pedrosoi transporter appears to behave like Pdr5p, a well-studied multidrug resistance transporter in Saccharomyces cerevisiae with the ability to hydrolyse different triphosphate nucleotides, as well as its response to classical inhibitors tested. Finally, a reverse transcription polymerase chain reaction (RT-PCR) approach was used and a 400 bp product was detected, corresponding to the highly conserved ATP-binding domain of ABC transporters. We suggest that an ABC transporter must be involved in F. pedrosoi multidrug resistance, and a complete understanding of this protein could bring an important contribution to antifungal treatment of this disease.
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Affiliation(s)
- Luciana P Rangel
- Departamento de Microbiologia Geral, Laboratório de Bioquímica Microbiana/IMPPG, CCS, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, CEP 21941902, Rio de Janeiro, Brazil
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Pires CAA, Xavier MB, Quaresma JAS, Macedo GMMD, Sousa BRDM, Brito ACD. Clinical, epidemiological and mycological report on 65 patients from the Eastern Amazon region with chromoblastomycosis. An Bras Dermatol 2012; 87:555-60. [DOI: 10.1590/s0365-05962012000400006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 05/23/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: Chromoblastomycosis is a chronic fungal infection caused by fungi from the Dematiaceae family. According to several studies, Fonsecaea pedrosoi is the most common of these fungi. The infection is more common in tropical countries, with the Brazilian state of Pará having one of the largest infected populations worldwide. The disease is difficult to treat and recurrences are common. OBJECTIVES: To describe the epidemiological and mycological aspects of cases of chromoblastomycosis and its clinical forms in the state of Pará, Brazil. METHODS: Mycological exams (direct mycological examinations, culture and microculture) were performed and a clinical/epidemiological evaluation was made of 65 patients receiving care at the Dermatology Department of the Federal University of Pará between 2000 and 2007. The clinical classification proposed by Carrión in 1950 was used in this study. RESULTS: The majority of the patients were male (93.8%), agricultural workers (89.2%) of 45 to 55 years of age, and the majority of lesions (55.4%) were of the verrucous type, located principally on the lower limbs (81.5%). In the majority of the cases investigated (61.5%), the infection had been present for a long time, with a mean duration of 11 years. Direct mycological examination was performed in 86.2% of the patients (n=56). Of these, 96.4% (n=54) tested positive. Culture and microculture were performed in vitro in 47 cases of those that tested positive at direct microscopy, results showing Fonsecaea pedrosoi to be the only agent present in this sample. CONCLUSION: This study highlighted the extent to which chromoblastomycosis still affects the quality of life of the local population, principally individuals working in agriculture. This is a chronic disease for which there is no effective treatment. The importance of continuing to investigate this disease should be emphasized, as further studies may lead to new clinical or epidemiological findings.
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González GM, Rojas OC, Bocanegra-García V, González JG, Garza-González E. Molecular diversity of Cladophialophora carrionii in patients with chromoblastomycosis in Venezuela. Med Mycol 2012; 51:170-7. [PMID: 22734968 DOI: 10.3109/13693786.2012.695457] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We identified 29 Cladophialophora carrionii isolates recovered from Venezuelan patients with chromoblastomycosis using phenotypic and molecular characteristics. The genetic diversity of isolates was assessed by enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) fingerprinting. We detected four electrophoretic patterns divided into two main clusters (I and II) comprising 10 and 17 isolates, respectively, and two minor clusters (III and IV) with one isolate each. An interesting cluster-age-lesion type association was detected. The median age of patients in cluster I was 37.5 years and in cluster II, 55 years of age (P = 0.04). The C. carrionii isolates found in cluster I were generally obtained from crusty lesions (60%) and isolates in cluster II were usually recovered from plaque type lesions (53%) even though the P values were only slightly less than significant (P = 0.08). No associations were found among the genetic features strains in the two clusters and gender, occupation, geographic origin, lesion size, severity, and duration of the disease. There was also no correlation between antifungal susceptibilities and strain clustering. In conclusion, molecular typing using ERIC-PCR revealed a genomic heterogeneity in the C. carrionii clinical isolates studied.
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Affiliation(s)
- Gloria M González
- Departamento de Microbiología, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
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Hsu LY, Wijaya L, Shu-Ting Ng E, Gotuzzo E. Tropical Fungal Infections. Infect Dis Clin North Am 2012; 26:497-512. [DOI: 10.1016/j.idc.2012.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Hoffmann CDC, Danucalov IP, Purim KSM, Queiroz-Telles F. Infections caused by dematiaceous fungi and their anatomoclinical correlations. An Bras Dermatol 2012; 86:138-41. [PMID: 21437537 DOI: 10.1590/s0365-05962011000100021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Accepted: 12/21/2010] [Indexed: 11/22/2022] Open
Abstract
The Exophiala genus comprises dimorphic melanized fungi responsible for a spectrum of diseases including phaeohyphomycosis, mycetoma, chromoblastomycosis and fungemia. The E. jeanselmei species is predominant in such infections, followed by E. dermatitidis. This paper aims at reporting four cases and at discussing clinical, histologycal, mycologycal and epidemiologycal aspects for its diagnosis.
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Mouchalouat MDF, Gutierrez Galhardo MC, Zancopé-Oliveira RM, Monteiro Fialho PC, de Oliveira Coelho JMC, Silva Tavares PM, Francesconi do Valle AC. Chromoblastomycosis: a clinical and molecular study of 18 cases in Rio de Janeiro, Brazil. Int J Dermatol 2011; 50:981-6. [PMID: 21781072 DOI: 10.1111/j.1365-4632.2010.04729.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Chromoblastomycosis (CBM) is a chronic subcutaneous mycosis caused by dematiaceous fungi. METHODS We described epidemiological data, clinical presentation, and treatment of 18 cases of CBM diagnosed in Rio de Janeiro, Brazil. Diagnosis was obtained by mycological, histopathological findings demonstrating typical muriform cells with confirmation of isolated by DNA sequencing of the ribosomal internal transcribed spacer. RESULTS The majority of patients were male (72.2%) ranging from 39 to 83 years old, farm laborers and construction workers. The duration of disease varied from four months to 32 years. The most common presentations were verrucous form in ten (55.6%) patients, followed by tumoral in three (16.7%) patients, primarily of moderate (55.6%) and severe (38.9%) intensity. Lower (44.4%) and upper limbs (33.3%) were the most affected sites. Fonsecaea pedrosoi isolated from 14 (77.8%), and Cladophialophora carrionii isolated from one case (5.6%). Fifteen patients (83.3%) were treated. Six patients (40%) received oral itraconazole 200-400 mg/day, five patients (33.3%) received oral itraconazole 200-400 mg/day combined with fluconazole 200 mg/day, and four (26.7%) patients were submitted to surgery. The duration of therapy varied from 12 to 48 months. Cure rate was 80% (12/15). No relapse was observed after two years of follow-up. CONCLUSIONS Success was due to attending a center with specialized clinical care, laboratory support, and pharmaceutical care.
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Affiliation(s)
- Marcelle de F Mouchalouat
- Laboratório de Dermatologia Laboratório de Micologia Laboratório de Anatomia Patológica, Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Brazil.
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Jucá NBH, Crisóstomo MGR, Oliveira LMPD, Cavalcante HA, Sousa ARDD. Linfangioma microcístico acral: diagnóstico diferencial em lesões verrucosas de extremidades. An Bras Dermatol 2011; 86:343-6. [DOI: 10.1590/s0365-05962011000200020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Accepted: 05/05/2010] [Indexed: 11/21/2022] Open
Abstract
Linfangioma é uma má-formação originária da migração anormal de tecido linfático, levando a falhas na comunicação e na drenagem da linfa. Apresenta-se mais comumente como vésico-pápulas agrupadas de conteúdo translúcido na pele ou mucosas. A apresentação inicial na forma de placa verrucosa limitada a um único pododáctilo é atípica e reforça a relevância deste relato. Ainda que considerado lesão benigna, o linfangioma, a depender de sua localização e dimensão, pode apresentar dor local ou infecções recorrentes, com interferência substancial na qualidade de vida. Relatamos caso de linfangioma circunscrito a pododáctilo de surgimento tardio na idade adulta, na forma de placa verrucosa - apresentação atípica confirmada apenas após histopatológico. A excisão cirúrgica garantiu resposta estética e funcional satisfatória.
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Queiroz-Telles F, Nucci M, Colombo AL, Tobón A, Restrepo A. Mycoses of implantation in Latin America: an overview of epidemiology, clinical manifestations, diagnosis and treatment. Med Mycol 2011; 49:225-36. [DOI: 10.3109/13693786.2010.539631] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Comparative analysis of extracellular matrix and cellular carbohydrate expression in the sporotrichosis and chromoblastomycosis. Mycopathologia 2011; 171:403-9. [PMID: 21365320 DOI: 10.1007/s11046-011-9399-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 02/09/2011] [Indexed: 10/18/2022]
Abstract
This work was based on the analysis of digital images of histochemical profile from subcutaneous lesions in sporotrichosis (ST) and chromoblastomycosis (CM) patients. An additional aim was the detection of carbohydrate expression using lectin histochemical analysis of the different carbohydrates in the fungal cell wall from four different species (Sporothrix schenckii, Fonsecaea pedrosoi, Phialophora verrucosa, and Cladophialophora carrionii) associated with diseases mentioned earlier. Slides from tissue biopsies from ST and CM positive patients (n=10, each) were stained according to routine techniques. Slides were incubated with 25 μg/ml of Con A lectins and WGA conjugated to peroxidase. Digital image analysis was carried out in a workstation using OPTIMAS™ software system. Routine histochemistry results indicated that there is significantly higher collagen deposition and elastic fibers in ST characteristic lesions compared with that found in CM cases. The ST interstitial fibrosis area was larger than in CM lesions. Comparative lectin binding showed a positive and intense lectin staining pattern in the cell wall of S. schenckii, suggesting a higher expression of glucose/mannose and N-acetyl glucosamine in their cell surface as evidenced by Con A and WGA, respectively. However, these lectins were not effective to recognize some carbohydrates moieties in the F. pedrosoi, P. verrucosa, and C. carrionii. Such findings contribute to additional information about specific recognition processes between fungal parasites and their host cell targets may be mediated by the interaction of carbohydrate-binding proteins, such as lectins, on the surface of one type of cell that combine with complementary sugars on the surface of another cells into fibro-connective tissues associated with lesions.
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França K, Villa RT, de Azevedo Bastos VR, Almeida ACC, Massucatti K, Fukumaru D, Bedin V. Auricular Chromoblastomycosis: A Case Report and Review of Published Literature. Mycopathologia 2011; 172:69-72. [DOI: 10.1007/s11046-011-9396-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 02/01/2011] [Indexed: 11/28/2022]
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Wu PA, Turner ML, Cowen EW, Wilson E, Shea YR, Jancel T, Freeman AF. Sixty-year-old man with slowly expanding nodular plaque on the thigh. J Am Acad Dermatol 2010; 63:1083-7. [PMID: 21093663 DOI: 10.1016/j.jaad.2010.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 06/06/2010] [Accepted: 06/21/2010] [Indexed: 10/18/2022]
Affiliation(s)
- Peggy A Wu
- Division of Dermatology, Washington University, St Louis, Missouri, USA
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Garcia-Reyne A, López-Medrano F, Morales JM, García Esteban C, Martín I, Eraña I, Meije Y, Lalueza A, Alastruey-Izquierdo A, Rodríguez-Tudela JL, Aguado JM. Cutaneous infection by Phomopsis longicolla in a renal transplant recipient from Guinea: first report of human infection by this fungus. Transpl Infect Dis 2010; 13:204-7. [PMID: 21457423 DOI: 10.1111/j.1399-3062.2010.00570.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We report the case of a 72-year-old female renal transplant recipient with a nodular lesion in the distal phalange of the third left finger produced by a dematiaceous fungus that was identified as Phomopsis longicolla. She was treated with itraconazole and terbinafine and later with voriconazole, without response. The patient underwent a surgical resection with lesion-free edge and continued on voriconazole. One year later she was asymptomatic and had not developed new lesions.
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Affiliation(s)
- A Garcia-Reyne
- Infectious Disease Unit, University Hospital 12 Octubre, Madrid, Spain.
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Badali H, Bonifaz A, Barrón-Tapia T, Vázquez-González D, Estrada-Aguilar L, Cavalcante Oliveira NM, Sobral Filho JF, Guarro J, Meis JFGM, De Hoog GS. Rhinocladiella aquaspersa, proven agent of verrucous skin infection and a novel type of chromoblastomycosis. Med Mycol 2010; 48:696-703. [DOI: 10.3109/13693780903471073] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Criado PR, Careta MF, Valente NYS, Martins JEC, Rivitti EA, Spina R, Belda W. Extensive long-standing chromomycosis due to Fonsecaea pedrosoi: three cases with relevant improvement under voriconazole therapy. J DERMATOL TREAT 2010; 22:167-74. [PMID: 20666671 DOI: 10.3109/09546630903585074] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate voriconazole in the treatment of extensive cases of chromomycosis. Chromomycosis is a chronic infection, which is extremely difficult to eradicate, and is caused by dematiaceous (dark-colored) fungi which affect the skin and subcutaneous tissues, with Fonsecaea pedrosoi being the major etiologic agent. Drugs such as itraconazole, terbinafine, posaconazole and amphotericin B have been employed with variable results. METHODS We treated three Caucasian male patients (ages 44, 57 and 77 years), two were farmers and one a trash collector, with long-standing (20, 10 and 21 years of disease, respectively) and extensive chromomycosis (one lower limb affected, at least) due to Fonsecaea pedrosoi. All patients had received previous therapy with the formerly indicated drugs itraconazole and terbinafine for several months either without or with incomplete response. After that, we started treatment with voriconazole per os 200 mg twice a day. RESULTS The patients were treated with voriconazole for 12 months until there was clinical and mycological improvement. Clinical response was evident after 30-50 days. One patient developed visual abnormalities and tremors, and the voriconazole was reduced to 200 mg/day without impairment of the clinical and mycological response. The same patient presented photosensitive dermatitis after 12 months of therapy and the voriconazole was stopped. All patients showed elevations of serum gamma-glutamyl transpeptidase (GGT) during the treatment without clinical relevance. Moreover, our three patients obtained partial response with this therapy. CONCLUSIONS This is the first report with a case series of chromomycosis treated with voriconazole. Despite its high cost, voriconazole is a safe and possibly promising drug for use on extensive chromomycosis refractory to conventional treatment.
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Affiliation(s)
- Paulo Ricardo Criado
- Dermatology Department, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
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Daboit TC, Stopiglia CDO, von Poser GL, Scroferneker ML. Antifungal activity ofPterocaulon alopecuroides(Asteraceae) against chromoblastomycosis agents. Mycoses 2010; 53:246-50. [DOI: 10.1111/j.1439-0507.2009.01704.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Chromoblastomycosis is a subcutaneous fungal infection caused by the traumatic inoculation of the skin with pigmented saprophytic moulds. Although infection is rarely fatal, it is characteristically chronic and can be complicated by lymphatic damage and malignant transformation. Despite a variety of treatment modalities, which are often combined and include long courses of antifungals, surgical excision and destructive physical therapies, it remains one of the most difficult deep mycotic infections to eradicate.
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Affiliation(s)
- Mahreen Ameen
- St John's Institute of Dermatology, Guy's and St. Thomas' Trust, London SE1 7EH, UK.
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Rubio G, Sánchez G, Porras L, Alvarado Z. [Sporotrichosis: prevalence, clinical and epidemiological features in a reference center in Colombia]. Rev Iberoam Micol 2010; 27:75-9. [PMID: 20346295 DOI: 10.1016/j.riam.2010.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 12/10/2009] [Accepted: 01/07/2010] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Sporotrichosis is a subacute and chronic infection caused by Sporothrix schenckii, which affects humans and other mammals. Clinical and epidemiological information in Colombia is scarce. OBJECTIVE To describe clinical and socio-demographic findings and diagnostic tests in patients with sporotrichosis from 1996 to 2005 in a national reference center in Colombia, and to determine the institutional prevalence from 2002 to 2005. MATERIAL AND METHODS This was a prevalence study, including patients with clinical diagnosis of sporotrichosis and at least one of the following criteria: positive culture with S. schenckii, pathologic diagnosis suggestive of sporotrichosis, or response to treatment with potassium iodide. RESULTS Sixty cases were included, 67% were male, and 25% of them were farmers. The most affected anatomical areas were the forearms and hands (32.5% and 22.8% respectively). Most cases came from the Cundinamarca and Boyacá areas. The cases presented as fixed cutaneous sporotrichosis and lymphangitic sporotrichosis. Differential diagnoses with: leishmaniasis and chromoblastomycosis were performed in most of the cases. All patients were treated with potassium iodide. The prevalence for our center from 2002 to 2005 was 8 cases per 100,000 patients. CONCLUSIONS The characteristics of our patients are similar to those described in other populations, with some differences. The culture continues to be the gold standard for diagnosis purposes. Potassium iodide is the treatment of choice in our center.
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Affiliation(s)
- Gustavo Rubio
- Oficina de Docencia e Investigación, Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá D.C. Colombia
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