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Reis EGD, Pereira SA, Miranda LHMD, Oliveira RDVCD, Quintana MDSB, Viana PG, Figueiredo ABF, Honorato CCDS, Pereira-Oliveira GR, Silva JN, Schubach TMP, Gremião IDF. A Randomized Clinical Trial Comparing Itraconazole and a Combination Therapy with Itraconazole and Potassium Iodide for the Treatment of Feline Sporotrichosis. J Fungi (Basel) 2024; 10:101. [PMID: 38392773 PMCID: PMC10889782 DOI: 10.3390/jof10020101] [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: 12/26/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Feline sporotrichosis is an endemic disease with high occurrence in Brazil. Itraconazole (ITZ) remains the drug of choice for treating this disease in cats, despite the increasing reports of therapeutic failure. A controlled, randomized clinical trial was performed on 166 naive cats with sporotrichosis to assess the effectiveness and safety of the combination therapy with ITZ and potassium iodide (KI) compared with ITZ monotherapy. Cats were randomly allocated into two treatment groups: G1-ITZ 100 mg/cat/day-and G2-ITZ 100 mg/cat/day + KI 2.5-20 mg/kg/day. Cats treated in G2 presented 77% more risk of reaching a clinical cure (a positive effect) than those treated in G1, even when controlled by negative predictors. The survival curves of the two treatment protocols indicate that a clinical cure was achieved faster in G2. An increase in the KI dose was necessary in 28 cats due to the persistence of clinical signs. Adverse reactions were equally frequent in both groups and manageable with a temporary drug suspension and/or a hepatoprotective therapy. The combination therapy was associated with a higher cure rate and a shorter treatment time, suggesting that ITZ+KI arises as a better option for treating feline sporotrichosis and should be considered the first-line treatment, especially in the presence of negative predictors.
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Affiliation(s)
- Erica Guerino Dos Reis
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | | | | | - Marcel de Souza Borges Quintana
- Laboratory of Clinical Epidemiology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-361, Brazil
| | - Paula Gonçalves Viana
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Anna Barreto Fernandes Figueiredo
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Cindy Caroline Dos Santos Honorato
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Gabriela Reis Pereira-Oliveira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Jéssica Nunes Silva
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Tânia Maria Pacheco Schubach
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
| | - Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro 21040-360, Brazil
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Gremião IDF, Miranda LHMD, Pereira-Oliveira GR, Menezes RC, Machado ACDS, Rodrigues AM, Pereira SA. Advances and challenges in the management of feline sporotrichosis. Rev Iberoam Micol 2022; 39:61-67. [PMID: 35840526 DOI: 10.1016/j.riam.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 12/12/2022] Open
Abstract
The domestic cat is the most susceptible host to Sporothrix infection, developing severe clinical forms. Few effective antifungal agents are available for treating feline sporotrichosis, and cases of treatment failure are common. Treatment success depends on cat health status, therapy-related factors, as well as social/economic issues, but it is mainly contingent upon the host-fungus interaction. The owner's adherence is critical and should be reinforced throughout the treatment to increase the chances of a successful outcome. The antifungal agents described for feline sporotrichosis are most often used in monotherapy regimens. Due to cases in which the treatment with itraconazole failed, the use of antifungal agents in combination should be considered to achieve synergy. The combination of itraconazole and potassium iodide represents an important option for the treatment of naïve cats presenting multiple cutaneous lesions, nasal mucosal lesions and/or respiratory signs, as well as for refractory cases. However, the therapeutic options for unsuccessfully treated cases are scarce. Therefore new options are needed, even more taking into account that there are many in vitro potential molecules not available for use in cats yet. More studies are necessary to correlate in vitro antifungal susceptibility tests results and the outcome of cats treated due to sporotrichosis. This review will briefly discuss both the antifungal drugs and treatment protocols used in cats with sporotrichosis, as well as the determinants of treatment failure.
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Affiliation(s)
- Isabella Dib Ferreira Gremião
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil.
| | | | - Gabriela Reis Pereira-Oliveira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Rodrigo Caldas Menezes
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Ana Caroline de Sá Machado
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | | | - Sandro Antonio Pereira
- Laboratory of Clinical Research on Dermatozoonoses in Domestic Animals, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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Ordoñez-Ortega J, Borbolla-Pertierra AM, Sánchez-Carrillo Y, Costta-Michuy MDLÁ, Mirabal-García M, Luengas-Bautista M, Palacios-Reyes D. Rhino-orbital entomophthoramycosis in pediatric patients: Report of two cases. Med Mycol Case Rep 2022; 36:23-26. [PMID: 35308591 PMCID: PMC8927958 DOI: 10.1016/j.mmcr.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/26/2022] [Accepted: 03/02/2022] [Indexed: 12/01/2022] Open
Abstract
Here we present two cases of entomophthoramycosis in young children, these were the first cases ever diagnosed at our center. Both cases represented a diagnostic and treatment challenge. Surgical treatment was key in the management of both patients. Even though atypical disease was encountered, clinical response was obtained after surgical excision and antifungal treatment for a few months.
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Affiliation(s)
- Javier Ordoñez-Ortega
- Infectious Disease Department at Instituto Nacional de Pediatría, Mexico City, Mexico
| | | | | | | | | | | | - Deborah Palacios-Reyes
- Infectious Disease Department at Instituto Nacional de Pediatría, Mexico City, Mexico
- Corresponding author.
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4
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Mondal A, Basu A, Mandal M, Mallik A, Modak DC, Pal D, Majumder D, Guha SK. Entomophthoramycosis: An unusual cause of facial disfigurement. Drug Discov Ther 2022; 15:341-343. [PMID: 35034927 DOI: 10.5582/ddt.2021.01095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Entomophthoramycosis is a rare fungal infection of nose, paranasal sinuses and subcutaneous tissues found in tropical and subtropical region. From India very few cases have been reported. Here we report a case of Entomophthoramycosis due to Conidiobolus coronatus from the eastern India who presented with slowly growing rhinofacial swelling and right sided nasal obstruction due to intranasal mass. The case was diagnosed by typical histopathological findings of broad aseptate hyphae with surrounding eosinophilic granular material (Splendore Hoeppli phenomenon) on microscopy of nasal biopsy material and confirmed by PCR assay of DNA and sequencing from biopsy tissue. Treatment with saturated solution of potassium iodide and itraconazole was successful and clinical cure was attained in 8 months.
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Affiliation(s)
- Agnibho Mondal
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, India
| | - Ayan Basu
- Department of Infectious Diseases & Advanced Microbiology, School of Tropical Medicine, Kolkata, India
| | | | - Arijit Mallik
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, India
| | - Dolan Champa Modak
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, India
| | - Dipankar Pal
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, India
| | - Debajyoti Majumder
- Department of Tropical Medicine, School of Tropical Medicine, Kolkata, India
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5
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Varghese L, Kurien R, Diana Sahni R, Manesh A, Mary Cherian L, Peter D, Dayanand D, Sarojini Michael J, Thomas M, Rupa V, Pulimood S, Varghese GM. Rhinofacial conidiobolomycosis: Clinical and microbiological characterisation and shift in the management of a rare disease. Mycoses 2021; 64:882-889. [PMID: 33915007 DOI: 10.1111/myc.13294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Conidiobolomycosis is a rare tropical rhinofacial fungal infection which has not been well characterised. The available evidence in its management is sparse due to lack of clinical studies and the limited data on antifungal susceptibility patterns. OBJECTIVE To analyse the clinical manifestations, antifungal treatment and outcomes of patients with conidiobolomycosis and to determine antifungal susceptibility profiles of the isolates. PATIENTS/METHODS Retrospective analysis of data of all patients with a diagnosis of conidiobolomycosis confirmed by histopathology and culture at a tertiary care hospital from 2012 to 2019 was done. RESULTS There were 22 patients, 21 males and one female, with a mean age of 37.1 years. Most common presenting symptom was nasal obstruction, found in 20 (90.90%) patients. Patients who presented within 12 months had a better cure rate (85%) compared to those who presented late (67%). Among the 19 patients who had a follow-up, good outcome was seen in 15 of the 17 (88.24%) patients who were on itraconazole or potassium iodide containing regimen. Of the six patients who received additional trimethoprim-sulphamethoxazole (co-trimoxazole), 67% showed good outcome with two patients showing complete cure and two patients still on treatment with significant improvement. High minimum inhibitory concentration (MIC) values were noted for azoles and amphotericin B, whereas co-trimoxazole showed lowest MIC ranges. CONCLUSION Itraconazole and potassium iodide are reasonable first-line options for the treatment of conidiobolomycosis. Good clinical response to KI and comparatively lower MIC of co-trimoxazole are promising. Further studies are required for developing clinical breakpoints that can predict therapeutic outcomes.
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Affiliation(s)
- Lalee Varghese
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Regi Kurien
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Rani Diana Sahni
- Department of Microbiology, Christian Medical College, Vellore, India
| | - Abi Manesh
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | - Lisa Mary Cherian
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Dincy Peter
- Department of Dermatology, Christian Medical College, Vellore, India
| | - Divya Dayanand
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | | | - Meera Thomas
- Department of Pathology, Christian Medical College, Vellore, India
| | - V Rupa
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Susanne Pulimood
- Department of Dermatology, Christian Medical College, Vellore, India
| | - George M Varghese
- Department of Infectious Diseases, Christian Medical College, Vellore, India
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6
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Zetterström S, Hanson R, Velloso Alvarez A, Caldwell F, Boone L, Schumacher J. Equine conidiobolomycosis: A review and case study. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- S. Zetterström
- Department of Clinical Sciences College of Veterinary Medicine J. T. Vaughan Large Animal Teaching Hospital Auburn University Auburn Alabama USA
| | - R. Hanson
- Department of Clinical Sciences College of Veterinary Medicine J. T. Vaughan Large Animal Teaching Hospital Auburn University Auburn Alabama USA
| | - A. Velloso Alvarez
- Department of Clinical Sciences College of Veterinary Medicine J. T. Vaughan Large Animal Teaching Hospital Auburn University Auburn Alabama USA
| | - F. Caldwell
- Department of Clinical Sciences College of Veterinary Medicine J. T. Vaughan Large Animal Teaching Hospital Auburn University Auburn Alabama USA
| | - L. Boone
- Department of Clinical Sciences College of Veterinary Medicine J. T. Vaughan Large Animal Teaching Hospital Auburn University Auburn Alabama USA
| | - J. Schumacher
- Department of Clinical Sciences College of Veterinary Medicine J. T. Vaughan Large Animal Teaching Hospital Auburn University Auburn Alabama USA
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Vatcharayothin N, Kasemsiri P, Thongrong C, Laohakittikul C, Suetrong S, Ungarreevittaya P, Chaisuriya N. Subcutaneous calcification as a supportive radiologic finding for diagnosis of rhinofacial entomophthoromycosis. Clin Pract 2019; 9:1125. [PMID: 31183026 PMCID: PMC6536838 DOI: 10.4081/cp.2019.1125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/20/2019] [Indexed: 11/22/2022] Open
Abstract
Rhinofacial entomophthoromycosis is an uncommon chronic fungal infection of the head and neck. The diagnosis is usually based on clinical manifestations; however, diagnosis of this infection based on early manifestations is difficult and occasionally rhinofacial entomophthoromycosis is mistaken for other diseases. Therefore, computed tomography is introduced to support the diagnosis. Radiologic findings were nonspecific with swelling of the sinonasal mucosa and perinasal region. However, subcutaneous calcification, that was observed in all our cases, may be a supportive radiologic evidence for diagnosis. The diagnosis should be confirmed definitively using histopathology or fungal culture. Early diagnosis allows prompt and appropriate treatment that will achieve excellent outcomes. We suggest that subcutaneous calcification radiologic finding may guide the aware physician to an early diagnosis of rhinofacial entomophthoromycosis.
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Affiliation(s)
- Navarat Vatcharayothin
- Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
| | - Pornthep Kasemsiri
- Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
| | - Cattleya Thongrong
- Department of Anesthesiology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
| | - Chanticha Laohakittikul
- Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
| | - Surapol Suetrong
- Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
| | - Piti Ungarreevittaya
- Department of Pathology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nipon Chaisuriya
- Department of Pathology, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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8
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Deak L, Mudalagiriyappa S, Ballin A, Saxton D, Chakrabarti A. A Rhinofacial Conidiobolus coronatus Fungal Infection Presenting as an Intranasal Tumour. Sultan Qaboos Univ Med J 2019; 18:e549-e552. [PMID: 30988980 DOI: 10.18295/squmj.2018.18.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/09/2018] [Accepted: 09/27/2018] [Indexed: 11/16/2022] Open
Abstract
Conidiobolomycosis is a rare fungal infection that affects adults in tropical regions. We report a 42-year-old male patient who was referred to the Sulaiman Al Habib Hospital, Dubai, United Arab Emirates (UAE), in 2013 with excessive nasal bleeding and a suspected nasal tumour. He reported having briefly visited central India nine months previously. Computed tomography and magnetic resonance imaging showed a highly vascularised mass in the nasal cavity. However, after surgical excision, initial treatment with amphotericin B deoxycholate was unsuccessful and the disease progressed, leading to external and internal nasal deformation and necessitating further excision and facial reconstruction. Histopathological analysis of the second biopsy revealed Splendore-Hoeppli changes consistent with a fungal infection. Microbiological findings subsequently confirmed Conidiobolus coronatus. Subsequently, the patient was successfully treated with a combination of itraconazole and fluconazole. To the best of the authors' knowledge, this is the first report of a case of rhinofacial conidiobolomycosis from the UAE.
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Affiliation(s)
- Levente Deak
- Department of Ear, Nose & Throat, Suliaman Al Habib Hospital, Dubai, UAE
| | | | - Annelyse Ballin
- Department of Ear, Nose & Throat, Al Zahra Hospital, Dubai, UAE
| | - David Saxton
- Department of Ear, Nose & Throat, Suliaman Al Habib Hospital, Dubai, UAE
| | - Arunaloke Chakrabarti
- Center of Advanced Research in Medical Mycology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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9
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Kamat D, Razmi T M, Kaur H, Gupta K, Vinay K. Use of potassium iodide in deep mycosis. Dermatol Ther 2019; 32:e12819. [PMID: 30637881 DOI: 10.1111/dth.12819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 01/11/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Divya Kamat
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Muhammed Razmi T
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Harsimran Kaur
- Derpartment of Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kirti Gupta
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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10
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Gupta N, Kumar R, Ramteke P, Soneja M. Look before you leap: A case series of conidiobolomycosis from the Indian subcontinent. J Family Med Prim Care 2019; 7:1113-1115. [PMID: 30598971 PMCID: PMC6259523 DOI: 10.4103/jfmpc.jfmpc_167_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Conidiobolomycosis is an extremely rare subcutaneous rhinofacial indolent infection caused by Conidiobolus coronatus and Conidiobolus incongruus. It is reported mainly from the tropical and subtropical parts of the world, mostly in form of isolated case reports or small case series. Two immunocompetent male patients presented to our center with indolent nasal swelling and features of nasal obstruction. They were treated outside with antibiotics and/or steroids and were referred to us with nonresolving symptoms. Both of them were diagnosed based on the characteristic histopathological findings and were successfully treated with saturated solution of potassium iodide. Conidiobolomycosis is an important differential in patients presenting with centrofacial swelling. Early suspicion and timely referral by the primary care physicians will help in early diagnosis and treatment of this disease.
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Affiliation(s)
- Nitin Gupta
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rajeev Kumar
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Ramteke
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Sanaei Dashti A, Nasimfar A, Hosseini Khorami H, Pouladfar G, Kadivar MR, Geramizadeh B, Khalifeh M. Gastro-intestinal basidiobolomycosis in a 2-year-old boy: dramatic response to potassium iodide. Paediatr Int Child Health 2018; 38:150-153. [PMID: 27376878 DOI: 10.1080/20469047.2016.1186343] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Gastro-intestinal basidiobolomycosis (GIB) is a rare fungal infection caused by Basidiobolus ranarum. Treatment includes surgical resection and long-term antifungal therapy. A 2.5-year-old boy presented with a 10-day history of abdominal pain, fever and diarrhoea, and a palpable abdominal mass was detected. Resection was undertaken and histology confirmed basidiobolomycosis. Treatment with amphotericin B and itraconazole was commenced, but the infection progressed and spread to involve the intestines, liver, ribs and lung, and also the abdominal wall after 6 months, requiring four operative procedures. Because of unresponsiveness to amphotericin and itraconazole, oral potassium iodide was added which resulted in complete resolution of the infection. Potassium iodide is an essential component of the treatment of systemic B. ranarum.
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Affiliation(s)
- Anahita Sanaei Dashti
- a Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Amir Nasimfar
- b Pediatric Department , Urmia University of Medical Sciences , Urmia , Iran
| | | | - Gholamreza Pouladfar
- a Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Mohammad Rahim Kadivar
- a Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Bita Geramizadeh
- d Transplant Research Center, Department of Pathology, Nemazee Hospital , Shiraz University of Medical Sciences , Shiraz , Iran
| | - Masoomeh Khalifeh
- a Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital , Shiraz University of Medical Sciences , Shiraz , Iran
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12
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Bhattacharjee R, Vinay K, Chatterjee D, Narang T. Potassium iodide: A forgotten remedy for cutaneous cryptococcosis. Dermatol Ther 2017; 31. [PMID: 29124847 DOI: 10.1111/dth.12573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 10/19/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Rajsmita Bhattacharjee
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Tarun Narang
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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13
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Orofino-Costa R, de Macedo PM, Rodrigues AM, Bernardes-Engemann AR. Sporotrichosis: an update on epidemiology, etiopathogenesis, laboratory and clinical therapeutics. An Bras Dermatol 2017; 92:606-620. [PMID: 29166494 PMCID: PMC5674690 DOI: 10.1590/abd1806-4841.2017279] [Citation(s) in RCA: 182] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 07/23/2017] [Indexed: 01/19/2023] Open
Abstract
In the late 90's there was a change in both the route of transmission and the people at risk for sporotrichosis. This zoonotic cat-man alternative transmission route elicited changes in strategies to control the epidemic. There was a progressive increase in the number of cases involving especially children and the elderly. In addition to becoming hyperendemic, uncommon clinical pictures like immunoreactive clinical presentations or severe systemic cases have emerged. New species were identified and classified through molecular tools using more virulent clinical isolates, like S. brasiliensis, compared to the environmental isolates. Likewise, different species of Sporothrix have been associated with different geographic regions. The serological and molecular techniques are used as an auxiliary tool for the diagnosis and/or for species identification, although the isolation and the identification of Sporothrix spp. in clinical specimen is still the gold standard. Currently sporotrichosis epidemics requires the knowledge of the epidemiological-molecular profile to control the disease and the specific treatment. Itraconazole, potassium iodide, terfinafine, and amphotericin B are the available drugs in Brazil to treat sporotrichosis. The drug of choice, its posology, and treatment duration vary according to the clinical presentation, the Sporothrix species, and host immune status. New treatment choices, including a vaccine, are being developed; nevertheless, more clinical trials are required to confirm its efficacy.
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Affiliation(s)
- Rosane Orofino-Costa
- Dermatology Department, Faculdade de Ciências
Médicas, Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro,
RJ, Brazil
- Medical Mycology Laboratory, Dermatology Department, Hospital
Universitário Pedro Ernesto, Rio de Janeiro, RJ, Brazil
| | - Priscila Marques de Macedo
- Infectious Dermatology Clinical Research Laboratory, Instituto
Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz
(INI/Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogen, Department of Microbiology,
Immunology and Parasitology, Universidade Federal de São Paulo (UNIFESP), SP,
Brazil
| | - Andréa Reis Bernardes-Engemann
- Dermatology Department, Faculdade de Ciências
Médicas, Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro,
RJ, Brazil
- Medical Mycology Laboratory, Dermatology Department, Hospital
Universitário Pedro Ernesto, Rio de Janeiro, RJ, Brazil
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Reis ÉG, Schubach TMP, Pereira SA, Silva JN, Carvalho BW, Quintana MSB, Gremião IDF. Association of itraconazole and potassium iodide in the treatment of feline sporotrichosis: a prospective study. Med Mycol 2016; 54:684-90. [PMID: 27207412 DOI: 10.1093/mmy/myw027] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 03/14/2016] [Indexed: 01/16/2023] Open
Abstract
Feline sporotrichosis is an endemic disease in Rio de Janeiro, Brazil, where zoonotic transmission of Sporothrix spp. has been reported since 1998. Itraconazole (ITZ) remains the first choice for treating this disease in cats. However, there have been reports of therapeutic failure and a long-term endeavor. Potassium iodide (KI), considered in the past as a drug with variable effectiveness in cats with sporotrichosis, arises as an important option in the treatment of cats from the endemic area of Rio de Janeiro. In order to evaluate the effectiveness of the association of ITZ and KI in naive cats with sporotrichosis, a prospective cohort study was conducted on 30 cats receiving ITZ 100 mg/day and KI 2.5 mg-20 mg/kg/day. Clinical and laboratory adverse effects were assessed once a month according to the standard care protocol. The cure rate was 96.15% within a median of 14 weeks of treatment. Adverse effects were observed in 50% of cats and were managed with a temporary drug suspension and/or a hepatoprotective therapy. The association of ITZ and KI emerges as an effective option for the treatment of feline sporotrichosis.
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Affiliation(s)
- Érica G Reis
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals (Lapclin-Dermzoo), Evandro Chagas National Institute of Infectious Diseases (INI)/Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Tânia M P Schubach
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals (Lapclin-Dermzoo), Evandro Chagas National Institute of Infectious Diseases (INI)/Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Sandro A Pereira
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals (Lapclin-Dermzoo), Evandro Chagas National Institute of Infectious Diseases (INI)/Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Jéssica N Silva
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals (Lapclin-Dermzoo), Evandro Chagas National Institute of Infectious Diseases (INI)/Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil Department of Mycology, Faculty of Veterinary Science, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Beatriz W Carvalho
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals (Lapclin-Dermzoo), Evandro Chagas National Institute of Infectious Diseases (INI)/Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Marcel S B Quintana
- Clinical Research Plataform, Evandro Chagas Nacional Institute of Infectious Diseases (INI) / Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Isabella D F Gremião
- Laboratory of Clinical Research on Dermatozoonosis in Domestic Animals (Lapclin-Dermzoo), Evandro Chagas National Institute of Infectious Diseases (INI)/Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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