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Guevara A, Siqueira NP, Nery AF, Cavalcante LRDS, Hagen F, Hahn RC. Chromoblastomycosis in Latin America and the Caribbean: epidemiology over the past 50 years. Med Mycol 2021; 60:6391503. [PMID: 34637525 DOI: 10.1093/mmy/myab062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 01/19/2023] Open
Abstract
Chromoblastomycosis is a chronic disease caused by melanized fungi that mainly affect individuals performing soil-related labour. The objective of this study was to analyse the epidemiological and clinical characteristics of chromoblastomycosis in Latin America and the Caribbean by an extensive literature review. An integrative review was performed of English, French, Portuguese, and Spanish publications in LILACS, SciELO, PubMed, SCOPUS and Web of Science databases covering the period 1969-2019. A total of 1,211 articles were identified, of which 132 were included in the review, covering 2,081 patients, 80.3% were male, the mean age was 56.1 years. The mean duration of the disease was 10.8 years. The lesions were mainly described in the lower limbs (60%). The most frequent clinical forms were verrucous (46.4%) and tumorous (21.7%). Major disease symptoms and signs consisted of itching and pain. Bacterial infection and functional limitation were important complications. Immunosuppression post-kidney transplantation was the most frequent comorbidity while leprosy was the main concomitant infectious disease. Fonsecaea pedrosoi and Cladophialophora carrionii were the predominant etiological agents. Majority of the cured cases were treated with itraconazole as monotherapy or in combination with other antifungals, surgery or cryosurgery. Chromoblastomycosis affects hundreds of rural workers in Latin America and the Caribbean, causing disability and personal, family and economic losses. It is important to prioritize epidemiological surveillance and early diagnosis of this disease in order to reveal its real prevalence and direct resources to preventive actions, diagnosis and early treatment. LAY SUMMARY Chromoblastomycosis is a slowly progressing chronic disease caused by melanized fungi. We collected data from South America and the Caribbean covering 1969-2019, the 132 articles included 2 081 patients, mean disease duration was 10.8 years. Fonsecaea pedrosoi and Cladophialophora carrionii predominated.
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Affiliation(s)
- Armando Guevara
- Mycology/Research Laboratory, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Nathan Pereira Siqueira
- Mycology/Research Laboratory, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Andreia Ferreira Nery
- Department of Internal Medicine, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.,Júlio Muller University Hospital, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | | | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, Utrecht, The Netherlands.,Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Utrecht The Netherlands
| | - Rosane Christine Hahn
- Mycology/Research Laboratory, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.,Júlio Muller University Hospital, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
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da Silva SF, da Silva Cavalcante LR, Fonseca Junior EA, da Silva JM, Lopes JC, Damazo AS. Analysis of the myeloid-derived suppressor cells and annexin A1 in multibacillary leprosy and reactional episodes. BMC Infect Dis 2021; 21:1050. [PMID: 34627197 PMCID: PMC8502368 DOI: 10.1186/s12879-021-06744-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 09/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Patients have distinct clinical forms, and the host´s immunological response regulate those manifestations. In this work, the presence of the myeloid-derived suppressor cell and the regulatory protein annexin A1 is described in patients with multibacillary leprosy and with type 1 and 2 reactions.
Methods Patients were submitted to skin biopsy for histopathological analysis to obtain a bacilloscopic index. Immunofluorescence was used to detect myeloid-derived suppressor cells and annexin A1. Results The data demonstrated that the presence of granulocytic and monocytic myeloid-derived suppressor cells in leprosy patients. A high number of monocytic myeloid-derived suppressor cells were observed in lepromatous leprosy and type 2 reactional patients. The presence of annexin A1 was observed in all myeloid-derived suppressor cells. In particular, the monocytic myeloid-derived suppressor cell in the lepromatous patients has higher levels of this protein when compared to the reactional patients. This data suggest that the higher expression of this protein may be related to regulatory response against a severe infection, contributing to anergic response. In type 1 reactional patients, the expression of annexin A1 was reduced. Conclusions Myeloid-derived suppressor cell are present in leprosy patients and annexin A1 might be regulated the host response against Mycobacterium leprae. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06744-x.
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Affiliation(s)
- Stephanni Figueiredo da Silva
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal de Mato Grosso (UFMT), 2367 Fernando Correa da Costa Avenue, Cuiabá, MT, 78060-900, Brazil.,Coordenator of the Laboratory of Clinical Analysis in Jangada, Jangada, MT, 78490-000, Brazil
| | - Leticia Rossetto da Silva Cavalcante
- Ambulatory of Leprosy, University Hospital Julio Müller, Luis Philippe Pereira Leite Street, Cuiabá, MT, 78048-902, Brazil.,Post-Graduate Program in Professional Master in Science Applied at Hospital Attention, University Hospital Julio Müller, Luis Philippe Pereira Leite Street, Cuiabá, MT, 78048-902, Brazil
| | - Ezequiel Angelo Fonseca Junior
- Ambulatory of Leprosy, University Hospital Julio Müller, Luis Philippe Pereira Leite Street, Cuiabá, MT, 78048-902, Brazil
| | - Joselina Maria da Silva
- Department of Basic Sciences in Health, Faculty of Medicine (FM), School of Medicine, Universidade Federal de Mato Grosso (UFMT), 2367 Fernando Correa da Costa Avenue, MT, 78060-900, Cuiabá, Brazil
| | - José Cabral Lopes
- Ambulatory of Leprosy, University Hospital Julio Müller, Luis Philippe Pereira Leite Street, Cuiabá, MT, 78048-902, Brazil
| | - Amilcar Sabino Damazo
- Post-Graduate Program in Health Sciences, Faculty of Medicine, Universidade Federal de Mato Grosso (UFMT), 2367 Fernando Correa da Costa Avenue, Cuiabá, MT, 78060-900, Brazil. .,Post-Graduate Program in Professional Master in Science Applied at Hospital Attention, University Hospital Julio Müller, Luis Philippe Pereira Leite Street, Cuiabá, MT, 78048-902, Brazil. .,Department of Basic Sciences in Health, Faculty of Medicine (FM), School of Medicine, Universidade Federal de Mato Grosso (UFMT), 2367 Fernando Correa da Costa Avenue, MT, 78060-900, Cuiabá, Brazil.
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Dorilêo GB, Cavalcante LRDS, Lopes JC, Damazo AS. Report of two cases of lepromatous leprosy at an early age. Int J Infect Dis 2020; 101:46-48. [PMID: 32992010 DOI: 10.1016/j.ijid.2020.09.1448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022] Open
Abstract
Leprosy is an infectious disease that has a broad spectrum of clinical manifestations. Lepromatous leprosy has a deficient cellular immune response and high bacillary multiplication. It has epidemiological importance, as it is the most contagious clinical form of the disease. Its manifestation in children and adolescents is unusual. In the present study, we report two cases of leprosy at an early age, manifesting the lepromatous clinical form, highlighting the auricular involvement in one case. Early diagnosis is an essential tool to avoid deformities and deficiencies.
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Affiliation(s)
| | - Leticia Rossetto da Silva Cavalcante
- Post-Graduate Program in Professional Master in Applied Science at Hospital Atention, University Hospital Julio Müller, Cuiabá, MT, Brazil; Ambulatory of Leprosy, University Hospital Julio Müller, Cuiabá, MT, Brazil
| | - José Cabral Lopes
- Ambulatory of Leprosy, University Hospital Julio Müller, Cuiabá, MT, Brazil
| | - Amilcar Sabino Damazo
- Post-Graduate Program in Professional Master in Applied Science at Hospital Atention, University Hospital Julio Müller, Cuiabá, MT, Brazil; Department of Basic Sciences in Health, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, MT, 78060-900, Brazil.
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