RESUMO
A 12-year-old girl had been presenting a woody infiltration and erythema in the frontal region and on the entire left half of the face, leading to deformity of the nose and buccal fissure, and adenomegaly in a posterior cervical chain, for the last 18 months. Sinusitis was diagnosed and treated with antibiotics, and submitted to ethmoid sinusotomy, with no improvement. Several laboratory tests were made to find the correct diagnosis. An intradermal test for delayed hypersensitivity showed a positive reaction (5 mm) with necrosis for metabolic antigens for Conidiobolus. An oral mucosa biopsy showed a dense lymphohistiocytic infiltrate and focal points of necrosis. Gomori staining for fungi revealed countless wide, nonseptate hyphae. Amphotericin B was prescribed during 35 days, with no improvement. Terbinafine given orally was started in association with amphotericin B. Reduction of the lesions was observed 2 months later. No side effects were seen during 4 months of treatment.
Assuntos
Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Entomophthora , Dermatoses Faciais/microbiologia , Naftalenos/uso terapêutico , Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Antígenos de Fungos/análise , Criança , Dermatomicoses/diagnóstico , Combinação de Medicamentos , Entomophthora/imunologia , Eritema/microbiologia , Sinusite Etmoidal/diagnóstico , Sinusite Etmoidal/tratamento farmacológico , Dermatoses Faciais/diagnóstico , Dermatoses Faciais/tratamento farmacológico , Feminino , Humanos , Doenças Linfáticas/microbiologia , Doenças da Boca/microbiologia , Naftalenos/administração & dosagem , Doenças Nasais/microbiologia , TerbinafinaRESUMO
Culture filtrate antigens of Basidiobolus ranarum and Conidiobolus coronatus were analyzed by immunodiffusion (ID) with homologous rabbit antisera. B. ranarum and C. coronatus were each found to have five specific antigens. Results of tests with heterologous antisera indicated that all of the species shared at least one antigen. ID tests incorporating the specific precipitin bands as references were developed for detection of basidiobolomycosis and conidiobolomycosis. These tests were performed with sera from humans and horses with proven basidiobolomycosis and conidiobolomycosis as well as with control sera from humans and animals with and without heterologous mycotic and oomycotic infections. Only sera from cases of basidiobolomycosis and conidiobolomycosis produced lines of identity with the reference precipitates of B. ranarum and C. coronatus, respectively. The ID tests were found to be completely sensitive and specific for determining the etiology of zygomycosis caused by these two species. In addition they appeared useful for monitoring resolution of the infections.
Assuntos
Imunodifusão/métodos , Mucormicose/diagnóstico , Animais , Anticorpos Antifúngicos , Antígenos de Fungos/isolamento & purificação , Entomophthora/imunologia , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/imunologia , Cavalos , Humanos , Mucormicose/imunologia , Mucormicose/veterinária , Especificidade da EspécieRESUMO
Exoantigens from Erynia neoaphidis, Conidiobolus major, C. thromboides, C. obscurus, Zoophthora radicans, and Basidiobolus ranarum were obtained from culture filtrates of fungal material grown in a yeast extract, peptone dialysate, dextrose medium and were tested against specific hyperimmune antisera prepared from E. neoaphidis, C. major, C. thromboides, and B. ranarum by the immunodiffusion technique. Specific precipitins were observed for E. neoaphidis and B. ranarum, while cross-reactions were detected among C. major, C. thromboides, and C. obscurus. The results suggest that genera of Entomophthorales can be easily separated by this simple immunological procedure.
