Trichophyton tonsurans in Chile: Genotyping in search of an origin.

Trichophyton tonsurans is a cosmopolitan dermatophyte, highly prevalent in Africa, South America, and endemic in North America, where it is mostly related to cases of tinea capitis. Recently, it was also reported in Chile for the first time in two outbreaks occurred in Santiago. In the present study, we sequenced the variable internal repeat (VIR) region of a Chilean isolate and compared its genotype with those of several global T. tonsurans isolates. The results showed that the Chilean isolate presented a new genotype which was strictly correlated with isolates from Europe, USA and Mexico. LAY SUMMARY: Trichophyton tonsurans is a fungus able to cause superficial mycosis infecting skin and hair. It is an emerging pathogen worldwide and some cases were recently reported also in Chile for the first time. We investigated by molecular techniques which geographical area could be the source of infections.

[Morphological and molecular differentiation by high resolution melting curves (HRMA) and sequencing of the Trichophyton mentagrophytes complex in human strains in Valparaíso, Chile]. / Diferenciación morfofisiológica y molecular por curvas de melting de alta resolución (HRMA) y secuenciación del complejo Trichophyton mentagrophytes en cepas humanas en Valparaíso, Chile.

Trichophyton mentagrophytes complex is the most frequent agent found in dermatophyte isolates after Trichophyton rubrum. It is divided into 3main groups: (1) Trichophyton benhamiae and related species; (2) Trichophyton simii and 2related species, Trichophyton quinckeanum and Trichophyton schoenleinii; and (3) T. mentagrophytes, T. interdigitale, and related species. They are all difficult to identify by morphophysiology. With the aim of classifying them at the species level, a descriptive study was performed on 17 isolated clinical strains identified in the Mycology Laboratory of the Universidad de Valparaíso as belonging to the T. mentagrophytes complex. They were compared with 3 reference strains (T. mentagrophytes CBS 318.56, T. interdigitale CBS 428.63, Trichophyton erinacei CBS 511.73). Morphophysiological and molecular tests were performed by high resolution melting analysis curves and ITS regions sequencing. Phenotypically, 3 species of the complex were identified. Molecular analyses reclassified all the species as belonging to T. interdigitale. In conclusion, no reliable morphophysiological patterns were established to differentiate between the species of the complex. Molecularly, all the strains studied were classified as T. interdigitale.

[Isolation of Aspergillus tritici from internal environment (Chile): Ecological and clinical scope]. / Aislamiento de Aspergillus tritici desde ambiente interno (Chile): alcances ecológicos y clínicos.

Indoor environments provide important protective habitats for humans, who live or work in them most of the time. Many of these environments lack ventilation, which affects the composition of microbial communities, especially that of the fungal community. The aim of this study is to report the isolation of Aspergillus section Candidi from indoor environments of the School of Medicine at Universidad de Valparaiso, Chile, and identification through morpho-physiological and molecular approaches. Their ecological and clinical features were highlighted. An environmental non-volumetric sampling was performed on PDA medium; 2 petri dishes were exposed in 10 different places to select the Aspergillus samples. Subcultures were performed on agar Czapek with yeast extract (CYA), malt extract agar (MEA) and creatin sacarose agar (CREA) media only for the morpho-physiological and later the molecular identification of white spore species. Of the 20 samples analyzed, one Aspergillus belonging to Candidi section was isolated. Based on its morphology and molecular features, it was classified as Aspergillustritici Mehrotra & Basu. Its ecology and medical relevance are reviewed and discussed.

[Virulence of Sporothrix globosa in murine models]. / Virulencia de Sporothrix globosa en modelos murinos.

INTRODUCTION: The sporothricosis disease is an infection caused by species included in Sporothrix schenkii complex. OBJECTIVE: Verify the virulence of a strain of S. globosa using two different concentrations of inoculum by intraperitoneally and subcutaneously, into a mouse model. MATERIALS AND METHODS: Nonrandomized pilot study, in murine inoculated with a strain of S. globosa (CBS 14.076M) by intraperitoneally and subcutaneously with inoculum concentrations of 0.5 and 4 McFarland. For this purpose 18 rodents CF-1 (ISP, Santiago, Chile) were used. RESULTS: The studied strain did not induce illness or injury on animals, they all survived and neither the tissue culture nor the histopathological analysis showed fungal growth or suggestive infection by organ abnormalities. CONCLUSIONS: The S. globosa strain did not present any virulence enough to cause disease at 0.5 and 4.0 McFarland concentration inoculum when inoculated in both intraperitoneally and subcutaneously, in murine models.

[Isolation of Sporothrix pallida complex in clinical and environmental samples from Chile]. / Aislamiento de Sporothrix pallida complex en muestras clínicas y ambientales de Chile.

The isolation of S. pallida complex from medical samples and home garden soil of a patient in Chile is here in reported. Fungi of the Sporothrix schenckii complex can cause various infections. In Chile, the medical and environmental isolates of these this complex are rare. The aim of this study was to identify an unusual agent in a case of onychomycosis and to detect its presence in the patient's home garden. For this purpose, clinical samples were obtained by scraping the patient's subungueal first right toe nail as well as by taking soil samples from different areas of her home garden. Species identification was performed by morphophysiology and one of the strains isolated from the patient's toe nail was sent to CBS for molecular confirmation (14.062). S. pallida complex was identified both from the patient's toe nail and samples taken from her home garden.

[Recommendations for the diagnosis and treatment of infection by Toxoplasma gondii]. / Recomendaciones para el diagnóstico y tratamiento de la infección por Toxoplasma gondii.

Toxoplasmosis is one of the most prevalent parasitosis in the world. It is associated with perinatal morbidity and in immunocompromised population. Currently, there are several diagnostic tests, both serological and molecular, that can help confirm the diagnosis and differentiate a recent infection of a pass. We propose some recommendations for the diagnosis and treatment of toxoplasmosis in different clinical scenarios based on the currently available evidence.

[Probable case of severe SARS-CoV-2 reinfection with Legionella pneumophila co-infection]. / Probable caso de reinfección grave por SARS-CoV-2 con coinfección por Legionella pneumophila.

The immunity conferred after a first SARS-CoV-2 infection and the consequent risk of persistent infection or reinfection are not fully elucidated. There are reports both in Europe and in North America of reinfection cases, recently highlighting the first case published in South America. On the other hand, reports of co-infections have been increasing, including those associated with Legionella pneumophila . We present the case of a 47-year-old male, health personnel who, after four months of a first SARS-CoV-2 infection, suffers a severe pneumonia certifying a new SARS-CoV-2 infection and a L. pneumophila co-infection by urinary antigen detection. He was treated in the ICU, requiring mechanical ventilation, dexamethasone, and moxifloxacin, with a good response. He is currently in respiratory and motor rehabilitation.

[Increase in the positivity of the galactomannan biomarker during the COVID-19 pandemic in the Fifth Region: Valparaíso]. / Aumento en la positividad del biomarcador galactomanano durante la pandemia de COVID-19 en la Quinta Región: Valparaíso.

BACKGROUND: The current pandemic due to SARS-CoV-2 has caused a high burden on health. Cases and series of invasive aspergillosis associated with COVID-19 patients (CAPA) on mechanical ventilation have been described. AIM: To describe the increase in the positivity of the galactomannan (GM) biomarker during the COVID-19 pandemic in the Fifth Region: Valparaíso. METHOD: Retrospective descriptive study. The GM results in both broncho-alveolar lavage (BAL) and serum and the BAL cultures that were sent to the Mycology Laboratory of the University of Valparaíso from January to September 2020 were reviewed; then they were compared with the examinations of the same period of 2019. RESULTS: There was a significant increase in GMs carried out in LBA during the pandemic, concentrating mainly between the months of July-September. CONCLUSIONS: There was a significant increase in GM carried out in LBA during the pandemic, concentrating mainly between the months of July-September.

[Myroides odoratimimus, a rare cause of soft tissue infection and osteomyelitis. Case report]. / Myroides odoratimimus, una causa infrecuente de infección de tejidos blandos y osteomielitis.

Infections due to Gram-negative bacteria of the genus Myroides are very rare and generally affect the skin and soft tissues of patients with some degree of immunocompromise. We present a case of a 23-year-old patient with a history of myelomeningocele surgically resolved at 3 years of age and bot foot, who presented with a deep infection of the right lower extremity by Myroides odoratimimus. The species identification was carried out with MALDI-TOF and the treatment was initially carried out with meropenem and finally then ciprofloxacin, in addition to right supramaleolar amputation.

Diagnóstico y tratamiento de abscesos hepáticos, a propósito de tres casos

El absceso hepático tiene baja incidencia, pero alta mortalidad. Su diagnóstico suele ser tardío dada la variabilidad de presentaciones clínicas. Presentamos tres casos en mujeres, de los cuales dos se manifestaron con síndrome febril con microbiología no precisada, mientras que el tercero con shock séptico secundario a colangitis, aislándose Escherichia coli. Todos fueron manejados con antibioticoterapia endovenosa empírica y drenaje quirúrgico, uno vía laparoscópica, dos percutáneos y uno asociado a una colangio-pancreatografía retrógrada endoscópica. La elección terapéutica se determina de acuerdo a la presencia de rotura, tamaño y/o loculaciones del absceso, combinando antibioticoterapia con métodos de drenaje quirúrgico mínimamente invasivos. Se contrasta y discute la bibliografía disponible, destacando la necesidad de investigaciones actualizadas en Chile.

Liver abscess has low incidence but high mortality. Its diagnosis is often delayed due to the variability of clinical presentations. We present three cases in women, two of which manifested with a febrile syndrome with unspecified microbiology, while the third presented with septic shock secondary to cholangitis, with Escherichia coli isolated. All cases were managed with empirical intravenous antibiotic therapy and surgical drainage, one through laparoscopy, two through percutaneous methods, and one associated with endoscopic retrograde cholangiopancreatography. The therapeutic approach is determined based on the presence of rupture, size, and/or loculations of the abscess, combining antibiotic therapy with minimally invasive surgical drainage methods. We discuss the available literature, emphasizing the need for updated research in Chile.

Micheli y el género Aspergillus / Micheli and genus Aspergillus

Pier Antonio Micheli nació en Florencia, Italia, en el año 1697. Fue un destacado científico, botánico y se le considera el padre de la micología. Dedicó su vida a la taxonomía y al estudio de especies no conocidas de plantas, hongos y líquenes. En 1729 publicó el libro Nova Plantarum Genera, donde describió 1900 plantas, entre las que se encontraban 900 hongos y líquenes. Aquí describió especies de hongos como Botrytis, Mucor y Aspergillus, las cuales tienen importancia en patología médica, animal y vegetal hasta el día de hoy. Murió el 1 de enero de 1737, en su natal Florencia, de una enfermedad pulmonar cuya causa no está bien clara. El legado de Micheli sigue presente y constituye un ejemplo para todos aquellos que se dedican al difícil arte de la taxonomía en sus distintas áreas y en especial a la micología

Pier Antonio Micheli was born in Florence, Italy, in 1697. He was a prominent scientist, botanist and is considered the father of mycology. He dedicated his life to taxonomy and the study of unknown species of plants, fungi, and lichens. In 1729 he published the book Nova Plantarum Genera, where he described 1900 plants, including 900 fungi and lichens. There he described fangal species such as Botrytis, Mucor and Aspergillus, wich are of importance in medical, animal, and plant pathology to this day. He died on January 1, 1737, in his native Florence, due to a lung disease whose cause is unclear. Micheli's legacy is still present, constituting an example for all those who are dedicated to the difficult art of taxonomy in its different areas, especially to mycology.

Nuevos nombres para antiguas especies fúngicas de importancia médica / New names for ancient fungal species of medical importance

En las últimas décadas ha existido un reordenamiento de los géneros y especies fúngicas de importancia médica debido a los constantes avances en la biología molecular. Desde la declaración de Amsterdam en el año 2011, se han ido abandonando la taxonomía de dos nombres (sexual y asexual) por cada especie, además se ha priorizado al primer nombre descrito. Dado que se recomienda comenzar a utilizar los nombres actualizados de los géneros y especies de levaduras y hongos filamentosos, se propone una transición utilizando el nombre actual, y el antiguo entre paréntesis escrito con minúscula, con el fin de evitar confusiones en los médicos clínicos ya acostumbrados a la nomenclatura previa.

In recent decades there has been a rearrangement of fungal genera and species of medical importance due to constant advances in molecular biology. Since the Amsterdam declaration in 2011, the taxonomy of two names (sexual and asexual) for each species has been abandoned, and the first name described has also been prioritized. Since it is recommended to start using the updated names of the genera and species of yeasts and filamentous fungi, a transition is proposed using the current name, and the old one in parentheses written with lower case, in order to avoid confusion in clinician physicians already accustomed to the previous nomenclature.

Primer aislamiento de Sporothrix brasiliensis en un caso humano de esporotricosis en Chile. Un hongo emergente y preocupante / First isolation of Sporothrix brasiliensis in a human case of sporotrichosis in Chile. An emerging and worrisome fungus

Se describe el aislamiento de Sporothrix brasiliensis desde una biopsia de piel de un caso humano de esporotricosis linfocutánea, en la región de Valparaíso, Chile. Esta especie es la más virulenta del género y es de transmisión zoonótica, desde los gatos a los humanos. Hasta ahora, solo se había publicado un brote por esta especie en gatos domésticos y asilvestrados en el extremo sur de Chile, por lo que este aislamiento, en una mujer residente de un sector densamente poblado de la Región de Valparaíso, constituye una preocupación por su eventual diseminación hacia otros gatos y la población general.

The isolation of Sporothrix brasiliensis from a skin biopsy of a human case of lymphocutaneous sporotrichosis in the region of Valparaíso, Chile is described. This species is the most virulent of the genus and is zoonotic in transmission from cats to humans. Until now, only one outbreak of this species has been published in domestic and feral cats in the extreme south of Chile, so this isolation in a woman residing in a densely populated sector of the fifth region is a concern for its eventual spread to other cats and the general population.

Peritonitis asociada a diálisis peritoneal causada por el complejo Paecilomyces variotii / Peritonitis associated with peritoneal dialysis caused by Paecilomyces variotii complex

La peritonitis asociada a diálisis peritoneal es una complicación grave en el paciente con este tipo de modalidad de terapia de reemplazo renal, siendo la etiología fúngica una de las que conlleva mayor morbimortalidad. Presentamos el caso de un paciente de 22 años que desarrolló una peritonitis asociada a diálisis peritoneal causada por el complejo Paecilomyces variotii; un hongo filamentoso poco frecuente en este grupo de pacientes.

Peritonitis associated with peritoneal dialysis is a serious complication in patients with this type of renal replacement therapy modality, with fungal aetiology being one of the most associated with morbidity and mortality. We present the case of a 22-year-old patient who developed fungal peritonitis associated with peritoneal dialysis caused by Paecilomyces variotii complex; a rare cause of peritonitis in this group of patients.

Recomendaciones para el diagnóstico y tratamiento de la infección por Toxoplasma gondii / Recommendations for the diagnosis and treatment of infection by Toxoplasma gondii

Resumen La toxoplasmosis es una de las parasitosis con mayor prevalencia en el mundo. Se asocia a morbimortalidad perinatal y en población inmunocomprometida. Actualmente se cuenta con varias pruebas diagnósticas, tanto serológicas como moleculares, que pueden ayudar a confirmar el diagnóstico y diferenciar una infección reciente de una pasada. Proponemos algunas recomendaciones para el diagnóstico y tratamiento de la toxoplasmosis en distintos escenarios clínicos basados en la evidencia actualmente disponible.

Abstract Toxoplasmosis is one of the most prevalent parasitosis in the world. It is associated with perinatal morbidity and in immunocompromised population. Currently, there are several diagnostic tests, both serological and molecular, that can help confirm the diagnosis and differentiate a recent infection of a pass. We propose some recommendations for the diagnosis and treatment of toxoplasmosis in different clinical scenarios based on the currently available evidence.