RESUMO
A sixty year old patient presented with a slowly progressive swelling of the nose, of one year duration, suggesting a clinical diagnosis of subcutaneous zygomycosis. On investigation, the tissue fungal culture grew Conidiobolus coronatus, confirming the diagnosis as rhinoentomophthoromycosis. He was treated with a combination of oral fluconazole and oral potassium iodide for a total period of 5 months. His symptoms subsided completely. Serial CT scanning of paranasal sinuses showed the gradual resolution of the swelling, in response to the treatment. Early detection of the disease and combination therapy gave rapid and good results. This is the first case of its kind to be reported from Kerala, the southern state of India.
Assuntos
Dermatomicoses/diagnóstico , Entomophthorales , Zigomicose/diagnóstico , Conidiobolus/isolamento & purificação , Dermatomicoses/tratamento farmacológico , Diagnóstico Diferencial , Entomophthorales/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/microbiologia , Nariz/patologia , Doenças dos Seios Paranasais/diagnóstico , Doenças dos Seios Paranasais/tratamento farmacológico , Iodeto de Potássio/uso terapêutico , Zigomicose/tratamento farmacológicoRESUMO
Since Mycobacterium leprae are rarely demonstrable in the tuberculoid spectrum of leprosy, a confirmatory diagnosis of leprosy can be made on the basis of finding active destruction of cutaneous nerves by granulomatous inflammation in a skin biopsy. Immunoperoxidase staining for S-100 protein, which is a marker for Schwann cells, was used to delineate nerves in lesional skin biopsies of 25 patients with tuberculoid and borderline tuberculoid leprosy as well as 15 controls with nonleprous granulomatous inflammation. Four different patterns of nerve damage were observed: infiltrated, fragmented, absent, and intact. All of the nonleprous granulomatous dermatoses showed only intact nerves, either inside or outside the granuloma, and so S-100 staining can be used to rule out leprosy.