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An. bras. dermatol ; 94(6): 744-746, Nov.-Dec. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1054899


Abstract This report describes a case of unusual deep skin ulcers with tortuous sinus tract formation in an immunocompetent woman. She was initially diagnosed with a Staphylococcus aureus skin infection and histopathologically diagnosed with pyoderma gangrenosum. However, culture from the deep end of ribbon gauze inserted into the subcutaneous sinus tract revealed shiny, light-yellow mucoid colonies, which were identified as Cryptococcus neoformans var. grubii. She was treated with fluconazole for nine months and completely healed. Cryptococcosis is an opportunistic infection caused by variants of C. neoformans species. Cutaneous manifestations of cryptococcosis are quite divergent, rarely occurring as deep skin ulcers with sinus formation.

Humanos , Feminino , Adulto , Úlcera Cutânea/microbiologia , Úlcera Cutânea/patologia , Criptococose/patologia , Cryptococcus neoformans/isolamento & purificação , Dermatomicoses/patologia , Imunocompetência , Úlcera Cutânea/tratamento farmacológico , Fluconazol/uso terapêutico , Hospedeiro Imunocomprometido , Criptococose/microbiologia , Criptococose/tratamento farmacológico , Dermatomicoses/microbiologia , Dermatomicoses/tratamento farmacológico , Antifúngicos/uso terapêutico
Arq. bras. med. vet. zootec. (Online) ; 71(4): 1093-1099, jul.-ago. 2019. tab, ilus, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1038630


Boids are large, constrictor snakes that feed mostly on mammals, reptiles, and birds. These animals are commonly raised as pets, and their improper handling can favor the emergence of fungal infections, which can lead to dermatological diseases that are undiagnosed in nature. Here, we isolate and identify the filamentous fungi that compose the mycobiota of the scales of boid snakes kept in captivity at the Biological Museum of the Butantan Institute. Thirty individuals of four species were evaluated: four Eunectes murinus, twelve Boa constrictor constrictor, seven Corallus hortulanus, and seven Epicrates crassus. Microbiological samples were collected by rubbing small square carpets on the snake scales. We isolated five genera of fungi: Penicillium sp. (30%), Aspergillus sp. (25%), Mucor sp. (25%), Acremonium sp. (10%), and Scopulariopsis sp. (10%). Approximately half of the snakes evaluated had filamentous fungi on the scales, but only 12% of the individuals were colonized by more than one fungal genus. We found no dermatophytes in the evaluated species. Our results provide an overview of the fungal mycobiota of the population of boids kept in the Biological Museum, allowing the identification of possible pathogens.(AU)

Boidae são serpentes grandes e constritoras, que comem normalmente mamíferos, répteis e aves. São comumente criadas como animais de estimação, e seu manuseio inadequado pode favorecer infecções fúngicas emergentes, as quais podem causar doenças dermatológicas que não são diagnosticadas na natureza. Foram isolados e identificados os fungos filamentosos da microbiota das escamas das serpentes Boidae mantidas em cativeiro no Museu Biológico do Instituto Butantan. Trinta indivíduos de quatro espécies foram avaliados: quatro Eunectes murinus, 12 Boa constrictor constrictor, sete Corallus hortulanus e sete Epicrates crassus. As amostras microbiológicas foram coletadas por fricção, em pequenos quadrados de carpete das escamas das serpentes. Isolaram-se cinco gêneros de fungos: Penicillium sp. (30%), Aspergillus sp. (25%), Mucor sp. (25%), Acremonium sp. (10%) e Scopulariopsis sp. (10%). Aproximadamente metade das serpentes avaliadas tinham fungos filamentosos nas escamas e apenas 12% dos indivíduos foram colonizados por mais de um gênero. Não foram encontrados dermatófitos nas espécies avaliadas. Os resultados mostraram uma visão geral da microbiota fúngica da população de boídeos mantidos no Museu Biológico, o que permitiu a identificação de possíveis patógenos.(AU)

Animais , Boidae/microbiologia , Dermatomicoses/veterinária , Escamas de Animais/microbiologia , Micobioma
Arq. bras. med. vet. zootec. (Online) ; 71(4): 1143-1148, jul.-ago. 2019. tab, ilus
Artigo em Português | LILACS, VETINDEX | ID: biblio-1038631


Objetivou-se neste estudo padronizar um protocolo de reação em cadeia da polimerase (PCR) para detecção de Microsporum canis em amostras de pelos e/ou crostas de cães e gatos. Foram selecionadas 48 amostras previamente identificadas por meio de cultura. Destas, 23 foram positivas para dermatófitos no cultivo. Padronizou-se a PCR a partir de primers desenhados para o alvo M. canis. Sessenta e um por cento (14/23) das amostras positivas para dermatófitos foram identificadas como M. canis em cultura. Desse total, 71,4% (10/14) apresentaram um fragmento de 218pb compatível com o esperado para a espécie fúngica alvo dessa reação. Observou-se uma sensibilidade de 71,4% e especificidade de 100% na PCR, além de uma boa concordância entre essas técnicas de diagnóstico (Kappa: 0,78; P<0,0001). O protocolo utilizado neste estudo apresentou alta especificidade na detecção de M. canis diretamente de amostras de pelos e/ou crostas de cães e gatos, viabilizando um diagnóstico mais rápido e específico, podendo esse protocolo ser empregado como um método confirmatório para agilizar a detecção de M. canis.(AU)

The aim of this study was to standardize a Polymerase Chain Reaction protocol (PCR) for the detection of Microsporum canis in fur and/or crusts of dogs and cats. 48 samples previously identified by culture were selected. Of these, 23 were positive for dermatophytes in culture. PCR was standardized from drawn primers whose target is M. canis. A total of 61% (14/23) of the dermatophyte positive samples were identified as M. canis in culture. Of this total, 71.4% (10/14) presented a fragment of 218bp compatible with that expected for the fungal species target of the reaction. A sensitivity of 71.4% and specificity of 100% in the PCR were observed, in addition to a good agreement between the techniques (Kappa: 0.78; P<0.0001). The protocol used in this study showed high specificity in the detection of M. canis directly from fur and/or crusts of dogs and cats, making possible a faster and more specific diagnosis. This protocol could be used as a confirmatory method, speeding the detection of M. canis.(AU)

Animais , Gatos , Cães , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase/veterinária , Dermatomicoses/diagnóstico , Dermatomicoses/veterinária , Pelo Animal/microbiologia , Microsporum , Técnicas de Diagnóstico Molecular/veterinária
An. bras. dermatol ; 94(1): 29-36, Jan.-Feb. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-983752


Abstract: Background: Diseases caused by melanized fungi include mycetoma, chromoblastomycosis and phaeohyphomycosis. This broad clinical spectrum depends on the dynamic interactions between etiologic agent and host. The immune status of the host influences on the development of the disease, as, an exemple. phaeohyphomicosis is more frequently observed in immunocompromised patients. Objectives: Examine the histological inflammatory response induced by Fonsecaea pedrosoi in several different strains of mice (BALB/c, C57BL/6, Nude and SCID, and reconstituted Nude). Methods: Fonsecaea pedrosoi was cultivated on agar gel and a fragment of this gel was implanted subcutaneously in the abdominal region of female adult mice. After infection has been obtained, tissue fragment was studied histopathologically. Results: There were significant changes across the strains, with the nodular lesion more persistent in Nude and SCID mice, whereas in immunocompetent mice the lesion progressed to ulceration and healing. The histopathological analysis showed a significant acute inflammatory reaction which consisted mainly of neutrophils in the initial phase that was subsequently followed by a tuberculoid type granuloma in immunocompetent mice. Study limitations: There is no a suitable animal model for chromoblastomycosis. Conclusions: The neutrophilic infiltration had an important role in the containment of infection to prevent fungal spreading, including in immunodeficient mice. The fungal elimination was dependent on T lymphocytes. The re-exposure of C57BL/6 mice to Fonsecaea pedrosoi caused a delay in resolving the infection, and appearance of muriform cells, which may indicate that re-exposure to fungi, might lead to chronicity of infection.

Animais , Feminino , Ascomicetos , Dermatomicoses/imunologia , Imunocompetência , Inflamação/imunologia , Inflamação/microbiologia , Especificidade da Espécie , Fatores de Tempo , Contagem de Células Sanguíneas , Doença Crônica , Cromoblastomicose/imunologia , Cromoblastomicose/patologia , Camundongos SCID , Dermatomicoses/patologia , Modelos Animais de Doenças , Inflamação/patologia , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Nus , Neutrófilos
Bol. micol. (Valparaiso En linea) ; 33(1): 21-25, jun. 2018. ilus
Artigo em Espanhol | LILACS | ID: biblio-904996


Se presenta un caso de dermatitis facial por Malassezia pachydermatis en un paciente de 34 años de edad, diagnosticado mediante clínica y estudio micológico. M. pachydermatis es una levadura que forma parte de la microbiota de mamíferos domésticos y animales salvajes, donde frecuentemente puede provocar dermatitis y otitis externa. En humanos, son escasas las infecciones por este agente, describiéndose desde infecciones superficiales hasta fungemias. En Chile se la ha encontrado como agente causal de pitiriasis versicolor y dermatitis seborreica principalmente en pacientes inmunocomprometidos.

We present a clinical case of facial dermatitis due to Malassezia pachydermatis in a patient of 34 years old, diagnosed by clinical and micology study. M. pachydermatis is a zoofilic yeast that is part of the microbiota of domestic mammals and wild animals, frequently causing dermatitis and external otitis. In humans, infections by this agent are very scarce, describing from superficial infections to fungemias. In Chile it has been found as causal agent of pitiriasis versicolor and seborrheic dermatitis mainly in inmunocompromised patients.

Humanos , Masculino , Adulto , Dermatomicoses/tratamento farmacológico , Face/microbiologia , Malassezia/isolamento & purificação , Malassezia/patogenicidade , Chile , Dermatomicoses/diagnóstico , Fungos Mitospóricos
An. bras. dermatol ; 93(1): 141-142, Jan.-Feb. 2018. graf
Artigo em Inglês | LILACS | ID: biblio-887158


Abstract: Dermatophytes are fungi capable of invading keratinized tissues. Isolation of the fungus with the culture is essential to guide the treatment, because there are more resistant species like Microsporum canis. The chronic use of corticosteroids leads to the deregulation of immunity, promoting atypical manifestations of infections. Topical antifungal therapy is often insufficient, requiring systemic medications. We describe the case of a patient undergoing systemic corticosteroid therapy with a large figurate lesion who presented complete response to exclusively topical treatment.

Humanos , Feminino , Adulto , Hospedeiro Imunocomprometido , Dermatomicoses/tratamento farmacológico , Eritema/tratamento farmacológico , Miconazol/análogos & derivados , Antifúngicos/uso terapêutico , Administração Cutânea , Dermatomicoses/microbiologia , Eritema/microbiologia , Miconazol/uso terapêutico , Microsporum/isolamento & purificação
Braz. J. Pharm. Sci. (Online) ; 54(2): e17149, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-951928


ABSTRACT Griseofulvin (GF) and terbinafine (TF) are commonly used drugs to treat dermatophytosis, a fungal infection of the skin. Today there is an increase in drug resistance to these antifungals which highlight the need for alternative synergistic therapies. Minimum Inhibitory Concentration (MIC) of GF and TF were determined against fungi clinical isolates from local hospitals with values ranging 0.03-2.0 µg mL-1 and 0.24-4.0 µg mL-1, respectively. A checkboard test was used to determine the combination of GF:TF which could induce an additive effect against the fungi isolates Multidrug-resistant isolates showed susceptibility after treatment with 16:2 µg mL-1 GF:TF. An MTT assay further verified that GF and TF combinations have greater additive effect against pathological and multidrug-resistant isolates than antifungals alone. Herein we disclose GF:TF combinations that could constitute as a possible new anti-dermatophyte therapy.

Técnicas In Vitro/métodos , Combinação de Medicamentos , Griseofulvina/análise , Tinha/patologia , Testes de Sensibilidade Microbiana/instrumentação , Dermatomicoses/classificação , Arthrodermataceae/classificação , Antifúngicos/análise
Bol. micol. (Valparaiso En linea) ; 32(2): 15-27, dic. 2017. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-907571


Antecedentes: Pitiriasis versicolor (PV) es una infección micótica superficial crónica de la piel, debido a la colonización del estrato córneo por Malassezia sp. Tradicionalmente M. furfur era considerada el agente causal de PV, hoy en día se ha demostrado que las especies de Malassezia más comunes cultivadas a partir de de lesiones de PV son M. globosa y M. sympodialis. Objetivos: Evaluar la epidemiología de la dermatomicosis PV, en pacientes de la ciudad de Talca, Chile. Metodología: En este estudio, 19 pacientes diagnosticados con PV fueron evaluados. Se realizó identificación fenotípica e identificación molecular por técnica de PCR-RFLP. Para esto, se diseñaron partidores que amplificaron una zona del 26S ADNr presente en todas las especies de Malassezia. Resultados: De un total de 19 pacientes con PV, 7 correspondieron a sexo masculino (36,8 por ciento) y 12 a sexo femenino (63,2 por ciento). Se obtuvieron 18 cepas, a partir de las pruebas fenotípicas fue posible identificar presuntivamente 11 especies de M. globosa (61,1 por ciento) y 7 especies de M. sympodialis (38,9 por ciento). Con los resultados obtenidos en la PCR-RFLP fue posible identificar 11 especies de M. globosa (61,1 por ciento) y 7 especies (38,9 por ciento) de M. sympodialis. Conclusiones: La especie identificada fenotípicamente y molecularmente en mayor proporción fue Malassezia globosa seguida de Malassezia sympodialis. Por lo que hay concordancia entre ambas técnicas de identificación. Este es el primer trabajo de investigación realizado en Talca, Chile, que identificó las especies de Malassezia spp. involucradas en PV, siendo un aporte al estudio de este cuadro clínico.

Background: Pytiriasis versicolor (PV) is a fungal infection of the skin due to the stratum corneum colonization by Malassezia sp. M. furfur traditionally was considered the etiological agent of PV but today it has been shown that M. globosa and M. sympodialis are the most common Malassezia species cultivated from PV lesions. Objective: To evaluate the epidemiological features of PV in patient of the Talca city, Chile. Method: In this study, 19 patients with diagnosis of PV were evaluated. Phenotypic and molecular identified were performed using PCR-RFLP. To do this, primers to amplify 26S ADNr secuence were designed. Result: From a total of 19 patients who presented PV, 7 were male (36.8 percent) and 12 female patients (63.2 percent). Eighteen strains were obtained, from the phenotypic tests, it was possible to presumably identify 11 species of M. globosa (61.1 percent) and 7 species of M. sympodialis (38.9 percent). With PCRRFLP results it was possible to identify 11 species of M. globosa (61.1 percent) and 7 species (38.9 percent) of M. sympodialis. Conclusion: The most commonly isolated species were Malassezia globosa followed by Malassezia sympodialis. So, there is agreement between both techniques of identification. This is the first research work carried out in Talca, Chile, which identified the species of Malassezia spp. Involved in PV, being a contribution to the clinical diagnosis.

Masculino , Feminino , Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Dermatomicoses , Malassezia/classificação , Malassezia/citologia , Malassezia/isolamento & purificação , Malassezia/patogenicidade , Tinha Versicolor/microbiologia , Chile/epidemiologia , Fungos Mitospóricos , Micoses
An. bras. dermatol ; 92(3): 304-311, May-June 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-886949


Abstract Cutaneous mucormycosis is an emerging fungal infection caused by opportunistic fungi of the phylum Glomeromycota. It is frequent in poorly controlled diabetic patients and individuals with immunosuppression. It is usually acquired by direct inoculation through trauma. The clinical presentation is nonspecific, but an indurated plaque that rapidly evolves to necrosis is a common finding. Diagnosis should be confirmed by demonstration of the etiological agent and new molecular diagnostic tools have recently been described. It is an invasive life-threatening disease and in order to improve survival, a prompt diagnosis and multidisciplinary management should be provided. The treatment of choice is amphotericin B, but new azoles, such as posaconazole and isavuconazole, must be considered.

Humanos , Dermatomicoses , Mucormicose , Dermatomicoses/diagnóstico , Dermatomicoses/microbiologia , Dermatomicoses/tratamento farmacológico , Dermatomicoses/epidemiologia , Mucormicose/diagnóstico , Mucormicose/microbiologia , Mucormicose/tratamento farmacológico , Mucormicose/epidemiologia , Antifúngicos/uso terapêutico
An. bras. dermatol ; 92(5,supl.1): 69-72, 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-887091


Abstract Cryptococcosis is a common fungal infection in immunocompromised patients, caused by genus Cryptococcus, presenting with meningitis, pneumonia, and skin lesions. Cutaneous presentation can be varied, but specifically in solid organ transplant recipients (iatrogenically immunocompromised), cryptococcosis should always be considered in the differential diagnosis of cellulitis-like lesions, since the delay in diagnosis leads to worse prognosis and fatal outcome. We report four cases of cryptococcosis with cutaneous manifestation not only for its rarity, but also to emphasize the important role of the dermatologist in the diagnosis of this disease.

Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Criptococose/patologia , Dermatomicoses/patologia , Pele/patologia , Biópsia , Criptococose/imunologia , Criptococose/tratamento farmacológico , Dermatomicoses/imunologia , Dermatomicoses/tratamento farmacológico , Diagnóstico Diferencial , Imunocompetência , Antifúngicos/uso terapêutico
Rev. Nac. (Itauguá) ; 9(2): 04-11, 2017.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-884652


Introducción: los dermatofitos son las principales causas de micosis superficial. Su epidemiología es poco conocida en Paraguay. Objetivos: describir las especies prevalentes, tipos de tiñas y características según sexo y edad de pacientes que acudieron al Laboratorio Central de Salud Pública, Asunción- Paraguay,en el período 2000-2016. Materiales y Métodos: se estudiaron pacientes de todas las edades con diagnóstico de micosis superficiales. Las muestras procesadas fueron uñas, pelos y escamas epidérmicas Se realizaron exámenes directos con KOH y cultivos. La identificación fue por macro y microscopía de las colonias. Resultados: de 6.652 pacientes con sospecha de micosis superficiales, 803 (12%) fueron positivas para dermatofitos. Los aislamientos fueron Microsporumcanis (33,9%), Trichophytonrubrum (23,8%), Trichophytonmentagrophytes (22%), Trichophytontonsurans (12,6%), Microsporumgypseum (6,2%), Trichophytonverrucosum (1,4%), un aislamiento para Microsporummanuumy Epidermophytonfloccosum respectivamente. Los tipos de tiñas fueron: capitis (54,3%), corporis (27,1%) yunguium (9,8%), pedís (3,8%), cruris (3%) y manuum (2%). Conclusión: el hongo prevalente fue Microsporumcanis (33,9%) y la tiña más frecuente fue capitis.

Introduction: dermatophytes are the main causes of superficial mycosis. Its epidemiology is less known in Paraguay. Objectives: to describe the prevalent species, types of tinea and features according to sex and age of patients who attended the Central Laboratory of Public Health, Asunción-Paraguay, in the period 2000-2016. Materials and Methods: patients of all ages with a diagnosis of superficial mycosis were studied. The samples processed were nails, hairs and epidermal scales. Direct tests were carried out with KOH and cultures. The identification was by macro scopy and microscopy of the colonies. Results: of 6,652 patients with suspected superficial mycoses, 803 (12%) were positive for dermatophytes. The isolates were Microsporum canis (33.9%), Trichophyton rubrum (23.8%), Trichophyton mentagrophytes (22%), Trichophyton tonsurans (12.6%), Microsporum gypseum (6.2%), Trichophyton verrucosum (1,4%), isolation for Microsporum manuum and Epidermophyton floccosum respectively. The types of tinea were: capitis (54.3%), corporis (27.1%) and unguium (9.8%), pedis (3.8%), cruris (3%) and manuum (2%). Conclusion: The prevalent fungus was Microsporum canis (33.9%) and the most frequent tinea was capitis.

Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Dermatomicoses/epidemiologia , Paraguai/epidemiologia , Tinha/epidemiologia , Tinha do Couro Cabeludo/epidemiologia , Estudos Transversais , Estudos Retrospectivos , Microsporum/isolamento & purificação
An. Fac. Cienc. Méd. (Asunción) ; 49(2): 87-96, jul-dic. 2016.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-884957


La Aspergilosis es una infección micótica oportunista que afecta principalmente a pacientes inmunodeprimidos con neutropenia, en quienes produce a menudo enfermedad invasiva de curso fulminante. Las manifestaciones cutáneas de la Aspergilosis son infrecuentes, apareciendo en el 5 a 10% de los casos diseminados. Comunicamos un caso de Aspergilosis en una mujer adulta con neutropenia severa por enfermedad hematológica, con afectación pulmonar y sinusal, que presenta múltiples lesiones ulceronecróticas en piel y mucosas, con evolución fatal. Las lesiones mucocutáneas de la Aspergilosis no son específicas, obligan a varios diagnósticos diferenciales y, como en este caso, la biopsia para estudio histopatológico y micológico es necesaria para el diagnóstico.

Aspergillosis is an opportunistic fungal infection that primarily affects immunocompromised patients with neutropenia, in whom invasive disease often results in fulminant course. Cutaneous manifestations of aspergillosis are rare, occurring in 5-10% of cases scattered. We report a case of aspergillosis in an adult woman with severe neutropenia for hematologic disease, lung and sinus disease, having multiple ulceronecróticas skin lesions and mucous membranes, with fatal outcome. The mucocutaneous lesions of aspergillosis are nonspecific, forcing several differential diagnoses, and as in this case, the biopsy for histopathological and mycological study is required for diagnosis.

Humanos , Feminino , Pessoa de Meia-Idade , Aspergilose/complicações , Aspergilose/diagnóstico , Úlcera Cutânea/diagnóstico , Úlcera Cutânea/microbiologia , Dermatomicoses/diagnóstico , Dermatomicoses/microbiologia , Pele/patologia , Evolução Fatal , Necrose/diagnóstico , Necrose/microbiologia
An. bras. dermatol ; 91(6): 832-834, Nov.-Dec. 2016. graf
Artigo em Inglês | LILACS | ID: biblio-837990


Abstract Cryptococcosis is a fungal infection of opportunistic behavior that is unusual in immunocompetent patients. We report a rare case of disseminated cryptococcosis with cutaneous involvement in an immunocompetent individual. During hospitalization, Cryptococcus gattii was isolated from skin lesions, lung and spinal fluid. The diagnosis of disseminated cryptococcosis was confirmed and treatment was established. The patient showed improvement. Due to the probable clinical severity of the disease and the possibility that skin lesions may be the first manifestation of this illness, prompt diagnosis must be established and treatment provided.

Humanos , Masculino , Adulto , Criptococose/imunologia , Criptococose/patologia , Dermatomicoses/imunologia , Dermatomicoses/patologia , Cryptococcus gattii/isolamento & purificação , Imunocompetência , Pele/microbiologia , Pele/patologia , Resultado do Tratamento , Criptococose/tratamento farmacológico , Dermatomicoses/tratamento farmacológico , Linfocitose/complicações , Pulmão/microbiologia , Antifúngicos/uso terapêutico
An. bras. dermatol ; 91(5,supl.1): 29-31, Sept.-Oct. 2016. graf
Artigo em Inglês | LILACS | ID: biblio-837926


Abstract Cryptococcosis is a fungal infection caused by Cryptococcus neoformans that tends to affect immunocompromised individuals. The fungi are mostly acquired by inhalation, which leads to an initial pulmonary infection. Later, other organs - such as the central nervous system and the skin - can be affected by hematogenous spread. In addition, cutaneous contamination can occur by primary inoculation after injuries (primary cutaneous cryptococcosis), whose diagnosis is defined based on the absence of systemic involvement. The clinical presentation of cutaneous forms typically vary according to the infection mode. We report an unusual case of disseminated cryptococcosis in an immunocompetent patient with cutaneous lesions similar to those caused by primary inoculation. This clinical picture leads us to question the definition of primary cutaneous cryptococcosis established in the literature.

Humanos , Masculino , Idoso , Hospedeiro Imunocomprometido , Criptococose/patologia , Dermatomicoses/patologia , Pele/microbiologia , Pele/patologia , Biópsia , Infecções Oportunistas/microbiologia , Criptococose/imunologia , Criptococose/microbiologia , Cryptococcus neoformans/isolamento & purificação , Dermatomicoses/imunologia , Dermatomicoses/microbiologia
An. bras. dermatol ; 91(3): 381-383, graf
Artigo em Inglês | LILACS | ID: lil-787301


Abstract: We describe the case of a 9-year-old boy with idiopathic bone marrow aplasia and severe neutropenia, who developed skin ulcers under cardiac monitoring electrodes. The diagnosis of primary cutaneous aspergillosis was made after the second biopsy and culture. Imaging investigation did not reveal internal fungal infection. The child was treated, but did not improve and died 3 months after admission. The report highlights and discusses the preventable risk of aspergillus skin infection in immunocompromised patients.

Humanos , Masculino , Criança , Aspergilose/microbiologia , Aspergillus niger/isolamento & purificação , Úlcera Cutânea/microbiologia , Dermatomicoses/microbiologia , Anemia Aplástica/imunologia , Aspergilose/complicações , Aspergilose/patologia , Úlcera Cutânea/patologia , Evolução Fatal , Hifas/isolamento & purificação , Dermatomicoses/complicações , Dermatomicoses/patologia , Eletrodos/efeitos adversos , Anemia Aplástica/complicações , Necrose , Neutropenia/complicações
An. bras. dermatol ; 91(3): 384-386, graf
Artigo em Inglês | LILACS | ID: lil-787305


Abstract: The authors report aspects of paracoccidioidomycosis, acute-subacute clinical form, juvenile type, in a 19-year-old female patient. Paracoccidioidomycosis, juvenile type, classically occurs in young patients, both sexes, with lymphoma-like aspects as initial presentation. However, following the natural history of the disease the lymph nodes assume patterns of infectious disease, as an abscess and fistulae. Systemic dissemination of the disease can occur and lethality and morbidity are significant in this clinical presentation.

Humanos , Feminino , Adulto Jovem , Paracoccidioidomicose/diagnóstico , Dermatomicoses/diagnóstico , Paracoccidioidomicose/complicações , Doença Aguda , Dermatomicoses/microbiologia , Fotografia , Linfangite/complicações , Pescoço
An. bras. dermatol ; 91(3): 362-364, graf
Artigo em Inglês | LILACS | ID: lil-787298


Abstract: A patient with systemic involvement, initially treated as tuberculosis, is presented in this report. There were only two painful subcutaneous nodules, from which we arrived at the correct diagnosis of histoplasmosis. The patient was attended by several experts in the fields of infectious diseases, nephrology and internal medicine, but the diagnosis was only possible after dermatological examination and skin biopsy. This case values multidisciplinary interaction between dermatologists and other medical areas for diagnosis of cases with atypical manifestations.

Humanos , Masculino , Tela Subcutânea/microbiologia , Dermatomicoses/diagnóstico , Histoplasmose/diagnóstico , Braço , Biópsia , Comunicação Interdisciplinar , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle
An. bras. dermatol ; 91(2): 243-244, Mar.-Apr. 2016. graf
Artigo em Inglês | LILACS | ID: lil-781368


Abstract Distinct cases of Paracoccidioidomycosis and Cryptococcosis with atypical and localized skin manifestation on the upper limbs of two elderly patients are reported. In the 2nd one, he presented asymptomatic pulmonary cancer; the blood tests for fungal infection were negative, and the etiologic agents were seen in skin biopsy samples. This report emphasizes the importance of the differential diagnosis of infectious diseases in elderly patients.

Humanos , Masculino , Feminino , Idoso , Paracoccidioidomicose/patologia , Dermatopatias Bacterianas/patologia , Criptococose/patologia , Dermatomicoses/patologia , Pele/patologia , Biópsia , Carcinoma de Células Escamosas/patologia , Evolução Fatal , Diagnóstico Diferencial , Neoplasias Pulmonares/patologia
Rev. bras. ortop ; 51(2): 231-234, Mar.-Apr. 2016. graf
Artigo em Inglês | LILACS | ID: lil-779981


Phaeohyphomycosis is caused by cutaneous fungi and rarely affects large joints. This is a case report on phaeohyphomycosis in the left knee of an elderly individual without immunosuppression. It was accompanied by pain and swelling the anterior knee. The case was first suspected to be suprapatellar bursitis, and was treated with nonsteroidal anti-inflammatory drugs, without remission of symptoms. Surgical treatment was performed, with resection of the suprapatellar bursa and anterior region of the quadriceps tendon. The material was sent for anatomopathological examination and culturing. The pathological examination showed phaeohyphomycosis. The treatment instituted consisted of itraconazole, 200 mg/day for six weeks, and complete remission of symptoms was achieved. The physical examination remained normal after one year of follow-up. This is the first published case of phaeohyphomycosis infection in the suprapatellar region of the knee. Although almost all the cases reported have been associated with immunosuppressed patients, this was an exception. It is important to suspect phaeohyphomycosis in cases of knee infection, in the area of the suprapatellar bursa, when the symptoms do not resolve after clinical treatment.

A feohifomicose, causada por fungos demáceos, raramente acomete grandes articulações. Este é um relato de caso de feohifomicose, em joelho esquerdo de idoso não imunossuprimido, acompanhado de dor e aumento de volume em região anterior do joelho. Suspeitou-se de bursite suprapatelar, sendo medicado com anti-inflamatório não esteroidal, sem apresentar remissão dos sintomas. Fez-se tratamento cirúrgico, foram ressecadas a bursa suprapatelar e a região anterior do tendão do quadríceps sendo a peça encaminhada para exame anatomopatológico e cultura. No exame anatomopatológico foi possível evidenciar o diagnóstico de feohifomicose. O tratamento instituído foi itraconazol, 200 mg/dia por seis semanas, apresentando remissão completa do quadro. O exame físico se manteve normal após um ano de seguimento. Este é o primeiro caso publicado a respeito da infecção por feohifomicose em região suprapatelar. Apesar de quase todos os casos registrados estarem associados a pacientes imunossuprimidos, este foi uma exceção. É importante que se suspeite de feohifomicose nas infecções de joelho, na área da bursa suprapatelar, quando os sintomas não resolverem após o tratamento clínico medicamentoso.

Humanos , Masculino , Idoso , Dermatomicoses , Fungos , Infecções , Joelho
An. bras. dermatol ; 90(5): 610-619, graf
Artigo em Inglês | LILACS | ID: lil-764414


AbstractCoccidioidomycosis is a highly prevalent disease in the Western hemisphere. It is considered one of the most virulent primary fungal infections. Coccidioides species live in arid and semi-arid regions, causing mainly pulmonary infection through inhalation of arthroconidia although many other organs can be affected. Primary inoculation is rare. Since the first case of coccidioidomycosis was reported in 1892, the skin has been identified as an important target of this disease. Knowledge of cutaneous clinical forms of this infection is important and very useful for establishing prompt diagnosis and treatment. The purpose of this article is to provide a review of this infection, emphasizing its cutaneous manifestations, diagnostic methods and current treatment.

Feminino , Humanos , Masculino , Coccidioidomicose/patologia , Dermatomicoses/patologia , Coccidioidomicose/classificação , Coccidioidomicose/terapia , Dermatomicoses/terapia , Pneumopatias Fúngicas/patologia , Pneumopatias Fúngicas/terapia , Fatores de Risco , Pele/patologia