Epidemiology of coccidioidomycosis in Argentina, an update.

The National Reference Laboratory in Clinical Mycology of Argentina conducted a retrospective review of human coccidioidomycosis cases diagnosed by the National Mycology Laboratory Network of Argentina between 2010 and 2022 to determine the burden of the disease in the country. A total of 100 human coccidioidomycosis cases were documented, with a higher prevalence in male patients (male-to-female ratio of 1.9:1), with a median age of 41 years. Comparing the number of cases between two 10-year periods (2000-2009 and 2010-2019), the increase was 36.51% (from 63 to 86 cases). Among the 100 recorded cases, 79 tested positive using the double immunodiffusion test. Spherules were observed in 19 cases through histopathology or direct microscopic examination and the fungus was isolated in 39 cases. Thirty-six isolates were identified as Coccidioides posadasii through partial sequencing of the Ag2/PRA gene. Catamarca province had the highest number of cases, comprising 64% of the total, with an incidence rate above 1.0-2.5/100,000 inhabitants until 2018. However, there has been a recent downward trend in the region from 2018 to 2022. It is concerning that more than half of diagnosed cases were chronic pulmonary or disseminated forms, indicating a lack of early disease detection. To rectify this issue, it is imperative to conduct targeted training programs for healthcare personnel and enhance public awareness within the endemic area. This will contribute to a better understanding of the true burden of coccidioidomycosis and enable the implementation of appropriate sanitary control measures.

[Incidence of fungal keratitis at the Hospital Nacional de Clínicas, Córdoba]. / Incidencia de queratitis fúngicas en el Hospital Nacional de Clínicas, Córdoba.

Introduction: Fungal keratitis is a severe, usually ulcerative, corneal suppurativa infection that can lead to blindness or reduced vision. Objectives: To report the incidence and the most common causal agents of fungal keratitis at the National Hospital of Clinics, in the city of Córdoba. Materials and Methods: A retrospective, descriptive and comparative study of case records diagnosed with fungal keratitis was carried out at the National Hospital of Clinics in the period from March 2007 to December 2017 inclusive, analyzing age variables, gender and predisposing factors. Percentages and frequencies of recovered microorganisms were determined and statistical analysis was carried out using a dependency test, determining the relationship between the sex of patients and incidence of fungal keratitis. Results: Of the 66 positive cases in 469 total samples, 57.5% were Fusarium sp, followed by Aspergillus sp. The main cause of fungal keratitis was trauma with plant remains. An average of 6 diagnosed cases were determined per year. Conclusions: The predominant genus was Fusarium sp, with an incidence of 14.1% for this infection in a proportion of 2.9:1 of men compared to women.

Introducción: La queratitis fúngica es una infección corneal supurativa grave, generalmente ulcerosa, que puede provocar ceguera o visión reducida. Objetivos: Reportar la incidencia y los agentes causales más comunes de queratitis micóticas en el Hospital Nacional de Clínicas, de la ciudad de Córdoba. Materiales y Métodos: Se llevó a cabo un estudio retrospectivo, descriptivo y comparativo de los registros de casos con diagnóstico de queratitis fúngica en el Hospital Nacional de Clínicas en el período comprendido desde marzo del 2007 a diciembre de 2017 inclusive, analizando las variables edad, sexo y factores predisponentes. Se determinaron porcentajes y frecuencias de los microorganismos recuperados y llevando a cabo un análisis estadístico mediante una prueba de dependencia, determinamos la relación entre sexo de los pacientes e incidencia de queratitis fúngica. Resultados: De los 66 casos positivos respecto de 469 muestras totales, el 57.5% correspondió a Fusarium sp, seguido de Aspergillus sp. La principal causa de queratitis fúngica fue traumatismo con restos de vegetales. Se determinó un promedio de 6 casos diagnosticados por año. Conclusiones: El género predominante fue Fusarium sp, con una incidencia del 14,1% para esta infección en una proporción de 2.9:1 hombres respecto de mujeres.

[Onychomycosis for Curvularia lunata var. aeria: presentation of a clinical case]. / Onicomicosis por Curvularia lunata var. aeria: presentación de un caso clínico.

We here report a clinical case of a female patient presenting with a three-month history of a white onychodystrophic lesion of both hallux. The infection was due to a mold, identified as Curvularia lunata var aeria. The Curvularia gender is related to the production of phaeohyphomycosis, Curvularia lunata cause onychomycosis occasionally. The patient was treated with itraconazole 200mg/day, during six month with complete remission of the lesions. In conclusion, it is important to consider these fungi as causative agent of nail mycosis since the initial site of infection may be a pathway for systemic dissemination in inmunocompromised patients.

Onicomicosis por Curvularia lunata var. aeria: presentación de un caso clínico / [Onychomycosis for Curvularia lunata var. aeria: Presentation of a clinical case]

We here report a clinical case of a female patient presenting with a three-month history of a white onychodystrophic lesion of both hallux. The infection was due to a mold, identified as Curvularia lunata var aeria. The Curvularia gender is related to the production of phaeohyphomycosis, Curvularia lunata cause onychomycosis occasionally. The patient was treated with itraconazole 200mg/day, during six month with complete remission of the lesions. In conclusion, it is important to consider these fungi as causative agent of nail mycosis since the initial site of infection may be a pathway for systemic dissemination in inmunocompromised patients

Se presenta el caso clínico de una paciente que consultó por una lesión onicodistrófica blanquecina en ambos hallux, de 3 meses de evolución. El examen micológico determinó que el agente causal de la infección era un moho, Curvularia lunata var. aeria. El género Curvularia se asocia a la producción de feohifomicosis. Curvularia lunata es una especie que ocasionalmente puede producir onicomicosis. Se administró tratamiento por pulsos con itraconazol 200mg/día durante 6 meses, con remisión completa de las lesiones. Es importante tener en cuenta a estos hongos como agentes oportunistas causales de micosis ungueales, ya que el lugar inicial de infección puede significar una vía para la diseminación sistémica en pacientes inmunodeprimidos

Onicomicosis por Curvularia lunata var. aeria: presentación de un caso clínico. / [Onychomycosis for Curvularia lunata var. aeria: Presentation of a clinical case].

We here report a clinical case of a female patient presenting with a three-month history of a white onychodystrophic lesion of both hallux. The infection was due to a mold, identified as Curvularia lunata var aeria. The Curvularia gender is related to the production of phaeohyphomycosis, Curvularia lunata cause onychomycosis occasionally. The patient was treated with itraconazole 200mg/day, during six month with complete remission of the lesions. In conclusion, it is important to consider these fungi as causative agent of nail mycosis since the initial site of infection may be a pathway for systemic dissemination in inmunocompromised patients.