Micosis en los pies: descripción clínico-epidemiológica en un centro de referencia de Bogotá, Colombia / Foot mycosis: clinical and epidemiological characterization in one referal center in Bogota, Colombia

Objetivo: Describir las características clínico-epidemiológicas de una población con diagnóstico de infección cutánea micótica en los pies confirmada por examen directo con KOH y cultivo en un centro de referencia de Bogotá, Colombia. Material y método: Estudio observacional descriptivo en el que se incluyeron todos los pacientes con lesiones en los pies que fueron atendidos en el servicio de micología entre el año 2011 y el 2016. Se analizaron las características sociodemográficas, clínicas, etiologías y el perfil de tratamiento por medio de un análisis bivariado. Resultados: Se incluyeron 305 pacientes, de los cuales el 82% residía en zona urbana de la ciudad de Bogotá. El hábito más frecuente fue bañarse descalzo, la forma clínica que predominó fue la interdigital y el 35% de los casos presentó de forma simultánea tiña del pie y onicomicosis. Los agentes etiológicos más comunes fueron los dermatofitos con el 95,2% de los casos. Discusión: La presentación clínica sugestiva de micosis, además del resultado positivo del examen directo y del cultivo, permiten hacer el diagnóstico de estas in fecciones. Las características sociodemográficas de quienes sufren este tipo de micosis en Colombia se relacionan con su contagiosidad y tendencia a la cronicidad. La intervención de tales aspectos debe hacer parte de las estrategias para su prevención.

Objective: To describe the clinical and epidemiological characteristics of the population with cutaneous mycosis in the feet confirmed by positive mycological studies diagnosed in a reference center in Bogota, Colombia. Methods: Descriptive observational study in which all patients with lesions in the feet that were treated in the mycology service between 2011 and 2016 were included. In all cases KOH examination and fungal culture were performed. The sociodemographic and clinical characteristics, etiologies and the treatment profile were assessed using a bivariate analysis. Results: A total of 305 patients were included, of which 61% were men and 82% lived in an urban area of the city of Bogota. The most common behavior was to take a barefoot bath, the most important comorbidities were venous insufficiency and psoriasis, the main clinical form was interdigital and 35% of the cases presented simultaneously tinea pedis and onychomycosis. The group of dermatophytes was the most frequently isolated (95.2%). Discussion: Clinical examination corresponding with mycosis in the feet, direct examination, and positive culture, allow the physician accurate diagnosis and guide the most appropriate treatment of these infections according to their etiology. The sociodemographic characteristics of those who suffer from this mycosis in Co lombia are related to their contagiousness and tendency to chronicity, therefore, the intervention of such aspects must be part of the strategies for their prevention.

Fungal diseases in children and adolescents in a referral centre in Bogota, Colombia.

A cross-sectional descriptive study was conducted at a dermatology referral centre in Bogotá, to estimate the frequencies and aetiologies of mycoses in the population under 18 years of age attending the medical mycology laboratory over a 13-year period (2000-2012). A total of 1337 samples from 1221 patients were evaluated, involving direct examination and culture for 1279 samples, direct examination alone for 50 and culture alone for 8. During the study period, dermatophytosis was diagnosed via culture in 537 cases (40.1%). The most common aetiological agents were Trichophyton rubrum (235 cases), Microsporum canis (177), Trichophyton mentagrophytes (74) and Microsporum gypseum (22). Pityriasis versicolor was found in 31 cases (5.1%), Candida spp. were found in 17 cases, and non-dermatophyte moulds were confirmed by a second sample in 6 cases (3 cases involving Fusarium spp., 2 Neoscytalidium dimidiatum and 1 Acremonium spp.). In addition, white piedra was diagnosed in 4 cases (0.7%), and tinea nigra in 2 cases (0.3%). Regarding subcutaneous mycoses, 14 cases of sporotrichosis were identified. The results from this study confirm the predominance of dermatophytosis in the paediatric population. T. rubrum and M. canis were the main aetiological agents. We found a few cases of onychomycosis by non-dermatophyte moulds. Sporotrichosis was the only subcutaneous mycosis diagnosed during the study period.

Non-dermatophyte mould onychomycosis: a clinical and epidemiological study at a dermatology referral centre in Bogota, Colombia.

Worldwide prevalence of non-dermatophyte mould onychomycosis has increased in recent years; however, available information on the topic is confusing and oftentimes contradictory, probably due to the small number of reported cases. The aim of this study was to determine and describe the aetiological agents, as well as the epidemiological and clinical characteristics of non-dermatophyte mould onychomycosis in a dermatology referral centre in Bogota, Colombia. A cross-sectional descriptive study was conducted between January 2001 and December 2011 among patients who attend the National Institute of Dermatology with a confirmed diagnosis of onychomycosis by non-dermatophytes moulds. There were 317 confirmed cases of non-dermatophyte mould onychomycosis in 196 women and 121 men whose average age was 43 years. Twenty-seven per cent of them had a history of systemic disease. The habit of walking and showering barefoot was the major infection-related factor. Distal and lateral subungual presentation was the most common pattern of clinical presentation. The most frequent non-dermatophyte mould was Neoscytalidium dimidiatum followed by Fusarium spp. No relationship was observed with predisposing factors previously reported in the literature. Clinical features found in this population are indistinguishable from onychomycosis caused by dermatophytes. High prevalence of N. dimidiatum found here was in contrast to a large number of studies where other types of moulds predominate.

Perforation of the nasal septum as the first sign of histoplasmosis associated with AIDS and review of published literature.

Disseminated histoplasmosis in South America is associated with AIDS in 70-90 % of cases. It is visceral and cutaneous, compromising the oral, pharynx, and laryngeal mucous membranes. The involvement of the nasal mucosa is unusual. Two patients with perforation of the nasal septum as the only sign of their disease were clinically and histopathologically diagnosed as leishmaniasis. The revision of the biopsies and the culture of nasal discharge secretions showed that the pathogens seen were not amastigotes but Histoplasma capsulatum. Other mycotic lesions were not detected, nor there was history of cutaneous leishmaniasis. The leishmanin skin test, available only for the male patient, was negative. The PCR and immunofluorescence antibody titers for Leishmania were negative in both patients. They were HIV positive; in the male, his CD4+ T cell count was 60/mm(3) and in the female 133/mm(3). The nasal ulcer was the only manifestation of histoplasmosis and the first of AIDS in both patients. The male patient recovered with amphotericin B and itraconazole treatment. The female has improved with itraconazole. Both patients received antiretroviral treatment. Nasal mucous membrane ulcers should include histoplasmosis among the differential diagnosis. In conclusion, two patients had perforation of their nasal septum as the only manifestation of histoplasmosis, a diagnosis confirmed by nasal mucosa biopsy and by culture of H. capsulatum, findings which demonstrated that both patients had AIDS.

Esporotricosis: prevalencia, perfil clínico y epidemiológico en un centro de referencia en Colombia / Sporotrichosis: prevalence, clinical and epidemiological features in a reference center in Colombia

Antecedentes La esporotricosis es una infección subaguda y crónica, producida por Sporothrix schenckii, que afecta al hombre y a otros mamíferos. Existe información limitada sobre sus características clínicas y epidemiológicas en Colombia. Objetivo Describir las características demográficas, clínicas y diagnósticas de los pacientes con esporotricosis en el Centro Dermatológico Federico Lleras Acosta de Bogotá (Colombia), entre 1996–2005, y conocer la prevalencia institucional para el periodo de 2002–2005. Material y métodos Se realizó un estudio de prevalencia, identificando pacientes con diagnóstico clínico de esporotricosis y al menos uno de los siguientes criterios: cultivo positivo para S. schenckii, examen histopatológico compatible con esporotricosis y/o respuesta al tratamiento con yoduro de potasio. Resultados Sesenta casos cumplieron los criterios definidos, el 67% fueron hombres y el 25% agricultores. La mayoría provenían de los departamentos de Cundinamarca y Boyacá. Las principales áreas corporales afectadas fueron los antebrazos (32,5%) y las manos (22,8%). Predominó la forma cutánea fija y linfangítica. Los principales diagnósticos diferenciales fueron la leishmaniasis y la cromoblastomicosis. Todos los pacientes recibieron tratamiento con yoduro de potasio. La prevalencia institucional entre los años 2002–2005 fue de 8 casos por 100.000 pacientes. Conclusión Las características de este grupo de pacientes son comunes a las descritas en otras poblaciones, con algunas discrepancias. El estándar de oro en el diagnóstico sigue siendo el cultivo. El tratamiento con yoduro de potasio es la primera elección para el manejo de la esporotricosis en nuestro medio(AU)

Background Sporotrichosis is a subacute and chronic infection caused by Sporothrix schenckii, which affects humans and other mammals. Clinical and epidemiological information in Colombia is scarce. Objective To describe clinical and socio-demographic findings and diagnostic tests in patients with sporotrichosis from 1996 to 2005 in a national reference center in Colombia, and to determine the institutional prevalence from 2002 to 2005. Material and methods This was a prevalence study, including patients with clinical diagnosis of sporotrichosis and at least one of the following criteria: positive culture with S. schenckii, pathologic diagnosis suggestive of sporotrichosis, or response to treatment with potassium iodide. Results Sixty cases were included, 67% were male, and 25% of them were farmers. The most affected anatomical areas were the forearms and hands (32.5% and 22.8% respectively). Most cases came from the Cundinamarca and Boyacá areas. The cases presented as fixed cutaneous sporotrichosis and lymphangitic sporotrichosis. Differential diagnoses with: leishmaniasis and chromoblastomycosis were performed in most of the cases. All patients were treated with potassium iodide. The prevalence for our center from 2002 to 2005 was 8 cases per 100,000 patients. Conclusions The characteristics of our patients are similar to those described in other populations, with some differences. The culture continues to be the gold standard for diagnosis purposes. Potassium iodide is the treatment of choice in our center(AU)

[Sporotrichosis: prevalence, clinical and epidemiological features in a reference center in Colombia]. / Esporotricosis: prevalencia, perfil clínico y epidemiológico en un centro de referencia en Colombia.

BACKGROUND: Sporotrichosis is a subacute and chronic infection caused by Sporothrix schenckii, which affects humans and other mammals. Clinical and epidemiological information in Colombia is scarce. OBJECTIVE: To describe clinical and socio-demographic findings and diagnostic tests in patients with sporotrichosis from 1996 to 2005 in a national reference center in Colombia, and to determine the institutional prevalence from 2002 to 2005. MATERIAL AND METHODS: This was a prevalence study, including patients with clinical diagnosis of sporotrichosis and at least one of the following criteria: positive culture with S. schenckii, pathologic diagnosis suggestive of sporotrichosis, or response to treatment with potassium iodide. RESULTS: Sixty cases were included, 67% were male, and 25% of them were farmers. The most affected anatomical areas were the forearms and hands (32.5% and 22.8% respectively). Most cases came from the Cundinamarca and Boyacá areas. The cases presented as fixed cutaneous sporotrichosis and lymphangitic sporotrichosis. Differential diagnoses with: leishmaniasis and chromoblastomycosis were performed in most of the cases. All patients were treated with potassium iodide. The prevalence for our center from 2002 to 2005 was 8 cases per 100,000 patients. CONCLUSIONS: The characteristics of our patients are similar to those described in other populations, with some differences. The culture continues to be the gold standard for diagnosis purposes. Potassium iodide is the treatment of choice in our center.