RESUMO
We report a case of chromoblastomycosis which resembled sporotrichosis due to the presence of warty nodules and lymphatic distribution on the forearm in a 56-year-old male. Mycological and histopathological investigation of exudates and biopsy tissue samples revealed a granulomatous lesion with muriform cells, the hallmark of chromoblastomycosis. The infection showed only localized expansion with verrucous plaques suggesting a new clinical type of the disease. The causative agent was identified as Rhinocladiella aquaspersa. This case prompted a study of the clinical spectrum of R. aquaspersa, through which we identified a second case caused by this fungus in a 62-year-old Brazilian female. The case was unusual in that R. aquaspersa exhibited hyphae rather than muriform cells in tissue. Given the difficulties treating chromoblastomycosis and other infections caused by melanized fungi, we evaluated the in vitro activities of extended-spectrum triazoles, amphotericin B, and echinocandins against these clinical isolates of R. aquaspersa. Itraconazole (MIC; 0.063 mg/l) and posaconazole (MIC; 0.125 mg/l) had the highest in vitro activities, while voriconazole and isavuconazole had somewhat lower activities (MICs; 2 mg/l) against the isolates. Amphotericin B and anidulafungin each had an MIC of 1 mg/l, whereas the MIC of caspofungin was 8 mg/l.
Assuntos
Ascomicetos/isolamento & purificação , Cromoblastomicose/diagnóstico , Cromoblastomicose/microbiologia , Pele/microbiologia , Pele/patologia , Anfotericina B/farmacologia , Antifúngicos/farmacologia , Ascomicetos/efeitos dos fármacos , Biópsia , Brasil , Cromoblastomicose/patologia , Técnicas Citológicas , Equinocandinas/farmacologia , Feminino , Antebraço/microbiologia , Antebraço/patologia , Histocitoquímica , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Triazóis/farmacologiaRESUMO
Onychomycosis epidemiology is a combination of various factors which include, among others, clinical presentation, etiologic agents of the infection and the patient's history background. Out of a total of 672 nail samples examined, 460 (68.4%) were microscopy positive for fungi and 306 (66.5%) of these were culture positive, including Candida (82%), dermatophytes (13.4%), Trichosporon spp (3.6%) and nondermatophyte molds (1%). Onychomycosis was more frequent in females (79.7%) than in males (20.3%). These were more common in fingernails (96.1%) than in toenails (60%) and yeasts were the most isolated etiologic agents. Among the clinical presentations, paronychia (CP) (57.2%) and onycholysis (CO) (24.8%) were the most common, caused frequently by C. albicans in 52.6% and 60.5% of the cases, respectively. T. rubrum (44.4%) and Trichosporon spp (22.2%) were the most frequent species in the case of distal lateral subungual onychomycosis (DLSO). Fusarium spp was the agent responsible for 33.3% of the cases of proximal subungual onychomycosis (PSO) and for 14.3% of white superficial onychomycosis (WSO), whereas Acremonium spp was responsible for 14.3% of the cases of WSO.
Assuntos
Onicomicose/epidemiologia , Acremonium/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Candida albicans/isolamento & purificação , Candidíase Cutânea/epidemiologia , Candidíase Cutânea/microbiologia , Criança , Pré-Escolar , Feminino , Dedos , Fusarium/isolamento & purificação , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Unhas/microbiologia , Onicomicose/microbiologia , Paroniquia/epidemiologia , Paroniquia/microbiologia , Prevalência , Tinha/epidemiologia , Tinha/microbiologia , Dedos do Pé , Trichosporon/isolamento & purificação , População UrbanaRESUMO
Onychomycosis epidemiology is a combination of various factors which include, among others, clinical presentation, etiologic agents of the infection and the patient's history background. Out of a total of 672 nail samples examined, 460 (68.4) were microscopy positive for fungi and 306 (66.5) of these were culture positive, including Candida (82), dermatophytes (13.4), Trichosporon spp (3.6) and nondermatophyte molds (1). Onychomycosis was more frequent in females (79.7) than in males (20.3). These were more common in fingernails (96.1) than in toenails (60) and yeasts were the most isolated etiologic agents. Among the clinical presentations, paronychia (CP) (57.2) and onycholysis (CO) (24.8) were the most common, caused frequently by C. albicans in 52.6 and 60.5 of the cases, respectively. T. rubrum (44.4) and Trichosporon spp (22.2) were the most frequent species in the case of distal lateral subungual onychomycosis (DLSO). Fusarium spp was the agent responsible for 33.3 of the cases of proximal subungual onychomycosis (PSO) and for 14.3 of white superficial onychomycosis (WSO), whereas Acremonium spp was responsible for 14.3 of the cases of WSO.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Onicomicose , Acremonium , Idoso de 80 Anos ou mais , Brasil , Candida albicans , Candidíase Cutânea/epidemiologia , Candidíase Cutânea/microbiologia , Dedos , Fusarium , Unhas , Onicomicose , Paroniquia , Prevalência , Tinha , Dedos do Pé , Trichosporon , População UrbanaRESUMO
Onychomycosis epidemiology is a combination of various factors which include, among others, clinical presentation, etiologic agents of the infection and the patients history background. Out of a total of 672 nail samples examined, 460 (68.4) were microscopy positive for fungi and 306 (66.5) of these were culture positive, including Candida (82), dermatophytes (13.4), Trichosporon spp (3.6) and nondermatophyte molds (1). Onychomycosis was more frequent in females (79.7) than in males (20.3). These were more common in fingernails (96.1) than in toenails (60) and yeasts were the most isolated etiologic agents. Among the clinical presentations, paronychia (CP) (57.2) and onycholysis (CO) (24.8) were the most common, caused frequently by C. albicans in 52.6 and 60.5 of the cases, respectively. T. rubrum (44.4) and Trichosporon spp (22.2) were the most frequent species in the case of distal lateral subungual onychomycosis (DLSO). Fusarium spp was the agent responsible for 33.3 of the cases of proximal subungual onychomycosis (PSO) and for 14.3 of white superficial onychomycosis (WSO), whereas Acremonium spp was responsible for 14.3 of the cases of WSO.(AU)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Onicomicose/epidemiologia , Acremonium/isolamento & purificação , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Candida albicans/isolamento & purificação , Candidíase Cutânea/epidemiologia , Candidíase Cutânea/microbiologia , Dedos , Fusarium/isolamento & purificação , Unhas/microbiologia , Onicomicose/microbiologia , Paroniquia/epidemiologia , Paroniquia/microbiologia , Prevalência , Tinha/epidemiologia , Tinha/microbiologia , Dedos do Pé , Trichosporon/isolamento & purificação , População UrbanaRESUMO
Onychomycosis epidemiology is a combination of various factors which include, among others, clinical presentation, etiologic agents of the infection and the patients history background. Out of a total of 672 nail samples examined, 460 (68.4
) were microscopy positive for fungi and 306 (66.5
) of these were culture positive, including Candida (82
), dermatophytes (13.4
), Trichosporon spp (3.6
) and nondermatophyte molds (1
). Onychomycosis was more frequent in females (79.7
) than in males (20.3
). These were more common in fingernails (96.1
) than in toenails (60
) and yeasts were the most isolated etiologic agents. Among the clinical presentations, paronychia (CP) (57.2
) and onycholysis (CO) (24.8
) were the most common, caused frequently by C. albicans in 52.6
and 60.5
of the cases, respectively. T. rubrum (44.4
) and Trichosporon spp (22.2
) were the most frequent species in the case of distal lateral subungual onychomycosis (DLSO). Fusarium spp was the agent responsible for 33.3
of the cases of proximal subungual onychomycosis (PSO) and for 14.3
of white superficial onychomycosis (WSO), whereas Acremonium spp was responsible for 14.3
of the cases of WSO.
