Queratitis por Absidia corymbifera en paciente inmunocompetente sin traumatismo corneal previo / Keratitis caused by Absidia corymbifera in an immunocompetent male with no corneal injuries

CASO CLÍNICO: Varón sano de 55 años sin antecedente de traumatismo corneal acude a urgencias por un infiltrado en el ojo izquierdo que responde parcialmente a tratamiento antibiótico tópico. Tras la introducción de corticoterapia tópica presenta un importante empeoramiento de la úlcera. El examen directo y la tinción de Gram permiten un rápido diagnóstico de las hifas de Absidia. Presenta buena respuesta al tratamiento combinado de anfotericina y posaconazol. DISCUSIÓN: Las queratitis por Zygomycetes son raras. Es rara la afectación de pacientes sanos sin antecedentes de traumatismo corneal. El tratamiento combinado de anfotericina y posaconazol ejerce un efecto sinergico contra hongos filamentosos

CASE REPORT: A healthy 55-years-old male went to emergency due to a white infiltrate in the left eye without corneal trauma which partially responds to antibiotic treatment. The infiltrate worsened by the use of topical steroids. Direct microscopic evaluation and Gram stain are a valuable diagnostic tool for the detection of Absidia filaments. There is a successful treatment with anphotericin and posaconazole. DISCUSSION: Keratitis caused by Zygomicetes are unusual. This is a rare condition in healthy patients with no corneal trauma. The treatment with amphotericin and posaconazole are synergistic against filamentous fungi

Primary cutaneous zygomycosis due to Absidia corymbifera in a patient with cutaneous T cell lymphoma.

A slowly enlarging arm ulcer appeared in a 61-year-old man with cutaneous T cell lymphoma. Skin biopsy revealed aseptate hyphae and nodular small/medium-sized pleomorphic CD4(+) T cell infiltration. Cultures yielded Absidia corymbifera which was identified by phenotypic and molecular methods. Since a thorough examination did not detect organ involvement, the patient was diagnosed as having primary cutaneous zygomycosis. This is the first case report of cutaneous zygomycosis caused by A. corymbifera in a patient with primary cutaneous CD4(+) small/medium-sized pleomorphic T-cell lymphoma. Other cases of primary cutaneous zygomycosis caused by A. corymbifera are also reviewed.

An increasing trend of cutaneous zygomycosis caused by Mycocladus corymbifer (formerly Absidia corymbifera): report of two cases and review of primary cutaneous Mycocladus infections.

Cutaneous zygomycosis is a rare but serious infection in trauma patients. We report two cases of cutaneous zygomycosis caused by Mycocladus corymbifer (formerly Absidia corymbifera) which were probably the result of soil contamination of wounds of the patient's lower extremities. Both patients received appropriate antifungal therapy in combination with aggressive surgical debridement. While a cure was achieved with amphotericin B in one, the other patient was intolerant to this antifungal and cure was achieved with a new drug, posaconazole. Twenty seven cases (including the two cases in this study) of cutaneous M. corymbifer zygomycosis reported in the literature were reviewed. The data showed an increase in infections with 16 cases (59.2%) reported since 2002.

Morphological observations on Absidia corymbifera and Absidia blakesleeana strains preserved under mineral oil.

Macro- and micromorphology of 30 living subcultures of Absidia corymbifera (10 strains plus three strains of Absidia ramosa) and Absidia blakesleeana (two strains) preserved under mineral oil at room temperature for periods ranging from 3 to 44 years in The Fungal Culture Collection of Instituto Oswaldo Cruz (IOC) were observed and described by permanent mycological preparations mounted in a glycerol 10% and/or Amann lactophenol solution. Vegetative and asexual reproductive structures are illustrated by drawings made with the aid of a camera-lucida. The study showed that the period of maintenance under mineral oil and the stress which took place during the period of storage did not affect the vegetative and asexual reproductive morphology of the Absidia strains and species studied here.