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1.
BMC Infect Dis ; 20(1): 171, 2020 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-32087692

RESUMO

BACKGROUND: Trichophyton benhamiae is a zoophilic dermatophyte that can cause tinea in humans and animals. Lesions caused by T. benhamiae tend to be highly inflammatory, and patients are often infected by animals or other patients infected with T. benhamiae. In this paper, we report the first case of tinea faciei caused by T. benhamiae in a Chinese girl who might be transmitted from a fox. CASE PRESENTATION: A 4-year-old girl from HaiNing city developed an itchy, erythematous, and annular plaque on her right face for the past 2 months. Before the lesion appeared, she was in close contact with the fur of a fox for almost 1 week. Septate hyaline hyphae were detected by direct mycological examination of the scales. Cultures grew on Sabouraud's dextrose agar (SDA) at 26 °C for 2 weeks revealed the presence of T. mentagrophytes. A molecular sequencing test confirmed that the isolate was consistent with reference strains to T. benhamiae. Then, the diagnosis of tinea faciei due to T. benhamiae was made. Treatment with terbinafine (oral 125 mg/d) and sertaconazole nitrate cream (topical, twice daily) for 4 weeks was initiated and achieved significant improvement of the skin lesions. CONCLUSIONS: This rare dermatophytosis case highlights the importance of ITS sequencing in helping to recognize rare pathogenic fungi that can be easily misdiagnosed with a conventional morphological diagnosis.


Assuntos
Arthrodermataceae/genética , Dermatomicoses/diagnóstico , Tinha/diagnóstico , Trichophyton/genética , Administração Oral , Administração Tópica , Animais , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Arthrodermataceae/isolamento & purificação , Pré-Escolar , China , Dermatomicoses/tratamento farmacológico , Dermatomicoses/microbiologia , Face/patologia , Feminino , Humanos , Imidazóis/administração & dosagem , Imidazóis/uso terapêutico , Pele/patologia , Terbinafina/administração & dosagem , Terbinafina/uso terapêutico , Tiofenos/administração & dosagem , Tiofenos/uso terapêutico , Tinha/tratamento farmacológico , Tinha/microbiologia , Resultado do Tratamento , Trichophyton/isolamento & purificação
2.
FP Essent ; 489: 16-20, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31995350

RESUMO

Fungal and viral skin infections are common and typically are managed by family physicians. The fungal skin infections commonly seen in family practice include the various forms of tinea: tinea corporis, tinea gladiatorum, tinea cruris, tinea pedis, tinea capitis, and tinea unguium (eg, onychomycosis). Common viral skin infections include herpes simplex virus infection, herpes zoster, cutaneous and genital warts, and molluscum contagiosum. Many fungal and viral skin infections have a classic appearance but variations and atypical manifestations can make patients with these conditions difficult to diagnose definitively. Confirmatory testing often is not required. In complex cases with atypical features, microscopy, culture, or blood tests can help in making a diagnosis. For some infections, treatment may be initiated before confirmatory test results are received. Most fungal skin infections can be managed effectively with topical antifungals. Tinea capitis and onychomycosis should be managed with oral drugs. Oral antiviral drugs are used to manage most viral skin infections but dosages vary based on the condition and phase of the infectious process. Cutaneous warts typically are managed with salicylic acid and/or cryotherapy.


Assuntos
Queimaduras , Dermatomicoses , Dermatopatias Infecciosas , Tinha , Queimaduras/complicações , Queimaduras/microbiologia , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Dermatomicoses/etiologia , Humanos , Pacientes Ambulatoriais , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/tratamento farmacológico , Dermatopatias Infecciosas/etiologia , Tinha dos Pés
3.
An Bras Dermatol ; 94(6): 744-746, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31789256

RESUMO

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.


Assuntos
Criptococose/patologia , Cryptococcus neoformans/isolamento & purificação , Dermatomicoses/patologia , Imunocompetência , Úlcera Cutânea/microbiologia , Úlcera Cutânea/patologia , Adulto , Antifúngicos/uso terapêutico , Criptococose/tratamento farmacológico , Criptococose/microbiologia , Dermatomicoses/tratamento farmacológico , Dermatomicoses/microbiologia , Feminino , Fluconazol/uso terapêutico , Humanos , Hospedeiro Imunocomprometido , Úlcera Cutânea/tratamento farmacológico
4.
Dermatol Online J ; 25(8)2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31553862

RESUMO

Histoplasmosis is a systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum, with disseminated histoplasmosis (HD) being one of its clinical forms. As a consequence of the HIV-AIDS pandemic, HD has become prevalent not only in regions that are recognized as endemic but also in areas not considered endemic, such as Europe and Asia. Its clinical manifestations are varied and mimic several infectious diseases, mainly tuberculosis. In endemic areas, it is the first manifestation of AIDS in 50 to 70% of patients. The diagnosis of histoplasmosis is difficult and HD can lead to death if not diagnosed early and if proper treatment is not instituted. The present report presents a patient with a recent diagnosis of HIV-AIDS, in treatment for miliary tuberculosis, who was diagnosed with disseminated histoplasmosis because of his dermatological manifestations.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Fármacos Anti-HIV/uso terapêutico , Antituberculosos/uso terapêutico , Dermatomicoses/diagnóstico , Histoplasmose/diagnóstico , Tuberculose Miliar/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/complicações , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Estado Terminal , Dermatomicoses/complicações , Dermatomicoses/tratamento farmacológico , Dermatomicoses/patologia , Histoplasma , Histoplasmose/complicações , Histoplasmose/tratamento farmacológico , Histoplasmose/patologia , Humanos , Itraconazol/uso terapêutico , Masculino , Tuberculose Miliar/complicações , Adulto Jovem
5.
Braz J Microbiol ; 50(4): 985-987, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31463867

RESUMO

Arthroderma benhamiae is a zoophilic dermathophyte that can cause highly inflammatory tinea corporis and tinea capitis in humans. This is the first report of a patient with dermatophytosis caused by A. benhamiae in Brazil. The lesion was an erythematous, annular plaque on the lumbar region that appeared few weeks after playing with a street cat in a 19-month-old girl. Initial presumed diagnosis was tinea corporis caused by Microsporum canis. Topical treatments were ineffective and the patient required systemic treatment with griseofulvin. Mycological diagnosis was inconclusive: morphological differentiation between M. canis and Trichophyton benhamiae may be difficult, especially when the latter present yellow colonies. The etiological agent was identified only by ITS sequencing of the isolates aligned with reference strains to A. benhamiae. This report highlights the importance of ITS sequencing in the identification of isolates from some cases of dermatophytosis, because conventional morphological diagnosis may result in misdiagnosis of the agent and delay proper treatment.


Assuntos
Arthrodermataceae/isolamento & purificação , Dermatomicoses/microbiologia , Tinha do Couro Cabeludo/microbiologia , Tinha/microbiologia , Antifúngicos/administração & dosagem , Arthrodermataceae/classificação , Arthrodermataceae/genética , Brasil , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Feminino , Humanos , Lactente , Tinha/diagnóstico , Tinha/tratamento farmacológico , Tinha do Couro Cabeludo/diagnóstico
6.
J Vet Intern Med ; 33(5): 2235-2238, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31448839

RESUMO

A 11-year-old male neutered Shih Tzu was referred to a tertiary facility with a history of weight loss, decreased appetite, polydipsia, and lethargy. The dog had a 10-year history of nonspecific allergic dermatitis and was being treated with 16 mg/kg of ketoconazole q12h for Malassezia dermatitis. Vague gastrointestinal signs, hypocholesterolemia, and lack of a stress leukogram increased suspicion for hypoadrenocorticism (HA). An adrenocorticotropic hormone (ACTH) stimulation test identified hypocortisolemia on pre- and post-ACTH samples and ketoconazole was discontinued. After a short course of corticosteroid treatment, an ACTH stimulation test was repeated and pre-ACTH cortisol concentration was within the reference range, and the post-ACTH cortisol concentration was mildly increased. The temporal association between return of adequate adrenocortical cortisol production and discontinuation of ketoconazole led to the conclusion that the dog had developed iatrogenic HA secondary to ketoconazole treatment.


Assuntos
Insuficiência Adrenal/veterinária , Doenças do Cão/induzido quimicamente , Doença Iatrogênica/veterinária , Cetoconazol/efeitos adversos , Insuficiência Adrenal/induzido quimicamente , Insuficiência Adrenal/diagnóstico , Hormônio Adrenocorticotrópico/administração & dosagem , Hormônio Adrenocorticotrópico/farmacologia , Animais , Antifúngicos/administração & dosagem , Antifúngicos/efeitos adversos , Antifúngicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Dermatomicoses/veterinária , Doenças do Cão/diagnóstico , Cães , Hidrocortisona/sangue , Cetoconazol/administração & dosagem , Cetoconazol/uso terapêutico , Malassezia , Masculino
7.
Photodiagnosis Photodyn Ther ; 27: 385-387, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31301435

RESUMO

Kerion refers to the severe inflammatory reaction which occurs in some cases of fungal infection of the hair or hair follicles. Successful treatment is a challenge for the small number of kerion patients who show poor efficacy of oral antifungal agents. In recent years, photodynamic therapy (PDT) has been proven to be a useful treatment for a variety of fungal infections. In this case report, a 9-year-old Chinese girl presented with erythema, pustular and tender plaques on her scalp for 2 month. The diagnosis of kerion was made based on clinical features and positive mycological findings. After the disease relapsed with oral administration of itraconazole for 6 weeks, she was successfully cured by three sessions of ALA-PDT combined with itraconazole. This case report suggests that ALA-PDT provides a good alternative and adjutant choice for kerion with safety, less side effects, and good repeatability.


Assuntos
Ácido Aminolevulínico/uso terapêutico , Dermatomicoses/tratamento farmacológico , Itraconazol/uso terapêutico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Ácido Aminolevulínico/efeitos adversos , Criança , Quimioterapia Combinada , Feminino , Humanos , Fotoquimioterapia/efeitos adversos , Fármacos Fotossensibilizantes/efeitos adversos , Couro Cabeludo
8.
Rev Soc Bras Med Trop ; 52: e20180480, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340356

RESUMO

We report a rare case of subcutaneous phaeohyphomycosis caused by Cladophialophora bantiana in an immunocompetent patient in Amazonas, Brazil. This dematiaceous fungus has been mainly associated with life-threatening infections affecting the central nervous systems of immunosuppressed patients. We present the clinical, laboratory, and therapeutic aspects, and in vitro susceptibility test results for different antifungal drugs. A brief review of the cases reported in the literature over the past 20 years has also been discussed. According to the literature review, the present case is the first report of subcutaneous phaeohyphomycosis due to C. bantiana in an immunocompetent patient in Latin America.


Assuntos
Ascomicetos/isolamento & purificação , Feoifomicose/diagnóstico , Feoifomicose/microbiologia , Antifúngicos/classificação , Antifúngicos/uso terapêutico , Biópsia , Brasil , Dermatomicoses/tratamento farmacológico , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Fungos Mitospóricos/isolamento & purificação , Feoifomicose/tratamento farmacológico , Feoifomicose/imunologia
9.
Rev. iberoam. micol ; 36(2): 93-95, abr.-jun. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185484

RESUMO

Paciente de 21 años, de sexo masculino, infectado por el VIH y que no sigue adecuadamente el tratamiento antirretroviral, que acude a consulta debido a una erupción papular en el tronco y las extremidades, acompañada de manera simultánea por manchas hipocrómicas en la espalda. El paciente estaba afebril y hemodinámicamente estable. En el estudio micológico de las muestras clínicas de diferentes lesiones se observaron levaduras compatibles con Malassezia. Se prescribió itraconazol por vía oral, con una excelente respuesta clínica. El hallazgo del mismo agente etiológico con 2 presentaciones clínicas diferentes en un solo paciente es poco habitual


A 21 year-old man, HIV infected, and with poor adherence to antiretroviral treatment, consulted us due to a papular rash on trunk and extremities, showing simultaneously hypochromic stains on his back. He was afebrile and hemodynamically stable. In the mycological study of the clinical samples taken from different lesions, yeasts compatible with Malassezia were observed. Oral itraconazole was prescribed, with an excellent clinical response. Finding the same etiolologic agent in 2 different clinical pictures on a single patient is extremely rare


Assuntos
Humanos , Masculino , Adulto Jovem , Dermatomicoses/microbiologia , Infecções por HIV/microbiologia , Malassezia/isolamento & purificação , Administração Oral , Antifúngicos/administração & dosagem , Dermatomicoses/tratamento farmacológico , Itraconazol/administração & dosagem , Transtornos da Pigmentação/microbiologia
11.
J Mycol Med ; 29(2): 185-188, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30956063

RESUMO

Dermatophytic mycetoma of the scalp is a rarity, especially when not associated with tinea capitis. Here, we report a case of dermatophytic mycetoma of the scalp, that was not associated with tinea capitis, caused by an atypical Microsporum audouinii strain. To our knowledge, this is the second reported case, thirty-eight years after the first that was published in 1980.


Assuntos
Dermatomicoses/diagnóstico , Microsporum/isolamento & purificação , Micetoma/diagnóstico , Micetoma/microbiologia , Couro Cabeludo/microbiologia , Adulto , Antifúngicos/uso terapêutico , Biópsia , DNA Intergênico/genética , Dermatomicoses/tratamento farmacológico , Feminino , Humanos , Microsporum/efeitos dos fármacos , Microsporum/genética , Micetoma/tratamento farmacológico , Couro Cabeludo/patologia , Senegal , Análise de Sequência de DNA , Pele/patologia , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
14.
Rev Iberoam Micol ; 36(2): 93-95, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-30862391

RESUMO

A 21 year-old man, HIV infected, and with poor adherence to antiretroviral treatment, consulted us due to a papular rash on trunk and extremities, showing simultaneously hypochromic stains on his back. He was afebrile and hemodynamically stable. In the mycological study of the clinical samples taken from different lesions, yeasts compatible with Malassezia were observed. Oral itraconazole was prescribed, with an excellent clinical response. Finding the same etiolologic agent in 2different clinical pictures on a single patient is extremely rare.


Assuntos
Dermatomicoses/microbiologia , Infecções por HIV/microbiologia , Malassezia/isolamento & purificação , Administração Oral , Antifúngicos/administração & dosagem , Dermatomicoses/tratamento farmacológico , Humanos , Itraconazol/administração & dosagem , Masculino , Transtornos da Pigmentação/microbiologia , Adulto Jovem
17.
Mycopathologia ; 184(2): 309-313, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30666543

RESUMO

We report a case of eczema-like cutaneous mucormycosis caused by Rhizopus arrhizus. A 4-year-old child was presented to our hospital with a history of gradually enlarging papule and plaque in the periumbilical area for nearly 4 years since 2 weeks after his birth, and it has been misdiagnosed as eczema for nearly 3 years. Based on histopathology examination, the fungus culture test and DNA sequencing, it was revealed that R. arrhizus should be the responsible fungus for skin infection. The patient was successfully cured by combination of intravenous drip and percutaneous injection amphotericin B for nearly 3 months, and no recrudescence was seen during a follow-up of 6-month observation.


Assuntos
Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Dermatomicoses/diagnóstico , Dermatomicoses/patologia , Mucormicose/diagnóstico , Mucormicose/patologia , Rhizopus/isolamento & purificação , Pré-Escolar , Dermatomicoses/tratamento farmacológico , Eczema/patologia , Histocitoquímica , Humanos , Infusões Intravenosas , Injeções , Masculino , Técnicas Microbiológicas , Mucormicose/tratamento farmacológico , Análise de Sequência de DNA , Resultado do Tratamento
18.
J Am Acad Dermatol ; 80(4): 883-898.e2, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30102950

RESUMO

As discussed in the first article in this continuing medical education series, angioinvasive fungal infections pose a significant risk to immunocompromised and immunocompetent patients alike, with a potential for severe morbidity and high mortality. The first article in this series focused on the epidemiology and clinical presentation of these infections; this article discusses the diagnosis, management, and potential complications of these infections. The mainstay diagnostic tests (positive tissue culture with histologic confirmation) are often supplemented with serum biomarker assays and molecular testing (eg, quantitative polymerase chain reaction analysis and matrix-assisted laser desorption ionization time-of-flight mass spectrometry) to ensure proper speciation. When an angioinvasive fungal infection is suspected or diagnosed, further workup for visceral involvement also is essential and may partially depend on the organism. Different fungal organisms have varied susceptibilities to antifungal agents, and knowledge on optimal treatment regimens is important to avoid the potential complications associated with undertreated or untreated fungal infections.


Assuntos
Antifúngicos/uso terapêutico , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Biomarcadores/sangue , Biópsia por Agulha , Vasos Sanguíneos/patologia , Terapia Combinada , Dermatomicoses/complicações , Dermatomicoses/patologia , Farmacorresistência Fúngica , Humanos , Técnicas de Tipagem Micológica , Infecções Oportunistas/complicações , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/tratamento farmacológico , Infecções Oportunistas/patologia , Reação em Cadeia da Polimerase , Pele/irrigação sanguínea , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
19.
Mycoses ; 62(2): 181-185, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30350895

RESUMO

BACKGROUND: Exserohilum species are environmental moulds that can cause skin infection and sinusitis in both normal and immunosuppressed children. This study reviews paediatric cases of Exserohilum infection in Queensland, Australia, to identify the spectrum of disease and its clinical course. METHODS: All culture-positive samples of Exserohilum species in children <18 years of age were identified from the Queensland Health Laboratory database (April 2003-April 2018). Clinical information was recorded from medical records. RESULTS: Eleven children were identified, and all had isolated Exserohilum rostratum. The mean age was 7.4 years (range 2.3-17.8) and 64% female. Four immunocompetent children (36%) had a skin infection (2/4), chronic sinusitis (1/4) or otitis externa (1/4). Seven children (64%) had an underlying oncological diagnosis with E. rostratum causing local skin infection (2/7), invasive rhinosinus disease (3/7) or disseminated infection (2/7). All oncological patients were empirically started on liposomal amphotericin B with addition, or switch, to posaconazole or voriconazole. CONCLUSION: Exserohilum rostratum infection of the skin has a favourable course, whereas rhinosinus infection can be rapidly invasive in the immunocompromised child requiring prompt surgical intervention and antifungal therapy. Susceptibility data support empiric use of liposomal amphotericin and/or posaconazole.


Assuntos
Ascomicetos/isolamento & purificação , Micoses/epidemiologia , Micoses/patologia , Adolescente , Distribuição por Idade , Antifúngicos/uso terapêutico , Ascomicetos/efeitos dos fármacos , Criança , Pré-Escolar , Dermatomicoses/tratamento farmacológico , Dermatomicoses/epidemiologia , Dermatomicoses/microbiologia , Dermatomicoses/patologia , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Micoses/tratamento farmacológico , Micoses/microbiologia , Queensland/epidemiologia , Distribuição por Sexo , Sinusite/tratamento farmacológico , Sinusite/epidemiologia , Sinusite/microbiologia , Sinusite/patologia , Resultado do Tratamento
20.
Int J Cancer ; 144(8): 1888-1895, 2019 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-30259971

RESUMO

Terbinafine is used for the treatment of several superficial fungal infections. In silico analyses and animal models suggest that terbinafine might have an anti-tumor effect. We aimed to explore whether subsequent administration of terbinafine might be associated with a lower mortality rate in patients with prostate cancer. We identified patients diagnosed with prostate cancer between July 2005 and December 2014 from the Swedish Cancer Registry, and linked them to the Swedish Prescribed Drug Register to ascertain subsequent use of terbinafine. A total of 799 patients received oral treatment of terbinafine during the study period with a mortality rate of 18.6 per 1,000 person-years. Compared to patients who did not use terbinafine and adjusting for a range of confounding factors, patients that received oral treatment of terbinafine had a decreased risk of death from prostate cancer (HR, 0.53; 95% CI, 0.38-0.73) and a decreased risk of death overall (HR, 0.64; 95% CI, 0.52-0.77). To account for indication bias, we further identified 907 patients who received topical use of terbinafine. However, the risk of death from prostate cancer in patients with topical use of terbinafine was 0.92 (95% CI 0.74-1.12) and the risk of death overall was 1.03 (95% CI 0.91-1.17) as compared to the controls, which suggests that there was no association between risk of death in patients with prostate cancer with topical use of terbinafine. These findings suggest that this drug's potential anti-tumor effect needs to be explored further.


Assuntos
Antifúngicos/administração & dosagem , Dermatomicoses/tratamento farmacológico , Neoplasias da Próstata/mortalidade , Terbinafina/administração & dosagem , Administração Cutânea , Administração Oral , Idoso , Animais , Comorbidade , Dermatomicoses/epidemiologia , Prescrições de Medicamentos/estatística & dados numéricos , Reposicionamento de Medicamentos , Humanos , Masculino , Pessoa de Meia-Idade , Pomadas , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Taxa de Sobrevida , Suécia , Comprimidos
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