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1.
PLoS Negl Trop Dis ; 14(12): e0008897, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33326425

RESUMO

BACKGROUND: Eumycetoma is a neglected tropical disease most commonly caused by the fungus Madurella mycetomatis. Identification of eumycetoma causative agents can only be reliably performed by molecular identification, most commonly by species-specific PCR. The current M. mycetomatis specific PCR primers were recently discovered to cross-react with Madurella pseudomycetomatis. Here, we used a comparative genome approach to develop a new M. mycetomatis specific PCR for species identification. METHODOLOGY: Predicted-protein coding sequences unique to M. mycetomatis were first identified in BLASTCLUST based on E-value, size and presence of orthologues. Primers were then developed for 16 unique sequences and evaluated against 60 M. mycetomatis isolates and other eumycetoma causing agents including the Madurella sibling species. Out of the 16, only one was found to be specific to M. mycetomatis. CONCLUSION: We have discovered a predicted-protein coding sequence unique to M. mycetomatis and have developed a new species-specific PCR to be used as a novel diagnostic marker for M. mycetomatis.


Assuntos
Madurella , Micetoma/diagnóstico , Micetoma/microbiologia , Reação em Cadeia da Polimerase/métodos , Reações Cruzadas , Proteínas Fúngicas , Humanos , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/microbiologia , Especificidade da Espécie
2.
BMC Infect Dis ; 20(1): 829, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33176717

RESUMO

BACKGROUND: Mycetoma is a chronic granulomatous subcutaneous infection caused by anaerobic pseudofilamentous bacteria or fungi. It is commonly prevalent in tropical and subtropical countries. Men are more susceptible to the disease due to greater participation in agricultural works. Mycetoma commonly involves lower extremities, wherein untreated cases lead to aggressive therapeutic choices, such as amputation of the affected body organs and consequently lifelong disability. CASE PRESENTATION: In this report, we present the rare case of a 58-year-old man, originally from Algeria with a left foot chronic tumefaction of 5 years. In the initial clinical examination, mycetoma was diagnosed based on tumefaction and the presence of multiple sinuses with the emission of white grains. The latter was observed via direct examination. The histopathological analysis demonstrated an actinomycetoma caused by bacteria, as the etiological agent. Imaging showed a bone involvement with osteolysis at the levels of 2nd to 4th metatarsal diaphysis. The mycological and bacterial cultures were both negative. For an accurate diagnosis, the obtained grains were subjected to molecular analysis, targeting the 16S-rDNA gene. Molecular identification yielded Actinomadura madurae as the causal agent, and 800/160 mg of trimethoprim/sulfamethoxazole was prescribed twice a day for 1 year, as a treatment. CONCLUSION: Considering low information about this disease, especially in non-endemic areas, it is of high importance to enhance the knowledge and awareness of clinicians and healthcare providers, in particular in the countries with immigration issues.


Assuntos
Actinobacteria/genética , Actinobacteria/isolamento & purificação , Antibacterianos/uso terapêutico , Micetoma/diagnóstico , Micetoma/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Argélia/etnologia , DNA Ribossômico/genética , Emigrantes e Imigrantes , Pé/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Micetoma/etnologia , Micetoma/microbiologia , Paris , Resultado do Tratamento
3.
PLoS Negl Trop Dis ; 14(9): e0008397, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32970667

RESUMO

BACKGROUND: Mycetoma, a chronic infection of the skin and underlying structures, affects those with a close relationship to the land, often in resource-poor areas of the world. Whether caused by any one of a variety of fungus or bacteria, mycetoma causes significant disability and mortality. Acknowledged as a neglected tropical disease (NTD) by the World Health Organization (WHO) in 2016, mycetoma is susceptible to being misunderstood, misdiagnosed, and mismanaged. In an effort to shift the balance in favor of recognition and effective treatment, sound epidemiological understanding is required. METHODS AND FINDINGS: In this paper, a literature review of case reports and series (332 papers in total) is presented as three maps. We identified 19,494 cases dating from 1876 to 2019, with cases contracted in 102 countries. The first map shows where mycetoma has ever been reported, the second shows how many cases have been reported, and the third shows the ratio of eumycetoma (fungal) to actinomycetoma (bacterial). Most cases are found in Mexico, India, and Sudan, where mycetoma is studied rigorously. We identified emergence of new geographical loci, including the United States, Venezuela, Italy, China, and Australia. Notably, mycetoma is reported far outside the tropics. In the Americas, bacterial forms dominate, whereas, in Africa and Asia, the picture is more varied. CONCLUSIONS: With better understanding of the epidemiology of mycetoma, more can be done to direct education, preventive measures, and treatment to at-risk areas, enabling a reduction in disease burden.


Assuntos
Micetoma/epidemiologia , Bactérias/genética , Fenômenos Fisiológicos Bacterianos , Fungos/genética , Fungos/isolamento & purificação , Fungos/fisiologia , Saúde Global , Humanos , Micetoma/diagnóstico , Micetoma/microbiologia
4.
PLoS Negl Trop Dis ; 14(7): e0008420, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32730340

RESUMO

Eumycetoma (mycotic mycetoma) is the fungal form of mycetoma, a subcutaneous infection occurring in individuals living in endemic areas of the disease. The Sudan is hyperendemic for mycetoma, with the highest incidence being reported from Gezira State, Central Sudan. The present study was conducted at the Gezira Mycetoma Center and aimed to determine the cause of black-grain eumycetoma in the state and describe its epidemiology. Black-grain specimens were collected during the surgical operation and direct detection of the causative agent was performed using M. mycetomatis species-specific PCR and ITS PCR followed by sequencing. Black-grain was reported from 93.3% of all confirmed mycetoma cases (n = 111/119), with a prevalence in young males. Of the 91 samples subjected to direct PCR, 90.1% (n = 82) gave positive results. The predominant species (88.2%) was Madurella mycetomatis. One sample was identified as M. fahalii, one as M. tropicana, and one matched the phytopathogenic species Sphaerulina rhododendricola. The highest endemic zones were Southern Gezira (76.6%) and Northern Sinnar (23.4%). The study confirmed that direct molecular detection on grains provides rapid and specific diagnosis of agents of eumycetoma.


Assuntos
Madurella/isolamento & purificação , Micetoma/microbiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Madurella/classificação , Madurella/genética , Masculino , Pessoa de Meia-Idade , Micetoma/epidemiologia , Filogenia , Sudão/epidemiologia , Adulto Jovem
5.
PLoS Negl Trop Dis ; 14(4): e0008240, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32348300

RESUMO

Mycetoma is considered a neglected tropical disease globally. However, data on its burden and the associated complications in Uganda are limited. Hence we aimed to estimate its burden in Uganda. Firstly, a systematic PubMed search for all studies of any design on mycetoma in Uganda without restriction to the year of publication was conducted. A retrospective review of all the biopsy reports at the Pathology Reference Laboratory, Department of Pathology, Makerere University, Kampala, Uganda from January 1950 to September 2019 was conducted to identify any reports on mycetoma histological diagnosis. During the 70-years study period, 30 cases were identified by the literature review, with 249 additional cases identified by review of biopsy reports (total of 279 cases). The average incidence was estimated at 0.32/100,000 persons and prevalence of 8.32/100,000 persons per decade. However, there was a general decline in the number of cases detected recently. Males and the age group of 21-30 years were the most affected by mycetoma in Uganda, and only 7% of the cases were children. The highest number of cases was recorded from Kampala (n = 30) and Jinja (n = 19) districts. The majority of the cases (68%) were referred from surgical units. The foot was the most affected part of the body (72%). Ten per cent of the cases had bone involvement of which 58% required amputation. Fungi were the most common causative agents (89%) followed by Nocardia species (5%) and Actinomycetes (4%). The index of clinical suspicion of mycetoma was low (45%) with a very large differential diagnosis. Mycetoma is a relatively rare disease in Uganda, mostly caused by fungi, and there is a big gap in data and epidemiological studies. More systematic studies are warranted to define the true burden of mycetoma in Uganda.


Assuntos
Micetoma/epidemiologia , Doenças Negligenciadas/epidemiologia , Actinomycetaceae/isolamento & purificação , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Feminino , Fungos/isolamento & purificação , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Micetoma/microbiologia , Doenças Negligenciadas/microbiologia , Nocardia/isolamento & purificação , Prevalência , Fatores Sexuais , Clima Tropical , Uganda/epidemiologia , Adulto Jovem
6.
An Bras Dermatol ; 95(3): 372-375, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32278631

RESUMO

Pseudomycetoma is an extremely rare deep mycosis, caused by dermatophytic fungi that penetrate the tissue from infected follicles of tinea capitis. Both clinically and histopathology are similar to eumycetoma, being distinguished through the isolation of the fungus, which in the case of pseudomycetoma can be Microsporum spp. or Trichophyton spp. genre. We present a 24-year-old man with an exuberant tumor in the occipital region with fistula, whose histopathological examination evidenced grains composed of hyaline hyphae and the culture for fungi isolated the agent Microsporum canis. Combined treatment of surgical excision followed by oral griseofulvin for two years was performed, with resolution of the condition.


Assuntos
Dermatomicoses/microbiologia , Microsporum/isolamento & purificação , Micetoma/microbiologia , Dermatoses do Couro Cabeludo/microbiologia , Dermatomicoses/patologia , Dermatomicoses/cirurgia , Humanos , Imunocompetência , Masculino , Micetoma/patologia , Micetoma/cirurgia , Dermatoses do Couro Cabeludo/patologia , Dermatoses do Couro Cabeludo/cirurgia , Resultado do Tratamento , Adulto Jovem
7.
PLoS Negl Trop Dis ; 14(1): e0007845, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31940343

RESUMO

The genus Madurella comprising four species, M. fahalii, M. mycetomatis, M. pseudomycetomatis, and M. tropicana, represents the prevalent cause of eumycetoma worldwide. The four species are phenotypically similar and cause an invariable clinical picture, but differ markedly in their susceptibility to antifungal drugs, and epidemiological pattern. Therefore, specific identification is required for optimal management of Madurella infection and to reveal proper epidemiology of the species. In this study, a novel multiplex real-time PCR targeting the four Madurella species was developed and standardized. Evaluation of the assay using reference strains of the target and non-target species resulted in 100% specificity, high analytical reproducibility (R2 values >0.99) and a lowest detection limit of 3 pg target DNA. The accuracy of the real-time PCR was further assessed using biopsies from eumycetoma suspected patients. Unlike culture and DNA sequencing as gold standard diagnostic methods, the real-time PCR yielded accurate diagnosis with specific identification of the causative species in three hours compared to one or two weeks required for culture. The novel method reduces turnaround time as well as labor intensity and high costs associated with current reference methods.


Assuntos
Madurella/classificação , Madurella/genética , Micetoma/diagnóstico , Reação em Cadeia da Polimerase em Tempo Real/métodos , Biópsia , DNA Fúngico/análise , Humanos , Micetoma/microbiologia , Sensibilidade e Especificidade
8.
BMC Dermatol ; 20(1): 1, 2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31918687

RESUMO

BACKGROUND: Mycetoma is an uncommon chronic granulomatous infection of cutaneous and subcutaneous tissues that can be caused by filamentous bacteria (actinomycetoma) or fungi (eumycetoma). It is the prerogative of young men between the third and fourth decade and is transmitted through any trauma causing an inoculating point. The classic clinical triad associates a painless hard and swelling subcutaneous mass, multiple fistulas, and the pathognomonic discharge of grains. Although endemic in many tropical and subtropical countries, mycetoma can also be found in non-endemic areas as in Morocco, and causes then diagnosis problems leading to long lasting complications. Therefore, we should raise awareness of this neglected disease for an earlier management. Under medical treatment however, mycetoma has a slow healing and surgery is often needed, and relapses are possible. CASE PRESENTATION: Herein we report a case of a 64 years old patient, with a history of eumycetoma occurring ten years ago treated with oral terbinafine coupled with surgery. A complete remission was seen after 2 years. He presented a relapse on the previous scar 6 months ago. There wasn't any bone involvement in the magnetic resonance imaging (MRI). The patient was put under oral terbinafine with a slow but positive outcome. CONCLUSION: Through this case report, we perform a literature review and highlight the importance of increase awareness of mycetoma in clinical practice especially in non-endemic regions.


Assuntos
Doenças do Pé/diagnóstico , Madurella/isolamento & purificação , Micetoma/diagnóstico , Antifúngicos/uso terapêutico , Diagnóstico Diferencial , Pé/diagnóstico por imagem , Pé/microbiologia , Pé/patologia , Doenças do Pé/microbiologia , Doenças do Pé/patologia , Doenças do Pé/terapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Marrocos , Micetoma/microbiologia , Micetoma/patologia , Micetoma/terapia , Doenças Negligenciadas , Medicina Tropical
9.
J Mycol Med ; 30(1): 100914, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31864802

RESUMO

Mycetoma remains endemic in the tropical and subtropical regions of the "mycetoma belt" including Senegal. It affects more commonly young men in the age group of 20 to 40 years. The foot represents the most commonly affected site. The most common extra-podal localizations are leg, knee, buttocks, hand and arm. We report an exceptional case of cervical fungal mycetoma that occurred in a 13-year-old Senegalese child. He consulted for a cervico-submandibular tumefaction with multiple sinuses and black grains discharge evolving since 6 years, associated to laryngeal dyspnoea. Mycological examination with culture isolated Madurella mycetomatis. Cervical CT Scan showed bone and soft tissue invasion. Terbinafine alone was administered. During the evolution, tracheotomy was performed following the aggravation of the laryngeal disorders. Death from severe sepsis occurred after 8 months of evolution. The particularities of our case are the occurrence of fungal mycetoma in a child, the cervical localization and the difficulties of therapeutic management largely due to the diagnostic delay.


Assuntos
Granuloma Laríngeo/diagnóstico , Madurella , Micetoma/diagnóstico , Adolescente , Criança , Diagnóstico Tardio , Dispneia/diagnóstico , Dispneia/microbiologia , Dispneia/cirurgia , Evolução Fatal , Granuloma Laríngeo/tratamento farmacológico , Granuloma Laríngeo/microbiologia , Granuloma Laríngeo/cirurgia , Humanos , Madurella/crescimento & desenvolvimento , Madurella/isolamento & purificação , Micetoma/tratamento farmacológico , Micetoma/microbiologia , Micetoma/cirurgia , Senegal , Sepse/diagnóstico , Sepse/microbiologia , Terbinafina/uso terapêutico , Cartilagem Tireóidea/microbiologia , Cartilagem Tireóidea/patologia , Cartilagem Tireóidea/cirurgia , Traqueotomia
10.
Clin Exp Dermatol ; 45(5): 544-548, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31729068

RESUMO

BACKGROUND: Mycetoma is recognized as a neglected tropical disease and there are still therapeutic challenges, especially in cases recalcitrant to standard therapy or with high risk of dissemination. Subcultures have been used previously to decrease the virulence of human pathogens. Previous reports have demonstrated that after carrying out 200 subcultures of Nocardia brasiliensis, a decrease in virulence was observed. AIM: To evaluate the effect of attenuated N. brasiliensis strains on the development of lesions in an established mycetoma infection. METHODS: Female 8-12-week-old BALB/c mice were injected with N. brasiliensis suspension to establish a mycetoma. Sixty mice were selected and divided into three groups: two of these groups were inoculated in the dorsum with N. brasiliensis subcultured 200 and 400 times, respectively, while the third group served as control. The thickness of each lesion was measured with calipers every week for 12 weeks. RESULTS: After 12 weeks, we observed that inoculation of 1 × 105 colony-forming units of attenuated N. brasiliensis strains was able to modify the natural history of the infection, with a decrease in the size of the lesions, particularly with P400, compared with the control group (P < 0.01). CONCLUSION: In this experimental evaluation of an immunomodulatory therapy with attenuated N. brasiliensis strains in a murine model, there was a greater stability in the size of the lesion over time in BALB/c mice inoculated with the P400 strain. This treatment could open the possibility of using the attenuated strain as immunomodulatory therapy in patients recalcitrant to standard therapy, with high risk of dissemination or who develop drug-related adverse effects.


Assuntos
Imunomodulação , Micetoma/terapia , Nocardia/patogenicidade , Animais , Modelos Animais de Doenças , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Micetoma/imunologia , Micetoma/microbiologia , Virulência
11.
Mycopathologia ; 185(1): 187-192, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31297666

RESUMO

Dermatophytic granuloma characterized by perifollicular granulomatous inflammation was first described by Domenico Majocchi and was later named after him, Majocchi's granuloma (MG). Although the initial description was related to a dermatophyte Trichophyton tonsurans, later reports linked MG to non-dermatophytes (Phoma, Aspergillus, Malbranchea), which led to a confusion of disease patterns caused by cutaneous pathogens and general opportunistic microorganisms. Furthermore, several causative agents of MG described in the literature were not confirmed as such. Our review addressed the following aspects: (1) significance of histopathological finding for MG diagnosis, (2) dermatophytes as exclusive agents of MG, (3) spectrum of etiological agents causing different types of invasive dermatophytic infections, and (4) treatment options.


Assuntos
Granuloma/diagnóstico , Granuloma/microbiologia , Arthrodermataceae/patogenicidade , Aspergillus/patogenicidade , Humanos , Micetoma/diagnóstico , Micetoma/microbiologia , Tinha/diagnóstico , Tinha/microbiologia
12.
Rev Chilena Infectol ; 36(4): 531-535, 2019 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-31859780

RESUMO

A case of plantar actinomycetoma without risk factors is presented, which was diagnosed by hystopatological analysis of a foot biopsy because of the suspicion of neoplasia. Since the patient did not fully respond to the first-line therapy antibiotics, a 24-weeks doxycycline regime was started, achieving a satisfactory response. Finally, a brief discussion on plantar mycetomas is presented.


Assuntos
Actinomyces/isolamento & purificação , Doenças do Pé/diagnóstico , Micetoma/diagnóstico , Biópsia , Diagnóstico Diferencial , Doenças do Pé/microbiologia , Doenças do Pé/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Micetoma/microbiologia , Micetoma/patologia
15.
PLoS Negl Trop Dis ; 13(8): e0007056, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31465459

RESUMO

Mycetoma is a devastating neglected tropical disease, caused by various fungal and bacterial pathogens. Correct diagnosis to the species level is mandatory for proper treatment. In endemic areas, various diagnostic tests and techniques are in use to achieve that, and that includes grain culture, surgical biopsy histopathological examination, fine needle aspiration cytological (FNAC) examination and in certain centres molecular diagnosis such as PCR. In this retrospective study, the sensitivity, specificity and diagnostic accuracy of grain culture, surgical biopsy histopathological examination and FNAC to identify the mycetoma causative organisms were determined. The histopathological examination appeared to have better sensitivity and specificity. The histological examination results were correct in 714 (97.5%) out of 750 patients infected with Madurella mycetomatis, in 133 (93.6%) out of 142 patients infected with Streptomyces somaliensis, in 53 (74.6%) out of 71 patients infected with Actinomadura madurae and in 12 (75%) out of 16 patients infected with Actinomadura pelletierii. FNAC results were correct in 604 (80.5%) out of 750 patients with Madurella mycetomatis eumycetoma, in 50 (37.5%) out of 133 Streptomyces somaliensis patients, 43 (60.5%) out of 71 Actinomadura madurae patients and 11 (68.7%) out of 16 Actinomadura pelletierii. The mean time required to obtain the FNAC result was one day, and for the histopathological examinations results it was 3.5 days, and for grain it was a mean of 16 days. In conclusion, histopathological examination and FNAC are more practical techniques for rapid species identification than grain culture in many endemic regions.


Assuntos
Testes Diagnósticos de Rotina/métodos , Micetoma/diagnóstico , Micetoma/microbiologia , Micetoma/patologia , Patologia Molecular/métodos , Actinobacteria/isolamento & purificação , Adolescente , Adulto , Idoso , Biópsia , Criança , Pré-Escolar , Feminino , Humanos , Madurella/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Micetoma/cirurgia , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Sensibilidade e Especificidade , Streptomyces/isolamento & purificação , Adulto Jovem
16.
Rev. chil. infectol ; 36(4): 531-535, ago. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1042672

RESUMO

Resumen Se presenta un caso clínico de un actinomicetoma plantar en un paciente sin factores de riesgo, cuyo diagnóstico fue realizado mediante una biopsia de tejido plantar por sospecha de una neoplasia. Dado que el paciente no respondió satisfactoriamente a la terapia de primera línea, debió completar 24 semanas de tratamiento con doxiciclina, a lo cual evolucionó favorablemente. Finalmente, se desarrolla una breve discusión sobre los micetomas plantares.


A case of plantar actinomycetoma without risk factors is presented, which was diagnosed by hystopatological analysis of a foot biopsy because of the suspicion of neoplasia. Since the patient did not fully respond to the first-line therapy antibiotics, a 24-weeks doxycycline regime was started, achieving a satisfactory response. Finally, a brief discussion on plantar mycetomas is presented.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Actinomyces/isolamento & purificação , Doenças do Pé/diagnóstico , Micetoma/diagnóstico , Biópsia , Diagnóstico Diferencial , Doenças do Pé/microbiologia , Doenças do Pé/patologia , Micetoma/microbiologia , Micetoma/patologia
17.
J Infect Chemother ; 25(12): 1065-1069, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31227382

RESUMO

Cunninghamella is a member of the class Zygomycetes. Cunninghamella species include ubiquitous filamentous fungi; infections caused by Cunninghamella species are less frequent but have higher mortality rates than infections caused by Mucorales group members such as Rhizopus and Mucor. Herein, we reported a rare fatal case of endobronchial metastasis from breast cancer accompanied with Cunninghamella bertholletiae tracheobronchial mycetoma. A 73-year-old female with a history of right-sided breast cancer who had undergone mastectomy 11 years previously and had no recurrence presented to our emergency department with a 1-week history of left-sided back pain. Chest X-ray revealed left lung atelectasis; bronchoscopy revealed an endobronchial mass lesion in the left main bronchus. Pathological examination revealed fungal mycetoma but malignant lesions were not detected. Endobronchial and lung mycetoma caused by Cunninghamella bertholletiae were initially diagnosed; liposomal amphotericin B was administered, but her condition deteriorated. Rigid endoscopy showed growth of hemorrhagic tissue occupying the left main bronchus just under the carina. Pathological examination of the shaved lesion revealed metastasis from breast cancer covered with abundant necrotic tissue. No mold was observed in the necrotic tissue; this was probably due to liposomal amphotericin B treatment. To our knowledge, this is the first case of endobronchial metastasis from breast cancer accompanied with Cunninghamella bertholletiae mycetoma. Distinguishing endobronchial metastases from breast cancer and atypical presentations of Cunninghamella endobronchial mycetomas can be very difficult. Repeated bronchoscopies maybe helpful in establishing an accurate diagnosis when clinical prognosis does not match the initial diagnosis.


Assuntos
Neoplasias da Mama/patologia , Neoplasias Brônquicas/complicações , Cunninghamella/isolamento & purificação , Pneumopatias Fúngicas/diagnóstico , Mucormicose/diagnóstico , Micetoma/diagnóstico , Idoso , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Neoplasias da Mama/cirurgia , Brônquios/diagnóstico por imagem , Brônquios/microbiologia , Neoplasias Brônquicas/secundário , Broncoscopia , Evolução Fatal , Feminino , Humanos , Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/microbiologia , Mastectomia , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Micetoma/tratamento farmacológico , Micetoma/microbiologia
18.
PLoS Negl Trop Dis ; 13(5): e0007276, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31145740

RESUMO

In this communication, a case of black grain eumycetoma produced by the fungus C. atrobrunneum is reported. The patient was initially misdiagnosed with M. mycetomatis eumycetoma based on the grains' morphological and cytological features. However, further aerobic culture of the black grains generated a melanised fungus identified as C. atrobrunneum by conventional morphological methods and by internal transcribed spacer 2 (ITS2) ribosomal RNA gene sequencing. This is the first-ever report of C. atrobrunneum as a eumycetoma-causative organism of black grain eumycetoma. It is essential that the causative organism is identified to the species level, as this is important for proper patient management and to predict treatment outcome and prognosis.


Assuntos
Chaetomium/isolamento & purificação , Micetoma/microbiologia , Adulto , Antifúngicos/uso terapêutico , Chaetomium/classificação , Chaetomium/genética , Chaetomium/fisiologia , DNA Fúngico/genética , DNA Espaçador Ribossômico/genética , Humanos , Masculino , Micetoma/diagnóstico , Micetoma/tratamento farmacológico , Filogenia , Sudão
19.
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
20.
PLoS Negl Trop Dis ; 13(4): e0007098, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30946748

RESUMO

Mycetoma is a neglected tropical disease, endemic in many tropical and subtropical regions, characterised by massive deformity and disability and can be fatal if untreated early and appropriately. Interleukins (IL) -35 and IL-37 are newly discovered cytokines that play an important role in suppressing the immune system. However, the expression of these interleukins in patients with Madurella mycetomatis (M. mycetomatis) induced eumycetoma has not yet been explored. The aim of this study is to determine the levels of IL-1 family (IL-1ß, IL-37) and IL-12 family (IL-12, IL-35) in a group of these patients and the association between these cytokines levels and the patients' demographic characteristics. The present, case-control study was conducted at the Mycetoma Research Centre, Soba University Hospital, University of Khartoum, Sudan and it included 140 individuals. They were divided into two groups; group I: healthy controls [n = 70; median age 25 years (range 12 to 70 years)]. Group II: mycetoma patients [n = 70 patients; median age 25 (range 13 to 70 years)]. Cytokines levels were measured in sera using enzyme linked immunosorbent assay (ELISA). There was a significant negative correlation between IL-1ß and IL-12 levels and lesion size and disease duration, while IL-37 and IL-35 levels were significantly positively correlated with both lesion size and disease duration. The analysis of the risk factors of higher circulatory levels of IL-37 in patients of mycetoma showed a negative significant association with IL-1ß cytokine, where a unit increment in IL-1ß will decrease the levels of IL-37 by 35.28 pg/ml. The levels of IL-37 among the patients with a duration of mycetoma infection ≤ 1 year were significantly low by an average of 18.45 pg/ml compared to patients with a mycetoma infection's duration of ≥ 5years (reference group). Furthermore, the risk factors of higher levels of IL-35 in mycetoma patients revealed a negative significant association with IL-12, as a unit increment in IL-12 decreases the levels of IL-35 by 8.99 pg/ml (p < 0.001). Levels of IL-35 among the patients with duration of mycetoma infection ≤ one year were significantly low on average by 41.82 pg/ml (p value = 0.002) compared to patients with a duration of mycetoma infection ≥ 5 years (reference group). In conclusion, this study indicates that both IL-35 and IL-37 are negatively associated with the levels of IL-1ß and IL-12 in eumycetoma mycetoma infection; and high levels of IL-37 and IL-35 may have a negative impact on disease progression.


Assuntos
Interações Hospedeiro-Patógeno , Interleucinas/sangue , Madurella/crescimento & desenvolvimento , Micetoma/patologia , Micetoma/fisiopatologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Micetoma/microbiologia , Fatores de Risco , Sudão , Adulto Jovem
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