RESUMO
The present report describes a case of onychoprotothecosis caused by Prototheca wickerhamii in a nonimmunocompromized female. Dermatological examination showed yellowish discoloration of the left and right forefinger nails, showing onicolysis and hyperkeratosis. The repeated isolation of the algae Prototheca (organisms morula-like) as well as the repeated culture in media, Sabouraud agar, confirmed the diagnosis. The patient was successfully treated with tioconazol 1% topic solution. The aim of this paper was to present a rare condition.
Assuntos
Infecções/diagnóstico , Doenças da Unha/diagnóstico , Prototheca/crescimento & desenvolvimento , Brasil , Feminino , Humanos , Imidazóis/uso terapêutico , Infecções/tratamento farmacológico , Infecções/microbiologia , Pessoa de Meia-Idade , Doenças da Unha/tratamento farmacológico , Doenças da Unha/microbiologia , Prototheca/efeitos dos fármacos , Prototheca/isolamento & purificação , Resultado do TratamentoRESUMO
The present report describes a case of cutaneous protothecosis caused by Prototheca wickerhamii in a nonimmunocompromised Brazilian female. Dermatological examination revealed a 15-cm diffusely infiltrated eczema-like plaque recovered with many pustule-like lesions on the right forearm. We emphasize the mycological and pathological aspects of this infection that can lead to misdiagnosis. The patient was successfully treated with itraconazole.
Assuntos
Infecções/diagnóstico , Prototheca/isolamento & purificação , Dermatopatias Infecciosas/diagnóstico , Idoso , Antifúngicos/uso terapêutico , Feminino , Antebraço , Humanos , Imunocompetência , Infecções/tratamento farmacológico , Itraconazol/uso terapêutico , Dermatopatias Infecciosas/tratamento farmacológicoRESUMO
The authors report a male patient, a seller with no detected immunosuppression, with an extensive ulcerated skin lesion localized on the left forearm, caused by Cryptococcus neoformans var. gattii serotype B. Oral treatment with fluconazole was successful. A review of the literature showed the rarity of this localization in HIV-negative patients. In contrast, skin lesions frequently occurs in HIV-positive patients, with Cryptococcus neoformans var. neoformans serotype A predominating as the etiological agent. In this paper, the pathogenicity of C. neoformans to skin lesions in patients immunocompromised or not, is discussed, showing the efficacy of fluconazole for the treatment of these processes.
Assuntos
Criptococose/microbiologia , Dermatomicoses/microbiologia , Idoso , Cryptococcus neoformans/isolamento & purificação , Humanos , Hospedeiro Imunocomprometido , MasculinoRESUMO
The authors report a male patient, a seller with no detected immunosuppression, with an extensive ulcerated skin lesion localized on the left forearm, caused by Cryptococcus neoformans var. gattii serotype B. Oral treatment with fluconazole was successful. A review of the literature showed the rarity of this localization in HIV-negative patients. In contrast, skin lesions frequently occurs in HIV-positive patients, with Cryptococcus neoformans var. neoformans serotype A predominating as the etiological agent. In this paper, the pathogenicity of C. neoformans to skin lesions in patients immunocompromised or not, is discussed, showing the efficacy of fluconazole for the treatment of these processes
Assuntos
Humanos , Masculino , Idoso , Criptococose , Dermatomicoses , Cryptococcus neoformans , Hospedeiro ImunocomprometidoRESUMO
We report a case of cutaneous infection caused by Phialemonium curvatum GAMS et COOKE, 1983, after bone marrow transplantation. The genus Phialemonium was created by GAMS & MCGINNIS in 1983 including three new species: Ph. obovatum, Ph. curvatum and Ph. dimorphosporum, and represents an intermediate genus between Acremonium and Phialophora. Nowadays, the genus Phialemonium is considered to be a pheoid fungus which may cause the eventual lesions observed in pheo- and hyalohyphomycosis. Species of this genus have been described as opportunistic agents in humans and animals, mainly as a result of immunosuppression. In the present case, the patient had multiple myeloma and received an allogenic bone marrow transplant from his HLA-compatible brother. Two months after transplantation, he developed purplish and painful nodular lesions on the right ankle. Some of these lesions drained spontaneously and apparently hyaline mycelial filaments were observed, whose culture was initially identified as Acremonium sp. Subsequent studies showed that the fungus was Phialemonium curvatum. The infection was treated with amphotericin B, followed by ketoconazole. The patient was submitted to surgical debridement followed by two skin grafts to repair the bloody area. The duration of the treatment was 4 months and secondary prophylaxis with ketoconazole alone was maintained for one additional month. No recurrence was observed after discontinuation of treatment. The authors comment on the pathogenicity of the genus Phialemonium
Assuntos
Humanos , Masculino , Adulto , Transplante de Medula Óssea/efeitos adversos , Dermatomicoses/microbiologia , Fungos Mitospóricos/isolamento & purificação , Infecções Oportunistas/complicações , Dermatomicoses/tratamento farmacológicoRESUMO
Os autores registram um caso de eumicetoma de gräos branco-amarelados, em paciente do sexo masculino, procedente da Bahia, com lesöes no pé esquerdo, provocadas por Acremonium kiliense (Grütz, 1925). O exame histopatológico näo demonstrou a presença de gräos, revelados, todavia, ao exame "a fresco", todos eles com estrutura de eumicetos. Discreta regressäo do quadro inflamatório com o uso de itraconazol, após tratamento prolongado