RESUMO
The present study analyses the clinical characteristics of patients diagnosed with cutaneous fusarium through a systematic review of cases reported in literature. A total of 39 cases were included, of which 53% were men, 30% were women, and in 17% the sex was not specified. The age ranged from 5 to 85 years. Most cases were reported in Brazil, followed by Japan and United States of America. The most common agent was Fusarium solani, in 37.5% of the patients. Most of the affected individuals had acute myeloid leukaemia and some of the predisposing factors, which included induction chemotherapy, febrile neutropenia, and bone marrow transplantation. The clinical topography of the lesions was located in 27.5% and disseminated in 72.5%, with the most observed clinical feature outstanding the presence of papules and nodules with central necrosis in 47% of the cases. Longer survival was demonstrated in those treated with more than three antifungals. It is concluded that cutaneous fusarium is a complex and challenging clinical entity, infection in patients with leukaemias underscores the need for thorough care to decrease morbidity and mortality.
Assuntos
Antifúngicos , Fusariose , Fusarium , Humanos , Fusariose/tratamento farmacológico , Fusariose/microbiologia , Fusarium/isolamento & purificação , Idoso , Adulto , Antifúngicos/uso terapêutico , Pessoa de Meia-Idade , Feminino , Masculino , Idoso de 80 Anos ou mais , Adulto Jovem , Adolescente , Brasil/epidemiologia , Criança , Japão/epidemiologia , Pré-Escolar , Leucemia Mieloide Aguda/complicações , Estados Unidos/epidemiologia , Leucemia/complicações , Leucemia/microbiologia , Dermatomicoses/microbiologia , Dermatomicoses/epidemiologia , Dermatomicoses/tratamento farmacológico , Dermatomicoses/patologiaRESUMO
BACKGROUND: Fusarium and allied genera (fusarioid) species are common colonizers of roots and aerial plant parts, or act as phytopathogens in forestry and horticultural or grain crops. However, they can also cause a wide range of infections in humans, including onychomycosis, cutaneous and invasive infections. Fusarioid keratitis is characterized by an infection of the cornea with a suppurative and ulcerative appearance, which may cause damage to vision and permanent blindness. The aim of the present study was to investigate the prevalence of fusarioid species, biofilm formation and antifungal susceptibility profiling of clinical isolates recovered from patients with keratitis and dermatomycoses. METHODOLOGY/PRINCIPAL FINDINGS: The study was performed between March, 2012-December, 2022. Demographic, clinical and epidemiological data of patients were also collected. In the present study, most of the patients with keratitis were male (74%), had a median age of 42 years old, worked with plant material or debris and 26% of them reported eye trauma. Regarding dermatomycosis, most of patients were female and exhibited toenail lesions. Forty-seven isolates belonged to the genus Neocosmospora (78.33%), nine to the Fusarium fujikuroi (15%) and four to the Fusarium oxysporum (6.66%) species complexes. Several strains were moderate biofilm producers, specifically among Fusarium annulatum. Most strains showed increased MICs to amphotericin B and ketoconazole and low MICs to itraconazole. MICs ranged from 0.25 to 16 µg/mL for amphotericin B, 0.0625 to >16 µg/mL for ketoconazole and 0.125 to 8 for itraconazole. CONCLUSIONS/SIGNIFICANCE: It is possible to conclude that fusarioid keratitis in Northeastern Brazil is an important and neglected disease, given the high number of cases, increased need for keratoplasty and poor outcome of the disease.
Assuntos
Antifúngicos , Fusarium , Ceratite , Testes de Sensibilidade Microbiana , Humanos , Feminino , Masculino , Adulto , Brasil/epidemiologia , Ceratite/microbiologia , Ceratite/epidemiologia , Estudos Prospectivos , Pessoa de Meia-Idade , Antifúngicos/farmacologia , Fusarium/efeitos dos fármacos , Fusarium/isolamento & purificação , Fusarium/classificação , Fusariose/microbiologia , Fusariose/epidemiologia , Fusariose/tratamento farmacológico , Adulto Jovem , Dermatomicoses/epidemiologia , Dermatomicoses/microbiologia , Dermatomicoses/tratamento farmacológico , Idoso , Biofilmes/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Prevalência , Adolescente , Infecções Oculares Fúngicas/microbiologia , Infecções Oculares Fúngicas/epidemiologia , Infecções Oculares Fúngicas/tratamento farmacológicoRESUMO
BACKGROUND Histoplasmosis is typically associated with immunocompromised individuals, but cases in immunocompetent patients are rare. Primary cutaneous histoplasmosis (PCH) is a challenging diagnosis due to its clinical polymorphism and can mimic other infectious and non-infectious diseases. Previous cases of PCH have been reported in immunocompetent patients with underlying medical conditions or trauma history. So far there have been no reports of PCH after platelet-rich plasma (PRP) application due to inadequate hygiene measures in an immunocompetent host. CASE REPORT This case report presents a rare occurrence of PCH following a cosmetic procedure (PRP injection) in an immunocompetent patient. The patient developed nodule-like lesions at the application sites, which progressed to ulceration with purulent discharge. Initially, atypical mycobacterial infection was suspected, and empirical antibiotic therapy was initiated. Complementary tests were performed, ruling out immunosuppression and systemic pathogens. The patient showed complete resolution of the lesions after one month of atypical treatment with trimethoprim-sulfamethoxazole (TMP/SMX). Pathological examination confirmed the diagnosis of PCH with intracytoplasmic inclusions of Histoplasma sp. CONCLUSIONS This case highlights the importance of considering histoplasmosis as a diagnostic possibility, especially in hyperendemic areas like Venezuela. Direct inoculation of Histoplasma sp. after aesthetic procedures without proper hygiene measures can lead to pathological lesions, even in immunocompetent individuals. TMP/SMX can be considered as an alternative treatment option in the absence of the first-line medication. Further exploration of this treatment approach may benefit patients with similar clinical conditions or when ideal treatment options are unavailable.
Assuntos
Histoplasmose , Plasma Rico em Plaquetas , Combinação Trimetoprima e Sulfametoxazol , Humanos , Histoplasmose/diagnóstico , Histoplasmose/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Feminino , Técnicas Cosméticas/efeitos adversos , Dermatomicoses/tratamento farmacológico , Dermatomicoses/diagnóstico , Imunocompetência , AdultoRESUMO
The epidemiology of psoriasis and cutaneous mycoses is scarce in Brazil. Thus, this cross-sectional study aimed to characterize the distribution of these diseases in Paraná. Data was obtained from the Outpatient Information System (SIA - Sistema de Informações Ambulatoriais), between 2016 and 2020. The procedures were filtered by the International Classification of Diseases (ICD). A total of 201,161 outpatient procedures were registered for psoriasis and psoriatic arthritis. The distribution concerning gender was similar (50.93% feminine; 49.07% masculine). The mean age was 51.55 years. The most frequent procedure was methotrexate dispensing (23.17%), followed by acitretin (14.29%) and adalimumab (12.55%). Adjusting to total population, the prevalence of procedures was 0.35%. Regarding cutaneous mycoses, 1,756 procedures were registered. 65% of them referred to females. White race/color was predominant (82.97%). The mean age was 37.6 years. The distribution concerning age varied according to the type of mycosis. Medical appointments (48.92%) and surgical pathology exam/biopsy (38.71%) were the most frequent procedures. The prevalence of procedures was 0.004%. This is the first epidemiological study using SIA about the population affected by psoriasis, psoriatic arthritis, and cutaneous mycoses in a Brazilian state. We believe that these findings allow relevant contribution to science and public policies in Brazil.
Assuntos
Dermatomicoses , Psoríase , Humanos , Brasil/epidemiologia , Masculino , Feminino , Psoríase/epidemiologia , Estudos Transversais , Pessoa de Meia-Idade , Prevalência , Adulto , Dermatomicoses/epidemiologia , Adulto Jovem , Adolescente , Idoso , Distribuição por Sexo , Distribuição por Idade , CriançaRESUMO
Brazil-grown outdoor-cultivated Agaricus brasiliensis KA21 fruiting body (KA21) significantly increases the production of serum anti-beta-glucan antibody. Therefore, KA21 ingestion may be useful for the prevention and alleviation of fungal infections. This study aimed to determine the effects of KA21 in fungal infections in animals. KA21 was administered to nine dogs infected with Malassezia. Notably, the anti-beta-glucan antibody titer remained unchanged or tended to decrease in the oral steroid arm, whereas in the non-steroid arm, antibody titer increased in almost all animals after KA21 ingestion. Dogs showing improved clinical symptoms exhibited increased anti-beta-glucan antibody titers. The results of this study suggest that KA21 ingestion may alleviate the symptoms of Malassezia and other fungal infections and that continuous ingestion may help prolong recurrence-free intervals. Additionally, the ingestion of KA21 during oral steroid dosage reduction or discontinuation may enable smoother steroid withdrawal.
Assuntos
Agaricus , Doenças do Cão , Carpóforos , Malassezia , Animais , Cães , Agaricus/química , Carpóforos/química , Malassezia/efeitos dos fármacos , Doenças do Cão/microbiologia , Doenças do Cão/tratamento farmacológico , Dermatomicoses/veterinária , Dermatomicoses/prevenção & controle , Dermatomicoses/tratamento farmacológico , Dermatomicoses/microbiologia , beta-Glucanas/administração & dosagem , beta-Glucanas/farmacologia , Masculino , Brasil , Dermatite/tratamento farmacológico , Dermatite/veterinária , Dermatite/microbiologia , Dermatite/prevenção & controle , Feminino , Anticorpos Antifúngicos/sangueRESUMO
Background: Dermatophytosis is a contagious fungal infection that affects mainly cats. It poses significant challenges in veterinary medicine due to its zoonotic potential and impact on animal and public health. Rapid and reliable diagnosis is crucial for preventing the spread of the disease, guiding treatment decisions, and monitoring disease control efforts. Although there are several studies on diagnostic methods in feline dermatophytosis, the comparison between them from the same sample lacks data. The absence of a universally accepted gold standard diagnostic method highlights the need for a multifaceted approach to diagnosing feline dermatophytosis. Aim: This study aims to assess the accuracy and efficacy of different diagnostic techniques comprehensively. Methods: For this, 48 samples of cats were analyzed by dermoscopy, direct hair examination, fungal culture using various media (Mycosel, Sabouraud, and Dermatophyte Test Medium), and polymerase chain reaction (PCR). Results: Direct examination and dermoscopy yielded unsatisfactory results. Mycosel and Sabouraud were suboptimal. DTM demonstrated superior selectivity, making it the most reliable among traditional methods. PCR was the top performer, exhibiting singular sensitivity, specificity, and accuracy. Conclusion: The study suggests that PCR may be the preferred choice for diagnosing feline dermatophytosis in clinical practice, especially when rapid and accurate results are essential.
Assuntos
Doenças do Gato , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade , Tinha , Gatos , Animais , Doenças do Gato/diagnóstico , Doenças do Gato/microbiologia , Tinha/veterinária , Tinha/diagnóstico , Tinha/microbiologia , Reação em Cadeia da Polimerase/veterinária , Dermoscopia/veterinária , Dermatomicoses/veterinária , Dermatomicoses/diagnóstico , Dermatomicoses/microbiologiaRESUMO
Bats worldwide play significant roles in ecosystem functions, encompassing pollination, seed dispersal, and pest control while concurrently serving as diseases reservoirs. As part of a comprehensive wildlife health surveillance effort, bats were systematically sampled within two national protected areas in Argentina. During this study 67 bats were examined and samples were collected from eight Molossus spp. individuals exhibiting conspicuous yellowish or white lesions on their noses. All samples were cultured on Sabouraud dextrose agar and lactrimel agar for fungal growth evaluation. Fungal isolates were identified using morphologic and molecular taxonomic techniques, leading to the detection of Microascus sp. in three Molossus rufus from Ibera National Park and Cephalotheca sp. in five Molossus molossus from Marsh Deer National Park. No fungal growth was identified in samples collected from the healthy hairs of the bats displaying lesions on their noses. The two fungi, which have not previously been isolated from bats, should be considered potentially pathogenic, evidenced by diseased hairs in the affected individuals.
Assuntos
Quirópteros , Animais , Quirópteros/microbiologia , Argentina , Ascomicetos/isolamento & purificação , Ascomicetos/classificação , Micoses/veterinária , Micoses/microbiologia , Micoses/epidemiologia , Dermatomicoses/veterinária , Dermatomicoses/microbiologia , Dermatomicoses/epidemiologiaAssuntos
Antifúngicos , Aspergilose , Terbinafina , Humanos , Terbinafina/uso terapêutico , Antifúngicos/uso terapêutico , Resultado do Tratamento , Aspergilose/tratamento farmacológico , Masculino , Dermatomicoses/tratamento farmacológico , Dermatomicoses/patologia , Feminino , Pessoa de Meia-IdadeRESUMO
Microsporum canis is a widely distributed dermatophyte, which is among the main etiological agents of dermatophytosis in humans and domestic animals. This fungus invades, colonizes and nourishes itself on the keratinized tissues of the host through various virulence factors. This review will bring together the known information about the mechanisms, enzymes and their associated genes relevant to the pathogenesis processes of the fungus and will provide an overview of those virulence factors that should be better studied to establish effective methods of prevention and control of the disease. Public databases using the MeSH terms "Microsporum canis", "virulence factors" and each individual virulence factor were reviewed to enlist a series of articles, from where only original works in English and Spanish that included relevant information on the subject were selected. Out of the 147 articles obtained in the review, 46 were selected that reported virulence factors for M. canis in a period between 1988 and 2023. The rest of the articles were discarded because they did not contain information on the topic (67), some were written in different languages (3), and others were repeated in two or more databases (24) or were not original articles (7). The main virulence factors in M. canis are keratinases, fungilisins and subtilisins. However, less commonly reported are biofilms or dipeptidylpeptidases, among others, which have been little researched because they vary in expression or activity between strains and are not considered essential for the infection and survival of the fungus. Although it is known that they are truly involved in resistance, infection and metabolism, we recognize that their study could strengthen the knowledge of the pathogenesis of M. canis with the aim of achieving effective treatments, as well as the prevention and control of infection.
Assuntos
Microsporum , Fatores de Virulência , Microsporum/patogenicidade , Microsporum/genética , Fatores de Virulência/genética , Fatores de Virulência/metabolismo , Animais , Humanos , Fenótipo , Dermatomicoses/microbiologia , Proteínas Fúngicas/genética , Proteínas Fúngicas/metabolismoRESUMO
Malassezia pachydermatis is often reported as the causative agent of dermatitis in dogs. This study aims to evaluate the in vitro and in vivo antifungal activity of azoles and terbinafine (TRB), alone and in combination with the 8-hydroxyquinoline derivatives (8-HQs) clioquinol (CQL), 8-hydroxyquinoline-5-(n-4-chlorophenyl)sulfonamide (PH151), and 8-hydroxyquinoline-5-(n-4-methoxyphenyl)sulfonamide (PH153), against 16 M. pachydermatis isolates. Susceptibility to the drugs was evaluated by in vitro broth microdilution and time-kill assays. The Toll-deficient Drosophila melanogaster fly model was used to assess the efficacy of drugs in vivo. In vitro tests showed that ketoconazole (KTZ) was the most active drug, followed by TRB and CQL. The combinations itraconazole (ITZ)+CQL and ITZ+PH151 resulted in the highest percentages of synergism and none of the combinations resulted in antagonism. TRB showed the highest survival rates after seven days of treatment of the flies, followed by CQL and ITZ, whereas the evaluation of fungal burden of dead flies showed a greater fungicidal effect of azoles when compared to the other drugs. Here we showed for the first time that CQL is effective against M. pachydermatis and potentially interesting for the treatment of malasseziosis.