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/patologiaAssuntos
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
Wildlife disease surveillance and pathogen detection are fundamental for conservation, population sustainability, and public health. Detection of pathogens in snakes is often overlooked despite their essential roles as both predators and prey within their communities. Ophidiomycosis (formerly referred to as Snake Fungal Disease, SFD), an emergent disease on the North American landscape caused by the fungus Ophidiomyces ophiodiicola, poses a threat to snake population health and stability. We tested 657 individual snakes representing 58 species in 31 states from 56 military bases in the continental US and Puerto Rico for O. ophiodiicola. Ophidiomyces ophiodiicola DNA was detected in samples from 113 snakes for a prevalence of 17.2% (95% CI: 14.4-20.3%), representing 25 species from 19 states/territories, including the first reports of the pathogen in snakes in Idaho, Oklahoma, and Puerto Rico. Most animals were ophidiomycosis negative (n = 462), with Ophidiomyces detected by qPCR (n = 64), possible ophidiomycosis (n = 82), and apparent ophidiomycosis (n = 49) occurring less frequently. Adults had 2.38 times greater odds than juveniles of being diagnosed with ophidiomycosis. Snakes from Georgia, Massachusetts, Pennsylvania, and Virginia all had greater odds of ophidiomycosis diagnosis, while snakes from Idaho were less likely to be diagnosed with ophidiomycosis. The results of this survey indicate that this pathogen is endemic in the eastern US and identified new sites that could represent emergence or improved detection of endemic sites. The direct mortality of snakes with ophidiomycosis is unknown from this study, but the presence of numerous individuals with clinical disease warrants further investigation and possible conservation action.
Assuntos
Dermatomicoses/patologia , Onygenales/isolamento & purificação , Animais , DNA Fúngico/genética , DNA Fúngico/metabolismo , Dermatomicoses/epidemiologia , Dermatomicoses/microbiologia , Dermatomicoses/veterinária , Modelos Logísticos , Instalações Militares , Onygenales/classificação , Onygenales/genética , Filogenia , Prevalência , Porto Rico/epidemiologia , Reação em Cadeia da Polimerase em Tempo Real , Serpentes , Estados Unidos/epidemiologiaRESUMO
Dermatophytes are known as a common cause of superficial mycosis, but atypical presentations in immunosuppressed patients make the diagnosis more challenging. Here, we report a case of a 39-year-old patient, a renal transplant recipient from a living donor, who presented with atypical cutaneous lesions of lower extremities caused by Arthroderma gypseum (Nannizzia gypsea), four months after receiving a renal transplant. It is important to highlight the importance of the early detection of fungal infections in immunosuppressed patients. Clinicians should have a high degree of suspicion for the early detection and treatment of the cases.
Assuntos
Arthrodermataceae/isolamento & purificação , Dermatomicoses/diagnóstico , Transplante de Rim/efeitos adversos , Adulto , Dermatomicoses/patologia , Diagnóstico Diferencial , Feminino , Humanos , Hialoifomicose/diagnóstico , Hospedeiro ImunocomprometidoAssuntos
Lacazia/isolamento & purificação , Lobomicose , Patologia Molecular , Adulto , Antifúngicos/uso terapêutico , Clofazimina/uso terapêutico , Dermatomicoses/complicações , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Dermatomicoses/patologia , Combinação de Medicamentos , Orelha , Pavilhão Auricular/microbiologia , Pavilhão Auricular/patologia , Fibrose/patologia , Histocitoquímica , Humanos , Lacazia/classificação , Lacazia/citologia , Lobomicose/complicações , Lobomicose/diagnóstico , Lobomicose/tratamento farmacológico , Lobomicose/patologia , Masculino , México , Combinação Trimetoprima e Sulfametoxazol/uso terapêuticoAssuntos
Humanos , Feminino , Adulto , Criptococose/patologia , Dermatomicoses/patologia , Pneumopatias Fúngicas/patologia , Fluconazol/uso terapêutico , Anfotericina B/uso terapêutico , Resultado do Tratamento , Criptococose/tratamento farmacológico , Dermatomicoses/tratamento farmacológico , Otopatias/microbiologia , Pneumopatias Fúngicas/tratamento farmacológico , Antifúngicos/uso terapêuticoRESUMO
Abstract 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
Humanos , Masculino , Adulto Jovem , Dermatoses do Couro Cabeludo/microbiologia , Dermatomicoses/microbiologia , Micetoma/microbiologia , Microsporum/isolamento & purificação , Dermatoses do Couro Cabeludo/cirurgia , Dermatoses do Couro Cabeludo/patologia , Resultado do Tratamento , Dermatomicoses/cirurgia , Dermatomicoses/patologia , Imunocompetência , Micetoma/cirurgia , Micetoma/patologiaRESUMO
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 JovemAssuntos
Criptococose/patologia , Dermatomicoses/patologia , Pneumopatias Fúngicas/patologia , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Criptococose/tratamento farmacológico , Dermatomicoses/tratamento farmacológico , Otopatias/microbiologia , Feminino , Fluconazol/uso terapêutico , Humanos , Pneumopatias Fúngicas/tratamento farmacológico , Resultado do TratamentoRESUMO
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.