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Braz. j. biol ; 83: e247840, 2023. graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1278531


Abstract Calvatia is a genus of gasteroid fungi, comprising about 47 species worldwide. In this paper we report the second worldwide occurrence of two poorly known species of Calvatia, recorded in the Cerrado biome of Brazil: C. oblongispora and C. nodulata. Detailed morphological descriptions and illustrations, including scanning electron micrographs of hyphae and basidiospores are provided, as well a discussion on their taxonomy and geographic distribution.

Resumo Calvatia é um gênero de fungos gasteroides que compreende cerca de 47 espécies em todo o mundo. Neste artigo relatamos a segunda ocorrência de duas espécies pouco conhecidas de Calvatia, registradas no bioma Cerrado do Brasil: C. oblongispora e C. nodulata. Descrições morfológicas detalhadas e ilustrações são fornecidas, incluindo micrografias eletrônicas de varredura de hifas e basidiósporos, bem como uma discussão sobre sua taxonomia e distribuição geográfica.

Basidiomycota , Agaricales , Spores, Fungal , Brazil , Ecosystem
Hematol., Transfus. Cell Ther. (Impr.) ; 44(1): 32-39, Jan.-Mar. 2022. tab, ilus
Article in English | LILACS | ID: biblio-1364905


Abstract Introduction Invasive fungal diseases represent important causes of morbidity and mortality among pediatric oncohematological patients. Acute invasive fungal rhinosinusitis is a rare and aggressive disease that occurs mainly in immunocompromised patients. The mortality rate is high and therefore, accurate and early diagnosis is essential. Objectives The aim of this study was to describe the frequency of acute invasive fungal rhinosinusitis among pediatric oncohematological patients and characterize them with confirmed diagnoses. Methods This was a retrospective study that analyzed the medical records of pediatric patients diagnosed with oncohematological diseases and suspected fungal infections, who were included after obtaining informed consent, from January to December 2017, in the pediatric unit of a tertiary university hospital. Data collected from medical record analysis included the following: underlying diagnosis, absolute neutrophil count, clinical presentation, culture and biopsy results, surgical procedures performed, survival and mortality. Results A total of 27 patients were evaluated, with three suspected cases of acute invasive fungal rhinosinusitis. Histopathological and microbiological analyses confirmed two cases. In both cases, the pathogen isolated in the culture was Fusarium sp. The two confirmed cases were female, aged 12 and 14 years, both with an absolute neutrophil count of 10 cells/μL. The underlying disease of the first patient was acute myeloid leukemia (subtype M5), whereas the second patient presented idiopathic bone marrow aplasia. Conclusion Both confirmed cases of acute invasive fungal rhinosinusitis presented with constitutional symptoms and signs of nasal and sinusital inflammation. This demonstrates the importance of fever as a symptom in immunocompromised patients and it should prompt otorhinolaryngological investigation.

Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Fusariosis , Invasive Fungal Infections , Hematologic Diseases , Sinusitis , Febrile Neutropenia , Fusarium
Braz. j. infect. dis ; 26(1): 102333, 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1364541


Abstract Introduction Stewardship programs have been developed to optimize the use of antibiotics, but programs focusing on antifungal agents are less frequent. Objective To evaluate the quality of antifungal prescriptions in a tertiary care hospital, and to test if a simple educational activity could improve the quality of prescriptions. Methods The study comprised three phases: 1) Retrospective audit of all antifungal prescriptions in a 6-month period, applying a score based on six parameters: indication, drug, dosage, route of administration, microbiologic adequacy after results of cultures, switching to an oral agent, and duration of treatment; 2) Creation of text boxes in the electronic medical records with information about antifungal agents, shown during prescription; 3) Retrospective audit of all antifungal prescriptions in a 6-month period, applying the same 6-parameters score, and comparison between the two periods. Results Among 333 prescriptions, fluconazole was the most frequently (80.5%) prescribed agent. Hematology (26.7%), Infectious Diseases Department (22.8%), Internal Medicine (15.9%) and Intensive Care Unit (14.4%) were the units with most antifungal prescriptions. The median score for the 333 prescriptions was 8.0 (range 0 - 10), and 72.7% of prescriptions were considered inappropriate. The median and mean scores in the first and second audit were 8.0 and 6.9, and 8.0 and 7.9, respectively (p<0.001). All items that comprised the score improved from the first to the second audit. Likewise, there was a reduction of inappropriate prescriptions (80.2% in the first audit vs. 64.6% in the second audit, p=0.001). Conclusions A large proportion of inappropriate prescriptions was observed, which improved with the implementation of simple educational activities.

Article in Spanish | LILACS, COLNAL | ID: biblio-1363389


Introducción: se presenta el caso clínico de un paciente con mucormicosis orbitorrinocerebral y revisión de la literatura. Caso clínico: se trata de hombre de 45 años que consultó por síntomas nasosinusales manejado ambulatoriamente con múltiples antibióticos sin mejoría, por lo cual se realizó manejo quirúrgico con toma de muestras que revelaron hifas compatibles con mucormicosis. Cuando acudió a la institución presentaba extensión de la infección a todas las cavidades nasales y parte de la base del cráneo. En la búsqueda de la inmunosupresión, se encontró una diabetes de novo de difícil control. Discusión: la mucormicosis orbitorrinocerebral es una enfermedad altamente invasiva que requiere un manejo multidisciplinario, cirugías seriadas y extendidas, antimicóticos tópicos y sistémicos. El pronóstico mejora y la evolución puede ser favorable cuando se logra controlar la causa de la inmunosupresión, en este caso la diabetes. Conclusiones: es requisito fundamental realizar un tratamiento multidisciplinario en el abordaje de estos pacientes, tanto en la especialidad clínica como en la quirúrgica, psicosocial, nutricional y de rehabilitación.

Introduction: It is the clinical case of a patient with rhino-orbital-cerebral mucormycosis and the review of the literature. Clinical case: We present the case of a previously healthy young man who started with sinonasal symptoms and hyphae compatible with mucormycosis were found in the initial samples of outpatient care. When he came to the institution, the infection had spread to all the nasal cavities and part of the skull base. Discussion: Searching for baseline immunosuppression, only difficult-to-control diabetes and de novo diagnosis were found. It required multidisciplinary management, serial and extended surgeries, topical, venous and oral antifungals. The prognosis improved and the evolution became favorable when glycemic control was achieved. Conclusion: It is a fundamental requirement to carry out a multidisciplinary work for the approach to these patients, both in the clinical, surgical, psychosocial, nutritional and rehabilitation specialties.

Humans , Mucormycosis , Immunosuppression
Braz. j. biol ; 82: e236219, 2022. tab, graf
Article in English | LILACS | ID: biblio-1249241


Abstract Fungi are important in several aspects of human life. In particular, to agriculture, pathogenic fungi are of great importance, as they are responsible for production losses of the most diverse types. Because of this, knowledge about pathogenic fungus is of extreme importance for farmers and professionals working in agricultural areas. Among farmers who use specific agroecological practices, this knowledge is even more valuable, since by not adopting conventional methods of production, they resort to non-invasive alternatives that are less or not harmful at all to the environment in consideration of production management methods. This study aimed to assess farmer perception in the Cerrado biome in the city of Goiás (GO), Brazil, in order to understand their ethnomycological perceptions to verify historical management practices, their knowledge about phytopathogenic fungi, and how these producers perceive fungi. We used the theoretical reference method "From peasant to peasant" formulated by ANPA - National Association of Small Farmers. Some aspects of farmers' ethnomycological knowledge are discussed. These ease identification the representatives of the Fungi Kingdom is associated with organisms that present easily recognizable characteristics, such as wood-ears or disease-causing fungi. In general, farmers are able to identify representatives of the Fungi Kingdom that are found in their daily lives. The perception of farmers about fungi, a group still much unknown by society, is very relevant for future actions of ethnomycology.

Resumo Percepção dos fungos por agricultores do Cerrado - Fungos são organismos importantes em vários aspectos da vida humana. Em particular, para a agricultura, fungos patogênicos são de grande importância, pois são responsáveis ​​por perdas de produção dos mais diversos tipos. Por isso, o conhecimento sobre fungos patogênicos é de extrema importância para agricultores e profissionais que trabalham em áreas agrícolas. Entre os agricultores que utilizam práticas agroecológicas, esse conhecimento é ainda mais valioso, pois, ao não adotar métodos convencionais de produção, recorrem a alternativas não invasivas que são menos ou não prejudiciais ao meio ambiente, considerando os métodos de gerenciamento da produção. Este estudo teve como objetivo avaliar a percepção de um grupo de agricultores do bioma Cerrado, na cidade de Goiás (GO), Brasil, a fim de compreender suas percepções etnomicológicas, de modo a verificar práticas históricas de manejo, seu conhecimento sobre fungos fitopatogênicos e como esses produtores percebem os fungos, de modo geral. Utilizamos o método "de camponês para camponês", formulado pela ANPA - Associação Nacional de Pequenos Agricultores. Discutimos alguns aspectos do conhecimento etnomicológico destes agricultores. A facilidade de identificação de representantes fúngicos está associada a organismos que apresentam características facilmente reconhecíveis, como estereótipo orelha-de-pau ou fungos causadores de doenças em cultivares. Em geral, os agricultores do estudo são capazes de identificar representantes do Reino Fungi que são encontrados em suas vidas cotidianas. A percepção dos agricultores sobre os fungos, um grupo ainda muito desconhecido pela sociedade, é muito relevante para ações futuras dentro da etnomicologia.

Humans , Agriculture , Farmers , Perception , Brazil , Fungi
Afr. J. Clin. Exp. Microbiol ; 23(1): 14-21, 2022. figures, tables
Article in English | AIM, AIM | ID: biblio-1355316


Invasive fungal diseases (IFDs) are major causes of morbidity and mortality among hospitalized patients all over the world with a global prevalence of 15%. Since the first case of COVID-19 was reported on February 27, 2020, in Nigeria, it had been discovered across all geopolitical zones in Nigeria. As the medical community confronts the ongoing COVID-19 pandemic, determining whether patients infected with SARS-CoV-2 develop fungal complications, especially invasive aspergillosis, is crucial. This review aimed to highlight the fungal co-infections that might be associated with SARS-CoV-2 infection, and modalities for their diagnosis, prevention, and management, with the view to reducing the high mortality associated with these infections

Humans , Male , Female , Invasive Fungal Infections , COVID-19 , Antifungal Agents , SARS-CoV-2
Journal of Clinical Hepatology ; (12): 311-317, 2022.
Article in Chinese | WPRIM | ID: wpr-920874


The prognosis of severe liver disease combined with invasive fungal infection (IFI) is poor, and the clinical manifestations are often atypical. Moreover, most of the antifungal drugs are metabolized in the liver, with severe toxicities and side effects, making clinical diagnosis and treatment difficult. The Professional Committee for Hepatology, the Chinese Research Hospital Association and the Hepatology Branch of China Medical Association organized relevant experts to formulate an expert consensus based on the characteristics of patients with severe liver disease combined with IFI, in order to provide reference for medical personnel in making decisions on the diagnosis and treatment.

Organ Transplantation ; (6): 240-2022.
Article in Chinese | WPRIM | ID: wpr-920855


Objective To investigate the risk factors of central airway stenosis after lung transplantation. Methods Clinical data of 155 recipients undergoing lung transplantation in Wuxi People's Hospital Affiliated to Nanjing Medical University from July 2016 to December 2017 were retrospectively analyzed. According to the incidence of central airway stenosis following lung transplantation, all recipients were divided into the stenosis group (n=36) and control group (n=119). The incidence of central airway stenosis after lung transplantation was summarized. The risk factors of central airway stenosis after lung transplantation were assessed by univariate and multivariate logistic regression analyses. Results Among 155 lung transplant recipients, 36 cases (23.2%) developed central airway stenosis. The average incidence time was (53±13) d after lung transplantation. Univariate analysis demonstrated that bilateral lung transplantation, grade 3 primary graft dysfunction (PGD), airway fungal infection, long cold ischemia time, long mechanical ventilation time and long intensive care unit (ICU) stay were the risk factors for central airway stenosis after lung transplantation (all P < 0.05). Multivariate analysis showed that airway fungal infection, long cold ischemia time and long mechanical ventilation time were the independent risk factors for central airway stenosis after lung transplantation (all P < 0.05). Conclusions Airway fungal infection after lung transplantation, long cold ischemia time and long mechanical ventilation time probably lead to central airway stenosis after lung transplantation. Active preventive measures and intimate monitoring should be taken to improve the quality of life of the recipients after lung transplantation.

China Pharmacy ; (12): 503-506, 2022.
Article in Chinese | WPRIM | ID: wpr-920470


OBJECTIV E To provide ideas for diagnosis and treatment of fungal endocarditis. METHODS The diagnosis and treatment of 1 case of aspergillus endocarditis participated by clinical pharmacists were analyzed. Clinical pharmacists suggested that blood macrogenomic next-generation sequencing (mNGS)detection and blood microbial culture should be performed to assist in the diagnosis of fungal endocarditis ;considering the mechanism ,target and safety of the drug ,it was suggested to use voriconazole combined with micafungin for antifungal treatment ;through combining with the patient ’s condition and weighing up the pros and cons ,the dose of micafungin was adjusted to 300 mg per day ;clinical pharmacists prevented ,evaluated and dealt with adverse drug reactions during treatment ,and also provided medication guidance and long-term follow-up for the patient after discharge. RESULTS The clinician adopted the advice of the clinical pharmacists. Aspergillus fumigatus was detected in blood mNGS,which bought time for early diagnosis and individualized treatment of the patient. After 1 month treatment of voriconazole combined with micafungin ,the patient ’s condition was well controlled. The alkaline phosphatase and γ-glutamyl transferase of the patient returned to normal after treatment with adenosylmethionine succinate. With the help of medication guidance ,education and discharge follow-up of clinical pharmacists ,the medication compliance of the patient was good and the condition was stable. CONCLUSIONS The clinical pharmacists participate in the diagnosis and treatment process of the patient ,formulate an individualized anti-infective treatment plan for the patient and achieve good results ,which reflect the professional ability and service level of the clinical pharmacist ,and provide ideas for the clinical treatment of fungal endocarditis.

Braz. j. biol ; 82: e254291, 2022. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1355847


Abstract Medicinal plants have long been prescribed in Thailand for centuries. Different constituents of extracts have been used for treating of various infectious diseases. However, there is even less information available regarding the use in fungal skin infection. In order to assess traditional Thai claims about the therapeutic potential, this study is focused on exploring the anti-dermatophyte property of the plants that are currently used as traditional medicines. The potential of four different plant species were selected for investigate in vitro anti-dermatophyte activity. Ethanolic extracts of Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.), and Acorus calamus (L.). were analysed for their total phenolic content as well as total flavonoid content and were then subjected to test of their anti-dermatophyte properties using agar well diffusion method. Qualitative flavonoids and phenolics analysis of the extracts showed their biologically active constituents. Among the species examined, the result indicated that most of the extracts demonstrated anti-dermatophyte activity. In particular, A. calamus showed the highest efficacy against test organisms. The experiment confirmed the chemical constituents and efficacy of some selected plants and provides a scientific confirmation of the use of Thai plants in traditional medicine for fungal skin infections.

Resumo As plantas medicinais são prescritas há muito tempo na Tailândia, há séculos. Diferentes constituintes de extratos têm sido usados para o tratamento de várias doenças infecciosas. No entanto, existem ainda menos informações disponíveis sobre o uso em infecções fúngicas da pele. A fim de avaliar as alegações tradicionais tailandesas sobre o potencial terapêutico, este estudo está focado em explorar a propriedade antidermatófita das plantas que são usadas atualmente como medicamentos tradicionais. O potencial de quatro espécies de plantas diferentes foi selecionado para investigar a atividade antidermatófita in vitro. Extratos etanólicos de Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.) e Acorus calamus (L.) foram analisados quanto ao seu conteúdo fenólico total, bem como ao conteúdo de flavonoides totais. E então submetidos ao teste de suas propriedades antidermatófitas usando o método de difusão em ágar bem. A análise qualitativa de flavonoides e fenólicos dos extratos mostrou seus constituintes biologicamente ativos. Entre as espécies examinadas, o resultado indicou que a maioria dos extratos demonstrou atividade antidermatófita. Em particular, A. calamus mostrou a maior eficácia contra organismos de teste. O experimento confirmou os constituintes químicos e a eficácia de algumas plantas selecionadas e fornece uma confirmação científica do uso de plantas tailandesas na medicina tradicional para infecções fúngicas da pele.

Plants, Medicinal , Phenols/analysis , Thailand , Plant Extracts/pharmacology , Medicine, Traditional
Arq. bras. neurocir ; 40(4): 412-415, 26/11/2021.
Article in English | LILACS-Express | LILACS | ID: biblio-1362160


Background Fungal spondylodiscitis is not common but should be suspected in some cases. Candida tropicalis infections are being more frequently diagnosed due to some factors related to the microorganism. Case Description A C. tropicalis spondylodiscitis is described in a 72-year-old man who was treated with a combination of echinocandin (micafungin) and surgery. Conclusion The presence of some risk factors should promptly raise the suspicion of fungal spondylodiscitis. Treatment should be instituted as early as possible for the best outcome for the patient.

Braz. j. biol ; 81(4): 1073-1080, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153435


Abstract The bats usually inhabit shelters with favorable conditions for fungal proliferation, including pathogenic and opportunistic species. The fungal diversity present on bats is little known and the studies are scarce in Brazil, which only a work has been performed in Cerrado and Pantanal biomes. Therefore, the objective of this study was evaluating the occurrence of filamentous fungi on the rostral region of Molossus molossus in an Atlantic Forest remnant of Brazil. The bats were captured with mist nets installed outside a shelter located in the municipality of Treviso, (28°29'23"S and 49°31'23"W), south region of state Santa Catarina. With a swab sterile moistened in saline solution, samples from the rostral region were obtained from all captured M. molossus individuals. The samples were taken to the laboratory for analysis and isolation in different culture media, followed of identification of fungal through the microculture technique. In total, 15 individuals were captured, which five fungal genus and 19 taxa were identified. Among the taxa registered, Aspergillioides sp.2, (47%), Penicillium sp.1 (33%), Chrysonilia sp. (33%), Cladosporium sp. (27%) were classified as little constant. In terms of abundance, Penicillium sp.1 (34%), Aspergillioides sp.2 (21%) and Aspergillus sp.2 (11%) were the most abundant in the samples. The results showed the occurrence of high diversity fungal in the rostral region of M. molossus in the Atlantic Forest, which is higher than observed in others Brazilian biomes. Some fungal genera found may harbor pathogenic and opportunistic species that need to be identified for preventing potential disease well as for bat conservation projects.

Resumo Os morcegos comumente abrigam-se em locais com condições favoráveis para proliferação fúngica, incluindo espécies patogênicas e oportunistas. A diversidade fúngica presente nos morcegos é pouco conhecida e os estudos são escassos no Brasil, no qual apenas um trabalho tem sido realizado nos biomas do Cerrado e Pantanal. Portanto, o objetivo deste estudo foi avaliar a ocorrência de fungos filamentosos na região rostral de Molossus molossus em um remanescente da Mata Atlântica no sul do Brasil. Os morcegos foram capturados com redes-de-neblina instaladas na saída de um abrigo localizado no município de Treviso (28°29'23"S e 49°31'23"W), região sul do estado de Santa Catarina. Com um swab esterilizado e umedecido em solução salina, amostras da região rostral foram obtidas de todos os indivíduos de M. molossus capturados. As amostras foram levadas ao laboratório para análise e isolamento em diferentes meios de cultura, seguido de identificação taxonômica fúngica pela técnica de microcultivo. No total, 15 indivíduos foram capturados, nos quais 5 gêneros fúngicos e 19 taxa foram identificados. Dentre os taxa registrados foram classificados como pouco constante Aspergillioides sp.2, (47%), Penicillium sp.1 (33%), Chrysonilia sp. (33%), Cladosporium sp. (27%). Em termos de abundância, Penicillium sp.1 (34%), Aspergillioides sp.2 (21%) e Aspergillus sp.2 (11%) foram os mais abundantes nas amostras. Os resultados mostraram ocorrência de elevada riqueza de fungos na região rostral de M. molossus na Mata Atlântica, riqueza essa que é superior àquela observada para outros biomas brasileiros. Alguns gêneros fúngicos encontrados podem abrigar espécies patogênicas e oportunistas que precisam ser identificadas tanto para prevenir potenciais doenças, assim como, para os projetos de conservação dos morcegos.

Humans , Animals , Chiroptera , Aspergillus , Brazil , Forests , Ecosystem
Rev. Hosp. Ital. B. Aires (2004) ; 41(4): 187-192, dic. 2021. ilus
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1366967


La sinusitis micótica alérgica es una enfermedad inflamatoria de la mucosa rinosinusal producida por hongos que pueden aislarse de la cavidad de nasal de individuos sanos. Se produce indirectamente por los hongos que actúan como antígeno y desencadenan una reacción inmunológica mediada por IgE que origina pólipos y una secreción mucosa espesa con detritus e hifas denominada mucina. Su presentación clínica más frecuente es una sinusitis crónica unilateral o bilateral con pólipos. Con menos frecuencia, las sustancias originadas por la desgranulación de los eosinófilos producen remodelación o destrucción ósea y la sinusitis puede simular una neoplasia. Se describe el caso clínico de un paciente que padeció una sinusitis micótica alérgica con destrucción ósea masiva de la base del cráneo y que tuvo extensión intracraneal extradural e intraorbitaria de la enfermedad. Fue tratado con éxito mediante cirugía y corticoides. (AU)

Allergic fungal sinusitis is an inflammatory disease of the rhinosinusal mucosa caused by fungi that can be isolated from the nasal cavity of healthy individuals. The pathology is produced indirectly by the fungus that acts as an antigen and triggers an IgE-mediated allergic reaction that causes polyps and a thick mucous discharge with detritus and hyphae called mucin. Its most common clinical presentation is unilateral or bilateral chronic sinusitis with polyps. Less commonly, substances originated by the degranulation of eosinophils cause bone remodeling or destruction, and sinusitis can simulate a neoplasia. We describe the clinical case of a patient who suffered from allergic fungal sinusitis with massive bone destruction of the skull base and who had intracranial, extradural and intraorbital extension of the disease. He was successfully treated with surgery and corticosteroids.Key words: allergic fungal sinusitis, intracranial extension, endoscopic surgery, transorbital transpalpebral approach. (AU)

Humans , Male , Middle Aged , Sinusitis/diagnostic imaging , Skull Base/physiopathology , Rhinitis, Allergic/diagnostic imaging , Invasive Fungal Infections/diagnostic imaging , Curvularia/pathogenicity , Sinusitis/surgery , Sinusitis/drug therapy , Prednisone/administration & dosage , Skull Base/surgery , Budesonide/administration & dosage , Rhinitis, Allergic/surgery , Rhinitis, Allergic/drug therapy , Invasive Fungal Infections/surgery , Invasive Fungal Infections/drug therapy
Medicina (B.Aires) ; 81(5): 780-785, oct. 2021. graf
Article in Spanish | LILACS | ID: biblio-1351051


Resumen Se realizó un estudio retrospectivo de las infecciones fúngicas atendidas en un centro de quemados de alta complejidad situado en Buenos Aires, entre 2011 y 2014, mediante el análisis de las histo rias clínicas (n = 36). Las edades de los pacientes estuvieron entre 18 y 87 años, y 23 (63.9%) fueron mujeres. La extensión de la superficie corporal afectada más prevalente varió entre 30 y 50% (p = 0.03), y entre 71% y 100% en pacientes de menor edad, relacionándose con intentos de femicidio. En el 69.4% la profundidad de la quemadura fue grado 4, y en el 50% de los casos se observaron lesiones por inhalación, con una alta mortali dad (p = 0.04). El Candida score resultó de 3 en el 77.7% de los casos. Se usaron vías centrales y ventilación mecánica. Todos los pacientes recibieron tratamiento antibiótico y en 33 (91.7%) antifúngicos. La escisión qui rúrgica de la quemadura se practicó en 33 (91.7%) y los autoinjertos de piel en 29 (80.6%). La infección fúngica se desarrolló en una media de 21.4 días del ingreso en UCI. Se estudiaron 52 muestras de levaduras que se aislaron de urocultivo (42.3%), hemocultivo (26.9%), biopsia cutánea (9.6%), punta de catéter (15.4%) y aspirado traqueal (5.8%). Por cultivo microbiológico y métodos moleculares se identificaron a Candida albicans (53.8%), C. tropicalis (23.1%), C. parapsilosis sensu stricto (13.5%), C. krusei (5.8%), C. glabrata (1.9%) y C. dubliniensis (1.9%). Las infecciones fúngicas representan severas complicaciones en quemados con factores de riesgo.

Abstract A retrospective analysis of fungal infections was carried out in a health-care burn center between 2011 and 2014 using the patients' medical records (n = 36). Patients ranged from 18 to 87 years of age, with 23 (63.9%) being women. The most prevalent widespread total body surface area affected (TBSA) was 30-50% (p = 0.03), and 71-100% in younger patients, mainly associated with femicide. Fourth degree burns were revealed in 69.4% of the patients while in 50%, inhalation injuries were observed to represent a higher mortality rate (p = 0.04). The Candida score was 3 in 77.7% of cases respectively. Central venous catheter and mechanical ventilation were used. All patients received antibiotic treatment and 91.7% antifungal treatment. Surgical excision of the burn was performed in 33 (91.7%) patients, and skin autografting in 29 (80.6%). The median of the fungal infection devel oped was 21.4 days after admission to the ICU. The specimens analyzed involved 52 yeast samples isolated from different cultures: urine (42.3%), blood (26.9%), skin biopsy (9.6%), catheter tip (15.4%) and tracheal aspirate (5.8%). The use of microbiological culture and molecular methods allowed for the identification of Candida albicans (53.8%), C. tropicalis (23.1%), C. parapsilosis sensu stricto (13.5%), C. krusei (5.8%), C. glabrata (1.9%) and C. dubliniensis (1.9%). Fungal infections observed in skin burns lead to severe complications in at-risk patients.

Humans , Female , Candida , Mycoses/drug therapy , Retrospective Studies , Risk Factors , Antifungal Agents
Infectio ; 25(3): 197-199, jul.-set. 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1250093


Abstract Mycetoma is a chronic and slow-developing granulomatous disease characterized by the triad of large painless tumour-like subcutaneous swellings, the formation of sinuses, and discharge that usually contains grains. Phellinus spp. are saprophytic wood-decaying filamentous basidiomycetes. They are an under-recognised cause of invasive fungal infections and are rarely reported worldwide. We report a 59-year-old male patient with mycetoma caused by Phellinus spp. The diagnosis was confirmed with clinical examination, magnetic resonance imaging (MRI) study, soft tissue and bone biopsy culture, and polymerase chain reaction. To the best of our knowledge, this is the first reported case of mycetoma due to Phellinus spp. without chronic granulomatous disease (CGD).

Resumen El micetoma es una enfermedad granulomatosa crónica y de lento desarrollo caracterizada por la tríada de grandes inflamaciones subcutáneas similares a tumores indoloras, la formación de los senos nasales y secreción que generalmente contiene granos. Phellinus spp. son basidiomicetos filamentosos saprofitos que descomponen la madera. Son un poco reconocido causa de infecciones fúngicas invasivas y rara vez se informan en todo el mundo. Presentamos un paciente masculino de 59 años con micetoma causado por Phellinus spp. El diagnostico se confirmó con examen clínico, estudio de resonancia magnética (RM), cultivo de biopsia de tejido blando y óseo y reacción en cadena de la polimerasa. A lo mejor que sepamos, este es el primer caso reportado de micetoma debido a Phellinus spp. sin enfermedad granulomatosa crónica (EGC).

Humans , Male , Middle Aged , Basidiomycota , Phellinus , Mycetoma , Brazil , Polymerase Chain Reaction , Invasive Fungal Infections , Mycoses
CES med ; 35(2): 113-125, mayo-ago. 2021. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1364607


Resumen Introducción: los hongos hacen parte de los microorganismos que se encuentran en el ser humano y que interactúan con bacterias, virus y archaeas. El equilibrio inter e intra-especies es importante para mantener la salud en los seres humanos. La mayoría de los estudios sobre el micobioma se han relacionado con estados de enfermedad causados por hongos, siendo de relevancia la exploración de las comunidades comensales en individuos sanos. Métodos: se realizó una búsqueda bibliográfica en PubMed, ScienceDirect, Scopus y Google Scholar, usando los términos mycobiome, intestinal fungi, skin mycobiome, vaginal mycobiome, fungal microbiome. Se incluyeron artículos desde 1996 hasta 2020, de revisión y de resultados de investigación en todos los idiomas. Resultados y discusión: existe variabilidad en las comunidades fúngicas en los sitios corporales según sus características intrínsecas y la relación con el medio ambiente. El estado de salud en los seres humanos puede estar influenciado por la densidad y diversidad fúngica, a diferencia de los individuos enfermos en quienes se evidencia una disminución en la diversidad y que se asocia con el oportunismo de agentes patógenos.

Abstract Introduction: Fungi are part of the microorganisms that are found in humans and interact with bacteria, viruses and archaeas. The balance inter and intra-species is important to maintain health in humans. Most studies on mycobiota have been related to disease states caused by fungi, the exploration of commensal communities in healthy individuals being relevant. Methods: literature search in PubMed, ScienceDirect, Scopus and Google Scholar, using the terms: mycobiome, intestinal fungi, skin mycobiome, vaginal mycobiome, fungal microbiome. Articles from 1996 to 2020, review and research results in all languages were included in this review. Results: Variability in fungal communities is determinated according to body site characteristics and the contact with the environment. Health status in humans can be influenced by fungal density and diversity, unlike sick individuals where there is evidence of a decrease in diversity and that is associated with the opportunism of pathogens.

An. bras. dermatol ; 96(4): 482-484, July-Aug. 2021. graf
Article in English | LILACS | ID: biblio-1285084


Abstract The species of the Cryptococcus neoformans complex show different epidemiological patterns in the infection of immunosuppressed or immunocompetent individuals, and a common tropism peculiarity for the central nervous system. Primary cutaneous cryptococcosis is a rare clinical entity, with manifestations that are initially restricted to the skin through fungal inoculation, and the absence of systemic disease. The authors report in the present study the case of a 61-year-old immunocompetent man, with a rapidly evolving mucoid tumor on abrasions in contact with bird droppings on the forearm. The early identification of the polymorphic skin manifestations and treatment are crucial for the favorable prognosis of the infection, which can be life-threatening.

Humans , Male , Cryptococcosis/diagnosis , Cryptococcosis/drug therapy , Cryptococcus neoformans , Dermatomycoses/diagnosis , Dermatomycoses/drug therapy , Skin , Immunocompromised Host , Early Diagnosis , Middle Aged
Radiol. bras ; 54(3): 198-203, May-June 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1250662


Abstract Fungal infections of the central nervous system (CNS) are rare. However, because of the increase in the number of immunocompromised individuals, they have been gaining prominence in the differential diagnosis of CNS infections. Imaging techniques are sensitive for detecting and localizing an abnormality, in many cases allowing the origin of a lesion to be categorized as infectious, inflammatory, neoplastic, or vascular. This essay illustrates the magnetic resonance imaging and computed tomography findings of the most common fungal infections of the CNS, based on the experience of the Radiology Department of the Hospital de Clínicas de Porto Alegre, in the city of Porto Alegre, RS, Brazil.

Resumo As infecções fúngicas do sistema nervoso central (SNC) são raras, entretanto, com o aumento no número de indivíduos imunocomprometidos elas têm ganhado destaque no diagnóstico diferencial de infecções no SNC. As atuais técnicas de imagem são sensíveis para detectar uma anormalidade, localizá-la, e em muitos casos categorizar a lesão como de origem infecciosa e/ou inflamatória, neoplásica ou vascular. Este ensaio ilustra os achados de ressonância magnética e tomografia computadorizada mais comuns nas infecções fúngicas do SNC baseadas na experiência do Serviço de Radiologia do Hospital de Clínicas de Porto Alegre.

An. bras. dermatol ; 96(3): 349-351, May-June 2021. graf
Article in English | LILACS | ID: biblio-1285054


Abstract Sporotrichosis is a subcutaneous mycosis that affects humans and animals, with a typically subacute or chronic evolution, caused by Sporothrix spp., a dimorphic fungus. Although the cutaneous form is the most frequent presentation, the ocular involvement has been more frequently diagnosed in endemic areas, affecting mainly children and the elderly. Approximately 80% of affected patients have the lymphocutaneous form, while only 2.3% have conjunctival lesions, with 0.7% showing primary ocular involvement. We describe two cases of sporotrichosis with ocular involvement in children through inoculation by felines, with a good response to antifungal treatment.

Humans , Animals , Child , Aged , Cats , Sporotrichosis/diagnosis , Sporotrichosis/drug therapy , Sporothrix , Dermatomycoses/drug therapy , Eye , Antifungal Agents/therapeutic use
Rev. bras. ortop ; 56(3): 390-393, May-June 2021. graf
Article in English | LILACS | ID: biblio-1288675


Abstract Spondylodiscitis is an uncommon but serious complication after spine surgeries, and its main etiologic agent is Staphylococcus aureus. Fungal infections are rare and mostly caused by Candida albicans. We report the clinical case of a 69-year-old male patient who underwent a L2-S1 arthrodesis for degenerative scoliosis correction. He presented an infection 2.5 months after the procedure, a spondylodiscitis at L5-S1 levels, caused by Candida parapsilosis. The treatment consisted of surgical material removal, tricortical iliac graft placement in an anterior approach (L5-S1), lumbopelvic fixation (from T10 to the pelvis) in a posterior approach, and drug treatment with anidulafungin and fluconazole. This last medication was administered for 12 months, with good clinical outcomes.

Resumo As espondilodiscites são complicações infrequentes, porém graves em pós-operatórios de cirurgias da coluna vertebral, tendo como principal agente etiológico o Staphylococcus aureus. As infecções fúngicas são raras, sendo a Candida albicans a principal representante desse grupo. Relatamos o caso clínico de um paciente do sexo masculino, 69 anos, operado com artrodese de L2 a S1 para correção de escoliose degenerativa. O paciente apresentou quadro clínico infeccioso 2 meses e meio após o procedimento, relacionado à espondilodiscite L5-S1, causada por Candida parapsilosis. O tratamento consistiu na remoção do material cirúrgico, colocação de enxerto tricortical de ilíaco pela via anterior (L5-S1) e fixação lombopélvica (de T10 à pelve) pela via posterior, além de iniciar o tratamento medicamentoso com anidulafungina e fluconazol, mantendo essa última medicação por 12 meses, com boa evolução clínica.

Staphylococcus aureus , Discitis , Fluconazole , Candida parapsilosis , Anidulafungin , Mycoses