Systemic sporotrichosis in an alcoholic patient

Abstract A 44-year-old male patient presented with nodules that evolved with inflammation, following drainage of seropurulent secretion and ulceration. The patient had a 6 year-history of alcohol addiction and reported contact with cats. At the physical examination, the patient had skin-colored and erythematous nodules, and ulcers covered with thick, blackened crusts on the face, trunk and limbs. A culture of a nodule fluid revealed growth of Sporotrix sp. He also had pulmonary involvement and therefore the disease was classified as systemic sporotrichosis, a rare form that usually affect patients infected with HIV. Chronic alcohol abuse was considered the factor of immunosuppression for the patient.

Disseminated cutaneous sporotrichosis associated with ocular lesion in an immunocompetent patient

Abstract: A 59-year-old female patient, previously healthy, immunocompetent, presented left bulbar conjunctiva lesions and nodular-ulcerated lesions on the arms and cervical region, besides left cervical and retroauricular lymphadenopathy. She had previous contact with domestic cats that excoriated her face. The diagnosis was conclusive of disseminated sporotrichosis through clinical and epidemiological history and cultures of skin and ocular secretions. It evolved with good response to oral antifungal therapy.

Diagnóstico serológico de la esporotricosis mediante el empleo del antígeno de micelio de Sporothrix schenckii sensu stricto / Serological diagnosis of sporotrichosis using an antigen of Sporothrix schenckii sensu stricto mycelium

En este estudio se desarrolló y se evaluó el ensayo por inmunoabsorción ligado a enzimas (ELISA), para la detección de anticuerpos en sueros de pacientes con esporotricosis, para lo cual se empleó un antígeno crudo de Sporothrix schenckii sensu stricto obtenido a partir de la forma micelial. Los sueros positivos para esporotricosis fueron ensayados por otras técnicas serológicas: inmunodifusión doble (IDD) y contrainmunoelectroforesis (CIE). El ensayo fue validado utilizando sueros de otras patologías como histoplasmosis, paracoccidioidomicosis, tuberculosis, leishmaniasis, lupus y sueros de individuos sanos como controles negativos. Se encontró una especificidad de 100 % con las técnicas utilizadas y una sensibilidad del antígeno de S.schenckii sensu stricto, por encima del 98% para IDD, CIE y ELISA. Estos resultados demuestran la alta sensibilidad y especificidad del antígeno de S. schenckii sensu stricto, para el diagnóstico de la esporotricosis, empleando las técnicas de IDD, CIE y ELISA. Los resultados sugieren, que este antígeno podría ser usado en conjunto con otras pruebas convencionales para el diagnóstico diferencial y puede ser útil para monitorizar la evolución de la enfermedad y respuesta al tratamiento.

We developed and analyzed an Enzyme-Linked Immunosorbent Assay (ELISA) in order to detect antibodies in sera from sporotrichosis patients. We used a crude antigen of Sporothrix schenckii sensu stricto, obtained from the mycelial phase of the fungi. Positive sera were analyzed by other serological techniques such as double immunodiffusion (IGG) and counterimmunoelectrophoresis (CIE). The assay was validated by using sera from patients with other pathologies such as: histoplasmosis, paracoccidioidomycosis, tuberculosis, leishmaniasis, lupus and healthy individuals as negative controls. For the Sporothrix schenckii sensu stricto antigen, we found a 100% of specificity by every technique and sensitivity higher than 98% with IDD, CIE and ELISA. Our results show a high sensitivity and specificity for the Sporothrix schenckii sensu stricto antigen, so it can be used for IDD, CIE and ELISA. The results suggest that this antigen could be used in conjunction with other conventional tests for differential diagnosis and may be useful for monitoring the disease progression and response to treatment.

Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature

We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.

Caracterização da glicoproteína de 70 kDa de Sporothrix schenckii e sua participação na regulação da resposta imune na esporotricose experimental / Characterization of the glycoprotein of 70 kDa of Sporothrix schenkii and its participation in the immune response in experimental sporotrichosis

A esporotricose é uma micose subcutânea de caráter crônico e de ampla distribuição mundial, cujo agente patogênico é o fungo dimórfico térmico, Sporothrix schenckii. Esse trabalho teve como principal objetivo a caracterização da atividade biológica da glicoproteína de 70 kDa (gp70), secretado pelas células leveduriformes de S. schenckii, visando à produção de anticorpos monoclonais e estudos de imunização passiva. Para atingir tais objetivos, foi produzido um hibridoma secretor de anticorpos monoclonais contra a fração de 70 kDa, denominado de AcMo P6E7. Através de ensaios de imunização passiva, foi observado que a administração do AcMo P6E7 em camundongos BALB/c foi capaz de modificar o curso da infecção experimental por S. schenckii, protegendo esses animais contra a infecção. Através de ensaios de imunofluorescência foi verificado que a gp70 está presente na superfície das células leveduriformes de S. schenckii e é uma adesina putativa para fibronectina e laminina...

Esporotricosis experimental en ratas / Sporotrichosis experimental on rats

Ratas endocriadas se infectaron por vía intraperitoneal y en la cola con una suspensión de conidios de Sporothrix schenckii. Los frotis coloreados con May Grunwald-Giemsa y Gram Nicolle, así como los cultivos de macerados de los órganos que se biopsiaron: hígado, bazo, pulmón y glándula suprarrenal y de la cola manifestaron a los l5 días de inoculación una diseminación del hongo; no así a los 30 días de infección, excepto el material correspondiente a la cola que presentó en ese tiempo elementos de S.schenckii. Los estudios inmunológicos realizados permitieron la estandarización del exoantígeno preparado, se detectaron anticuerpos en los sueros de las ratas a los 15 y 30 días posteriores a la inoculación. Las intradermorreacciones realizadas en los animales provocaron una buena respuesta frente al exoantígeno preparado. De esta forma, se comprueba que la rata es un animal adecuado para la infección experimental y la estandarización de antígenos de S.schenckii

Diagnóstico serológico de la esporotricosis cutánea: estudio comparativo entre diferentes técnicas y antígenos / Serologic diagnosis of cutaneous sporotrichosis: comparative study between different techniques

La esporotricosis es una micosis de distribución mundial, en Venezuela su incidencia es más elevada en los estados Centrales, Bolívar y Andinos. Debido a la discrepancia en los resultados publicados en el empleo de las técnicas serológicas para el diagnóstico de las localizaciones cutáneas, se usan las técnicas de aglutinación (C.D.C., Atlanta, U.S.A.) y las de precipitación en los mismos sueros (Sección Micología, Instituto de Biomedicina, Caracas) procedentes de 32 casos de esporotricosis, observandose con ambos procedimientos