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1.
Braz. j. biol ; 83: e246230, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1339369

ABSTRACT

Abstract Dengue fever vectored by the mosquito Aedes aegypti is one of the most rapidly spreading insect-borne diseases. Current reliance of dengue vector control is mostly on chemical insecticides. Growing insecticide resistance in the primary mosquito vector, Aedes aegypti, limits the effectiveness of vector control through chemical insecticides. These chemical insecticides also have negative environmental impacts on animals, plants and human health. Myco-biocontrol agents are naturally occurring organisms and are found to be less damaging to the environment as compared to chemical insecticides. In the present study, entomopathogenic potential of local strains of fungi isolated from soil was assessed for the control of dengue vector. Local fungal isolates presents better alternative to introducing a foreign biocontrol strain, as they may be better adapted to environmental conditions of the area to survive and may have more entomopathogenic efficacy against target organism. Larvicidal efficacy of Fusarium equiseti and Fusarium proliferatum was evaluated against Aedes aegypti. Local strains of F. equiseti (MK371718) and F. proliferatum (MK371715) were isolated from the soil of Changa Manga Forest, Pakistan by using insect bait method. Larvicidal activity of two Fusarium spp. was tested against forth instar larvae of A. aegypti in the laboratory, using concentrations 105, 106, 107 and 108 conidia /ml. LC50 values for F. equiseti after 24h, 48h, 72h and 96h of exposure were recorded as 3.8x 108, 2.9x107, 2.0x107, and 7.1x106 conidia /ml respectively while LC50 values for F. proliferatum were recorded as 1.21x108, 9.6x107, 4.2x107, 2.6x107 conidia /ml respectively after 24h, 48h, 72h and 96h of exposure. The results indicate that among two fungal strains F. equiseti was found to be more effective in terms of its larvicidal activity than F. proliferatum against larvae of A. aegypti.


Resumo A dengue transmitida pelo mosquito Aedes aegypti é uma das doenças transmitidas por insetos de propagação mais rápida. A dependência atual do controle do vetor da dengue é principalmente de inseticidas químicos. O aumento da resistência a inseticidas no principal vetor do mosquito, Aedes aegypti, limita a eficácia do controle do vetor por meio de inseticidas químicos. Esses inseticidas químicos também têm impactos ambientais negativos sobre os animais, plantas e saúde humana. Os agentes de micobiocontrole são organismos que ocorrem naturalmente e são menos prejudiciais ao meio ambiente em comparação com os inseticidas químicos. No presente estudo, avaliou-se o potencial entomopatogênico de cepas locais de fungos isolados do solo para o controle do vetor da dengue. Isolados de fungos locais apresentam melhor alternativa para a introdução de uma cepa de biocontrole estrangeira, pois podem ser mais bem adaptados às condições ambientais da área para sobreviver e podem ter maior eficácia entomopatogênica contra o organismo-alvo. A eficácia larvicida de Fusarium equiseti e Fusarium proliferatum foi avaliada contra Aedes aegypti. Cepas locais de F. equiseti (MK371718) e F. proliferatum (MK371715) foram isoladas do solo de Changa Manga Forest, Paquistão, usando o método de isca para insetos. Atividade larvicida de dois Fusarium spp. foi testado contra larvas de quarto ínstar de A. aegypti em laboratório, nas concentrações 105, 106, 107 e 108 conídios / ml. Os valores de LC50 para F. equiseti após 24 h, 48 h, 72 h e 96 h de exposição foram registrados como 3,8x 108, 2,9x107, 2,0x107 e 7,1x106 conídios / ml, respectivamente, enquanto os valores de LC50 para F. proliferatum foram registrados como 1,21x108, 9,6 x107, 4,2x107, 2,6x107 conídios / ml, respectivamente, após 24 h, 48 h, 72 h e 96 h de exposição. Os resultados indicam que entre duas cepas de fungos F. equiseti se mostrou mais eficaz em termos de atividade larvicida do que F. proliferatum contra larvas de A. aegypti.


Subject(s)
Humans , Animals , Aedes , Fusarium , Insecticides/pharmacology , Pakistan , Soil , Plant Extracts , Forests , Mosquito Vectors , Larva
2.
Braz. j. biol ; 83: e244261, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1285633

ABSTRACT

Abstract Endophytic bacteria serve key roles in the maintenance of plant health and growth. Few studies to date, however, have explored the antagonistic and plant growth-promoting (PGP) properties of Prunus cerasifera endophytes. To that end, we isolated endophytic bacteria from P. cerasifera tissue samples and used a dual culture plate assay to screen these microbes for antagonistic activity against Verticillium dahliae, Botryosphaeria dothidea, Fusarium oxysporum, F. graminearum, and F. moniliforme. Of the 36 strains of isolated bacteria, four (strains P1, P10, P16, and P20) exhibited antagonistic effects against all five model pathogens, and the P10 strain exhibited the strongest antagonistic to five pathogens. This P10 strain was then characterized in-depth via phenotypic assessments, physiological analyses, and 16s rDNA sequencing, revealing it to be a strain of Bacillus subtilis. Application of a P10 cell suspension (1×108 CFU/mL) significantly enhanced the seed germination and seedling growth of tomato in a greenhouse setting. This P10 strain further significantly suppressed tomato Verticillium wilt with much lower disease incidence and disease index scores being observed following P10 treatment relative to untreated plants in pot-based experiments. Tomato plants that had been treated with strain P10 also enhanced defense-related enzymes, peroxidase, superoxide dismutase, and catalase activity upon V. dahliae challenge relative to plants that had not been treated with this endophytic bacterium. The results revealed that the P10 bacterial strain has potential value as a biocontrol agent for use in the prevention of tomato Verticillium wilt.


Resumo As bactérias endofíticas desempenham papel fundamental na manutenção da saúde e do crescimento das plantas. Poucos estudos até o momento, no entanto, exploraram as propriedades antagônicas e promotoras de crescimento de plantas (PGP) de endófitos de Prunus cerasifera. Para esse fim, isolamos bactérias endofíticas de amostras de tecido de P. cerasifera e usamos um ensaio de placa de cultura dupla para rastrear esses micróbios quanto à atividade antagonista contra Verticillium dahliae, Botryosphaeria dothidea, Fusarium oxysporum, F. graminearum e F. moniliforme. Das 36 cepas de bactérias isoladas, quatro (cepas P1, P10, P16 e P20) exibiram efeitos antagônicos contra todos os cinco patógenos modelo, e a cepa P10 exibiu o antagonista mais forte para cinco patógenos. Essa cepa P10 foi então caracterizada em profundidade por meio de avaliações fenotípicas, análises fisiológicas e sequenciamento de rDNA 16s, revelando ser uma cepa de Bacillus subtilis. A aplicação de uma suspensão de células P10 (1 × 108 UFC / mL) aumentou significativamente a germinação das sementes e o crescimento das mudas de tomate em casa de vegetação. Essa cepa P10 suprimiu ainda mais a murcha de Verticillium do tomate com incidência de doença muito menor e pontuações de índice de doença sendo observadas após o tratamento com P10 em relação a plantas não tratadas em experimentos baseados em vasos. As plantas de tomate que foram tratadas com a cepa P10 também aumentaram as enzimas relacionadas à defesa, peroxidase, superóxido dismutase e atividade da catalase após o desafio de V. dahliae em relação às plantas que não foram tratadas com essa bactéria endofítica. Os resultados revelaram que a cepa bacteriana P10 tem valor potencial como agente de biocontrole para uso na prevenção da murcha de Verticillium em tomate.


Subject(s)
Lycopersicon esculentum , Verticillium , Prunus domestica , Plant Diseases/prevention & control , Ascomycota , Bacillus subtilis , Fusarium
3.
Hematol., Transfus. Cell Ther. (Impr.) ; 44(1): 32-39, Jan.-Mar. 2022. tab, ilus
Article in English | LILACS | ID: biblio-1364905

ABSTRACT

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.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Fusariosis , Invasive Fungal Infections , Hematologic Diseases , Sinusitis , Febrile Neutropenia , Fusarium
4.
Braz. arch. biol. technol ; 64: e21200088, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249211

ABSTRACT

Abstract Fusarium is producing several important mycotoxins including beauvericin (BEA). Two species of Fusarium viz. F. subglutinans and F. sacchari cause the Pokkahboeng disease of sugarcane. The studies on the occurrence and toxicity of BEA are scarce. Therefore, this study aimed to identify the isolates of Fusarium and detect their ability to produce BEA. The toxicity of BEA was also tested on brine shrimp Artemia salina. Many isolates of Fusarium were isolated from the infected plants of sugarcane in Malaysia. We identified the species of Fusarium according to their morphological characteristics. The capability of Fusarium isolates for producing the BEA was estimated by using a thin layer chromatography. The toxicity bioassay of BEA was conducted on the brine shrimp larvae. The results were identified on F. subglutinans and F. sacchari in 55 isolates of Fusarium. All isolates demonstrated the ability to produce BEA. Interestingly, BEA exhibited variation in toxicity between low toxic to very higher toxicity 100%. F. subglutinans and F. sacchari were able to produce BEA and possibly BEA may be causing toxicity in the host tissue and may be acting as a potential pathogenicity factor. Therefore, we consider BEA as an interesting factor in determining the virulence of fusarium isolate.


Subject(s)
Artemia , Depsipeptides , Fusarium , Mycotoxins
5.
Article in English | LILACS | ID: biblio-1284447

ABSTRACT

This paper described the chemical compositions and antimicrobial activity of the essential oils from the leaves and stem of Amomum rubidumLamxay & N. S. Lý, collected from Bidoup Nui Ba National Park, Lam Dong, Vietnam. The essential oils were obtained by hydrodisitllation method while antimicrobial activity was evaluetd by microdilution broth susceptibility assay. The main constituents of the leaf essential oil were identified as 1,8-cineole (37.7%), δ-3-carene (19.5%) and limonene (16.3%) while δ-3-carene (21.9%), limonene (17.8%) and ß-phellandrene (14.6%) dominated in the stem essentialoil. The leaf and stem essential oils displayed stronger inhibition of Pseudomonas aeruginosa with MIC of 25 µg/mLand 50 µg/mL respectively. The stem essential oil was active against Candida albicans (MIC, 50 µg/mL) while both essential oils inhibited the growth of Fusarium oxysporum (MIC 50 µg/mL). This is the first report on chemical constituents and antimicrobial activity of the essential oils of A. rubidum.


Este artículo describe la composición química y la actividad antimicrobiana de aceites esenciales de las hojas y el tallo de Amomum rubidum Lamxay & N. S. Lý recolectados del Parque Nacional Bidoup Nui Ba, Lam Dong, Vietnam. Los aceites esenciales se obtuvieron mediante el método de hidrodisitilación, mientras que la actividad antimicrobiana se evaluó mediante un ensayo de susceptibilidad de caldo de microdilución. Los principales componentes del aceite esencial de la hoja se identificaron como 1,8-cineol (37,7%), δ-3-careno (19,5%) y limoneno (16,3%), mientras que δ-3-careno (21,9%), limoneno (17,8 %) y ß-felandreno (14,6%) dominaron en el aceite esencial del tallo. Los aceites esenciales de hoja y tallo mostraron una inhibición más fuerte de Pseudomonas aeruginosa con un MIC de 25 µg/mL y 50 µg/mL, respectivamente. El aceite esencial del tallo fue activo contra Candida albicans (MIC, 50 µg/mL) mientras que ambos aceites esenciales inhibieron el crecimiento de Fusarium oxysporum (MIC 50 µg/mL). Este es el primer informe sobre los componentes químicos y la actividad antimicrobiana de los aceites esenciales de A. rubidum.


Subject(s)
Oils, Volatile/pharmacology , Amomum/chemistry , Anti-Infective Agents/pharmacology , Pseudomonas aeruginosa/drug effects , Candida albicans/drug effects , Oils, Volatile/chemistry , Microbial Sensitivity Tests , Distillation , Chromatography, Gas , Plant Stems , Plant Leaves , Monoterpenes/analysis , Fusarium/drug effects , Anti-Infective Agents/chemistry
6.
Article in Chinese | WPRIM | ID: wpr-921697

ABSTRACT

Fusarium is the major pathogen of root rot of Pseudostellaria heterophylla. This study aims to explain the possible distribution of Fusarium species and the contamination of its toxin-chemotypes in tuberous root of P. heterophylla. A total of 89 strains of fungi were isolated from the tuberous root of P. heterophylla. Among them, 29 strains were identified as Fusarium by ITS2 sequence, accounting for 32.5%. They were identified as five species of F. avenaceum, F. tricinctum, F. fujikuroi, F. oxysporum, and F. graminearum based on β-Tubulin and EF-1α genes. LC-MS/MS detected 18, 1, and 5 strains able to produce ZEN, DON, and T2, which accounted for 62.1%, 3.4%, and 17.2%, respectively. Strain JK3-3 can produce ZEN, DON, and T2, while strains BH1-4-1, BH6-5, and BH16-2 can produce ZEN and T2. PCR detected six key synthase genes of Tri1, Tri7, Tri8, Tri13, PKS14, and PKS13 in strain JK3-3, which synthesized three toxins of ZEN, DON, and T2. Four key synthase genes of Tri8, Tri13, PKS14, and PKS13 were detected in strains BH1-4-1, BH6-5, and BH16-2, which were responsible for the synthesis of ZEN and T2. The results showed that the key genes of toxin biosynthesis were highly correlated with the toxins produced by Fusarium, and the biosynthesis of toxin was strictly controlled by the genetic information of the strain. This study provides a data basis for the targeted prevention and control of exo-genous mycotoxins in P. heterophylla and a possibility for the development of PCR for rapid detection of toxin contamination.


Subject(s)
Caryophyllaceae , Chromatography, Liquid , Fusarium/genetics , Mycotoxins , Tandem Mass Spectrometry
7.
Article in Chinese | WPRIM | ID: wpr-921668

ABSTRACT

Zearalenone(ZEN) is a mycotoxin produced by Fusarium, possessing estrogen-like effects, carcinogenicity, and multiple toxicities. To seek more efficient and practical agents for biological detoxification and broaden their application, this study isolated 194 bacterial strains from the moldy tuberous root of Pseudostellaria heterophylla, which were co-cultured with ZEN. An efficient ZEN-degrading strain H4-3-C1 was screened out by HPLC and identified as Acinetobacter calcoaceticus by morphological observation and molecular identification. The effects of culture medium, inoculation dose, culture time, pH, and temperature on the degradation of ZEN by H4-3-C1 strain were investigated. The mechanism of ZEN degradation and the degrading effect in Coicis Semen were discussed. The degradation rate of 5 μg·mL~(-1) ZEN by H4-3-C1 strain was 85.77% in the LB medium(pH 6) at 28 ℃/180 r·min~(-1) for 24 h with the inoculation dose of 1%. The degradation rate of ZEN in the supernatant of strain culture was higher than that in the intracellular fluid and thalli. The strain was inferred to secret extracellular enzymes to degrade ZEN. In addition, the H4-3-C1 strain could also degrade ZEN in Coicis Semen. If the initial content of ZEN in Coicis Semen was reduced from 90 μg·g~(-1) to 40.68 μg·g~(-1), the degradation rate could reach 54.80%. This study is expected to provide a new strain and application technology for the biological detoxification of ZEN in food processing products and Chinese medicinal materials.


Subject(s)
Bacteria , Fusarium , Mycotoxins , Temperature , Zearalenone
8.
Pesqui. vet. bras ; 41: e06912, 2021. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1346689

ABSTRACT

Equine leukoencephalomalacia (LEM) is a disease caused by the ingestion of food, especially corn, contaminated by fumonisin, a Fusarium verticillioides (synonymous with F. moniliforme) metabolite. The clinical signs of brain injuries have an acute onset and rapid evolution. This study aimed to describe the clinical findings in 11 animals diagnosed with LEM, including cerebrospinal fluid (CSF) analysis. Of these animals, 91% (10/11) were horses, and only 9% (1/11) were asinine. The clinical localization of the lesions was 64% (7/10) cerebral, manifested mainly by altered mental state and behavioral disturbance, and 36% (4/11) were brainstem lesions, manifested by incoordination, head tilt, nystagmus, facial hypoalgesia, difficulty in apprehension, chewing, and swallowing food. Postmortem findings revealed that 82% (9/11) of the lesions were in the cerebrum and 18% (2/11) in the brainstem. CSF findings, such as xanthochromia (43%, 3/7), hyperproteinorrachia (50%, 3/6), and pleocytosis (43%, 3/7) were observed. The affected animals showed neurological signs that were compatible with cerebral and/or brainstem injuries. The CSF from animals with LEM may present with xanthochromia, hyperproteinorrachia, and pleocytosis, reinforcing the fact that this disease should be included in the differential diagnosis of encephalomyelopathies.(AU)


A leucoencefalomalácia (LEM) é uma enfermidade que acomete equídeos causada pela ingestão de milho e seus derivados e feno contaminados pela micotoxina fumonisina, um metabólito do fungo Fusarium verticillioides (sinônimo para F. moniliforme). Os sinais clínicos apresentam início agudo e evolução rápida e são decorrentes de lesões encefálicas. O objetivo deste estudo é descrever os achados clínicos de 11 equídeos diagnosticados com LEM, incluindo a análise do líquido cefalorraquidiano (LCR). 91% dos animais afetados eram equinos e somente 9% (1/11) era asinino. A localização clínica das lesões era 64% (7/10) cerebrais, manifestadas por alterações no estado mental e comportamento e 36% (4/10) no tronco encefálico, manifestadas por incoordenação, desvio lateral de cabeça, nistagmo, hipoalgesia da face e dificuldade de apreensão, mastigação e deglutição de alimentos. Comparativamente, os achados post mortem revelaram que 82% (9/11) das lesões eram no cérebro e 18% (2/11) no tronco encefálico. Alterações no LCR, tais como xantocromia (43%, 3/7), hiperproteinorraquia (50%, 3/6) e pleocitose (43%, 3/7), foram observadas. Os animais afetados apresentaram sinais clínicos compatíveis com lesões encefálicas e/ou de tronco cerebral. O LCR de animais com LEM pode apresentar xantocromia, hiperproteinorraquia, e pleocitose, reforçando que esta doença deve ser incluída como diagnóstico diferencial de encefalomielites.(AU)


Subject(s)
Animals , Brain Injuries , Cerebrospinal Fluid , Leukoencephalopathies/microbiology , Fusarium , Horses , Leukocytosis , Mycotoxins , Eating
9.
Rev. bras. oftalmol ; 79(5): 315-319, set.-out. 2020. tab, graf
Article in English | LILACS | ID: biblio-1137981

ABSTRACT

Abstract Purpose: To report etiological diagnosis, predisposing risk factors, therapeutic strategies and visual outcome of patients treated at the Department of Ophthalmology of Federal University of São Paulo. Methods: This is a retrospective, descriptive, and observational study from medical and laboratory records of the Department of Ophthalmology of Federal University of São Paulo, including all patients with culture proven fungal keratitis in 5 years, from October 2012 through October 2017. Results: There were 2260 fungi microbiologic test requests. Of these, 140 samples had positive cultures for fungi and sixty-six patients were followed at our clinic. Forty-five patients (68.2%) were men, and the mean age was 48.06 (±17.39) years. Fusarium spp. was the most frequently isolated fungus (32 cases; 48.5%), followed by Candida parapsilosis (12 cases; 18.2%). Thirty-four patients (51.5%) underwent intracameral injection of amphotericin B (5 µg per 0.1 ml). In 11 patients (32.3%), infection was eradicated after intracameral amphotericin B associated to topical antifungal treatment and, in 23 patients (67.7%), therapeutic keratoplasty was needed. No complication related to intracameral amphotericin B injection was observed in this series. Forty-three patients (65.1%) ended up with therapeutic keratoplasty. Three patients (4.5%) evolved to evisceration or enucleation. At the last follow-up visit, 53 patients (80.3%) had visual acuity worse than 20/200. Conclusion: Despite current antifungals drugs and distinct administration strategies, fungal keratitis remains challenging. Delayed antifungal therapy may explain poor clinical outcomes. Intracameral amphotericin B associated to topical antfungal treatment seems to be a safe and helpful alternative for non-responsive fungal keratitis. But it is important to formulate other treatment strategies, hence to improve patients' outcomes, since most patients ended-up with significant visual impairment even after current treatment.


Resumo Objetivo: Descrever diagnósticos etiológicos, fatores de risco, estratégias terapêuticas e resultados visuais de pacientes com ceratite fúngica tratados no Departamento de Oftalmologia da Universidade Federal de São Paulo. Métodos: Trata-se de um estudo retrospectivo, descritivo e observacional, a partir da análise de prontuários médicos e laboratoriais do Departamento de Oftalmologia da Universidade Federal de São Paulo, incluindo todos os pacientes com ceratite fúngica comprovada por cultura no período de outubro de 2012 a outubro de 2017. Resultados: Foram realizadas 2260 solicitações de testes microbiológicos. Destas, 140 amostras apresentaram culturas positivas para fungos, e 66 pacientes foram acompanhados em nosso serviço. Quarenta e cinco pacientes (68,2%) eram do sexo masculino, e a média de idade foi de 48,06 (± 17,39) anos. Fusarium spp. foi o fungo mais freqüentemente isolado (32 casos; 48,5%), seguido por Candida parapsilosis (12 casos; 18,2%). Trinta e quatro pacientes (51,5%) foram submetidos à injeção intracameral de anfotericina B (5 µg por 0,1 ml). Destes, 11 pacientes (32,3%) tiveram a infecção erradicada. Nos outros 23 pacientes (67,7%), o transplante terapêutico foi necessário. Nenhuma complicação relacionada à injeção intracameral de anfotericina B foi observada neste estudo. No total, 43 pacientes (65,1%) evoluíram para transplante terapêutico, e 3 pacientes (4,5%) foram submetidos à evisceração ou enucleação. Cinquenta e três pacientes (80,3%) apresentaram acuidade visual final pior que 20/200. Conclusões: Apesar dos diversos medicamentos antifúngicos atuais e vias de administração, o tratamento das ceratites fúngicas permanece desafiador. O atraso no início do tratamento adequado pode justificar o desfecho clínico desfavorável de grande parte dos pacientes. A injeção intracameral de anfotericina B mostrou-se uma alternativa terapêutica segura para ceratites fúngicas refratárias. Mas outras estratégias de tratamento devem ser formuladas, visando melhorar os resultados visuais dos pacientes.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Eye Infections, Fungal/drug therapy , Amphotericin B/therapeutic use , Corneal Transplantation , Candida parapsilosis/isolation & purification , Fusarium/isolation & purification , Keratitis/microbiology , Antifungal Agents/therapeutic use , Brazil , Medical Records , Epidemiology, Descriptive , Retrospective Studies , Observational Study
10.
An. bras. dermatol ; 95(5): 609-614, Sept.-Oct. 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130953

ABSTRACT

Abstract Fusariosis is a superficial or systemic infection, which occurs mainly in immunocompromised hosts, especially in patients with hematological neoplasia; 70%-75% of the cases present cutaneous manifestations. The disseminated form is rare and difficult to diagnose; even with specific treatment, the evolution is usually fatal. Currently, it is considered an emerging disease; in some centers, it is the second most common cause of invasive mycosis, after aspergillosis. The authors describe a case of a female patient with idiopathic bone marrow aplasia and disseminated fusariosis, who initially appeared to benefit from voriconazole and amphotericin B; however, due to persistent neutropenia, her clinical condition deteriorated with fatal evolution.


Subject(s)
Humans , Female , Fusariosis , Fusarium , Bone Marrow , Immunocompromised Host , Voriconazole/therapeutic use , Antifungal Agents/therapeutic use
11.
An. bras. dermatol ; 95(5): 645-648, Sept.-Oct. 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130952

ABSTRACT

Abstract This report presents the case of a 13-year-old female patient with history of acute myeloid leukemia, who, after a bone marrow transplant, began to vomit and experienced rapidly progressive deterioration of consciousness, in addition to disseminated erythematous-violaceous macules, and some blisters with hemorrhagic content inside. Skin biopsy evidenced intravascular filamentous structures. A blood culture confirmed the presence of Fusarium oxysporum. Intravenous treatment with voriconazole was initiated. The patient evolved unfavorably with multiple necrotic skin lesions, ischemic brain lesions, and death.


Subject(s)
Humans , Female , Adolescent , Fusariosis/diagnosis , Fusariosis/drug therapy , Fusarium , Bone Marrow Transplantation , Voriconazole/therapeutic use , Antifungal Agents/therapeutic use
13.
Biosci. j. (Online) ; 36(3): 691-701, 01-05-2020. tab, graf
Article in English | LILACS | ID: biblio-1146440

ABSTRACT

The application of chemical pesticides for the control of fungal diseases results in impacts on the environment and human health. The use of vegetal extracts with antifungal properties for the proper management of crops becomes a viable alternative, mainly for organic and family farming. The objective of this study was to carry out the phytochemical evaluation of Datura inoxia, evaluating its antifungal potential against the mycelial growth of Fusarium solani and Sclerotinia sclerotiorum. The extracts, aqueous and ethanolic, obtained from the leaves of the plant collected in areas of the municipality of Campo Grande, Mato Grosso do Sul, were submitted to phytochemical prospecting and quantification of flavonoids and total phenols. It was evaluated its antifungal activity at concentrations of 800, 1200, 1600, 2000, and 2400 µg 100 mL-1. Each concentration was separately incorporated into BDA agar, poured into Petri dishes, and inoculated with the mycelial disc of the fungus. The diameter of the colonies were measured daily. Two solutions were prepared as control, one containing the solvent added to PDA medium (ethanol solution), and another with only PDA medium (without D. inoxia extract, control). In both extracts were found the same diversity of secondary metabolites (nine classes). The ethanolic extract, a solvent of lower polarity than water, was more efficient in the extraction of these constituents. Alkaloids and phenolic compounds were the most frequent compounds (100%). In relation to antifungal activity, the ethanolic extract provided 100% inhibition of mycelial growth ofSclerotinia sclerotitorum in all concentrations, relative to the control. On the other hand, the growth ofFusarium solani was only negatively affected at the highest concentrations of 800 and 1200 µmL-1 100 mL-1. The antifungal potential of Datura inoxia was probably related to the abundance of alkaloids and phenolic compounds in its chemical constitution that negatively effects the development of the vegetative mycelium.


A aplicação de defensivos químicos para o controle de doenças fúngicas tem por consequência impactos sobre o ambiente e a saúde humana. Desta forma, a utilização de extratos vegetais com propriedades antifúngicas associado ao manejo adequado de culturas, torna-se uma proposta viável de controle alternativo, principalmente na agricultura orgânica e familiar. Neste sentido, objetivou-se realizar a avaliação fitoquímica das folhas de Datura inoxia, avaliando seu potencial antifúngico frente ao crescimento micelial de Fusarium solani e Sclerotinia sclerotiorum. Os extratos, aquoso e etanólico, obtidos das folhas da planta coletadas em áreas do município de Campo Grande, Mato Grosso do Sul, foram submetidos à prospecção fitoquímica e quantificação flavonoides e fenóis totais, avaliando-se sua atividade antifúngica em concentrações de 800, 1200, 1600, 2000 e 2400 µg 100 mL-1. Cada concentração foi incorporada, separadamente, em ágar BDA, vertida em placas de petri, seguida da colocação do disco de micélio do fungo, com diâmetro das colônias sendo medido diariamente. Utilizou-se como controle negativo, ágar sem extrato e ágar com solução etanólica. Nos dois extratos ocorreu a mesma diversidade de metabólitos secundários (nove classes); porém o extrato etanólico, um solvente de menor polaridade que a água, foi mais eficiente na extração destes constituintes, com destaque aos alcaloides e compostos fenólicos com maior frequência (100%). Em relação a atividade antifúngica, o extrato etanólico proporcionou inibição de 100% do crescimento micelial de Sclerotinia sclerotitorum, em todas as concentrações, em relação a testemunha. Por outro lado, o crescimento de Fusarium solani foi afetado negativamente apenas nas maiores concentrações, 800 e 1200 µmL-1 100 mL-1.O potencial antifúngico da planta provavelmente está relacionado a sua constituição química, com abundância de alcaloides e compostos fenólicos, afetando negativamente o desenvolvimento do micélio vegetativo.


Subject(s)
Soil , Plant Extracts , Datura metel , Fungi , Pesticides , Plant Diseases , Ascomycota , Control , Phenolic Compounds , Phytochemicals , Fusarium , Noxae
14.
Biosci. j. (Online) ; 36(2): 364-375, 01-03-2020. tab, graf
Article in English | LILACS | ID: biblio-1146258

ABSTRACT

This work evaluated the antifungal activity of essential oils of Myrcia ovata chemotypes (MYRO-175, MYRO-156, MYRO-154, MYRO-165, and MYRO-015) and their major compounds (linalool, geraniol, citral, and (E)-nerolidol) on the phytopathogenic fungi Fusarium pallidoroseum (which causes melon postharvest rot) and Colletotrichum musae (which causes anthracnose in banana). The essential oils were obtained by hydrodistillation and analyzed by GCMS/FID. To evaluate the antifungal activity, the essential oils and their major compounds were tested at different concentrations (0.1; 0.3; 0.4; 0.5; 0.7; 1.0; 3.0, and 5.0 mL/L). The major compounds found in the essential oils were nerolic acid, linalool, geraniol, citral, and (E)-nerolidol. The essential oils of the plants MYRO-154, MYRO-165, and MYRO-015 had the minimum inhibitory concentration (MIC) (0.3 mL/L) for F. pallidoroseum and the lowest minimum fungicidal concentration (MFC) (0.7 mL/L), for C. musae. Geraniol and citral had the lowest MFC (0.5 mL / L) for the two fungi tested. For F. pallidoroseum, the essential oils of the chemotypes were more effective than their major compounds. Conversely, the major compounds geraniol of the chemotype MYRO-156 (74.37%) and citral were more effective than their respective essential oils for C. musae. (E)-nerolidol and geraniol of the chemotype MYRO-015 (33.15%) were responsible for the antifungal activity of the essential oils of their respective chemotypes.


No presente trabalho avaliou-se a atividade antifúngica de óleos essenciais de quimiotipos de Myrcia lundiana (MYRO-175, MYRO-156, MYRO-154, MYRO-165, and MYRO-015) e seus compostos majoritários (linalol, geraniol, citral e (E)-nerolidol) sobre os fungos fitopatogênicos Fusarium pallidoroseum(causa podridão em frutos de melão) e Colletotrichum musae (causa antracnose em frutos de banana). Os óleos essenciais foram obtidos hidrodestilação e analisados por CGEM/DIC. Para avaliação da atividade antifúngica foram testados os óleos essenciais e os compostos majoritários nas concentrações: 0,1; 0,3; 0,4; 0,5; 0,7; 1,0; 3,0 e 5,0 mL/L. Os principais compostos presentes nos óleos essenciais foram o ácido nerólico, o linalol, o geraniol, o citral e o (E)-nerolidol. Os óleos essenciais das plantas MYRO-154, MYRO-165 e MYRO-015 apresentaram CIM de 0,3 mL/L e a planta MYRO-015 apresentou a menor concentração fungicida mínima (CFM) (1,0 mL/L). O geraniol e o citral foram os compostos que apresentaram o menor valor de CFM, 0,5 mL/L, frente aos dois fungos testados. O óleo essencial dos quimiotipos testados foram mais promissores que seus componentes majoritários puros, frente o F. pallidoroseum. Já para o C. musae, os componentes majoritários geraniol do quimiotipo MYRO-156 (74,37%) e o citral foram mais promissores que seus respectivos óleos essenciais. Já o (E)-nerolidol e o geraniol do quimiotipo MYRO-015 (33,15%) foram os responsáveis pela atividade antifúngica apresentada pelos óleos essenciais dos respectivos quimiotipos.


Subject(s)
Oils, Volatile , Colletotrichum , Fusarium , Antifungal Agents
15.
Rev. Soc. Bras. Med. Trop ; 53: e20200013, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1136810

ABSTRACT

Abstract Fusarium spp. has been associated with a broad spectrum of emerging infections collectively termed fusariosis. This review includes articles published between 2005 and 2018 that describe the characteristics, clinical management, incidence, and emergence of these fungal infections. Fusarium solani and F. oxysporum are globally distributed and represent the most common complexes. Few therapeutic options exist due to intrinsic resistance, especially for the treatment of invasive fusariosis. Therefore, the use of drug combinations could be an important alternative for systemic antifungal resistance. Increase in the number of case reports on invasive fusariosis between 2005 and 2018 is evidence of the emergence of this fungal infection.


Subject(s)
Humans , Communicable Diseases, Emerging/parasitology , Fusariosis/parasitology , Fusarium/classification , Antifungal Agents/administration & dosage , Brazil/epidemiology , Incidence , Communicable Diseases, Emerging/drug therapy , Communicable Diseases, Emerging/epidemiology , Drug Resistance, Fungal , Fusariosis/drug therapy , Fusariosis/epidemiology
16.
Chinese Journal of Biotechnology ; (12): 1181-1189, 2020.
Article in Chinese | WPRIM | ID: wpr-826860

ABSTRACT

Trichoderma spp. is a kind of filamentous fungi with important biocontrol value. Twelve strains of Trichoderma spp. were isolated from the soils of different types of crops in Shaoxing, Zhejiang and Foshan, Guangdong. The antagonistic resistance to Fusarium oxysporum was compared by plate confrontation test. The further analysis of volatile secondary metabolites for two strains were carried out using HS-SPME-GC-MS analysis. The results showed that T. asperellum ZJSX5003 and GDFS1009 had fast growth ability, and the inhibition effects on F. oxysporum were 73% and 74% respectively. Six identical volatile metabolites were detected as follows 2-Methyl-1-propanol, 3-Methyl-1-butanol, 3-Methyl-3-buten-1-ol, Acetyl methyl carbinol, Butane-2,3-diol and 6-n-pentyl-2H-pyran-2-one (6-PAP). Among them, 6-PAP was validated to have a higher inhibitory effect on F. oxysporum in vitro. This study will provide basis for the development of biocontrol agents with metabolites of Trichoderma, such as 6-PAP.


Subject(s)
Antibiosis , Antifungal Agents , Pharmacology , Fusarium , Physiology , Gas Chromatography-Mass Spectrometry , Trichoderma , Chemistry , Metabolism
17.
Arq. Inst. Biol ; 87: 0702018, 2020. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1096038

ABSTRACT

Currently, the common bean (Phaseolus vulgaris L.) productivity has been reduced by the fungus Fusarium oxysporum f. sp. phaseoli (Fop), the causative agent of Fusarium wilt. Considering the integrated management of diseases, the objectives of the present work were to verify the compatibility between chemical and biological fungicides for Fusarium oxysporum Schlecht. f. sp. phaseoli Kendrick & Snyder (Fop) control in common bean seeds. In laboratory, the effects of the treatments were evaluated by sanity, germination, seedling total length and seedling dry matter tests. In greenhouse conditions, the emergence speed rate, the percentage of emergence and the rate of pathogen transmission through the pathogen infestation in a substrate to plants were evaluated. Common bean seeds BRS Estilo were artificially inoculated with Fop isolate (IAC 11.299-1). In the seeds' treatment, the chemical fungicides fludyoxonyl, flutriafol, methyl tiofanate, and biological products of Trichoderma sp. (isolates SF04, GF 422 and strain 1306), separately and mixed, were used. Treatments that promoted the best pathogen control in seeds were the combination of methyl tiophanate with biological products. Both flutriafol and GF 422 isolated and in mixed treatments affected the seeds' physiological quality. The protective effect of the products was noted in the transmission test, whose Fop incidence was from 5 to 40% in the hypocotyl and from 5 to 30% in common bean roots.(AU)


Atualmente, a produtividade do feijão comum (Phaseolus vulgaris L.) foi reduzida pelo fungo Fusarium oxysporum f. sp. ­phaseoli (Fop), o agente causador da murcha de Fusarium. Considerando o manejo integrado de doenças, os objetivos do presente trabalho foram verificar a compatibilidade entre fungicidas químicos e biológicos para Fusarium oxysporum Schlecht. f. sp. phaseoli Kendrick & Snyder (Fop) em sementes de feijão. Em laboratório, foram avaliados os efeitos dos tratamentos pelos testes de sanidade, germinação, comprimento total de plântulas e matéria seca de plântulas. Em uma estufa, foram avaliadas a velocidade de emergência, a porcentagem de emergência e a taxa de transmissão de patógenos através da infestação de patógenos no substrato às plantas. As sementes de feijão comum BRS Estilo foram inoculadas artificialmente com isolado Fop (IAC 11.299-1). No tratamento das sementes, foram utilizados os fungicidas químicos fludioxoxil, flutriafol, tiofanato metílico e produtos biológicos de Trichoderma sp. (isolados SF04, GF 422 e cepa 1306), separadamente e misturados. Os tratamentos que promoveram o melhor controle de patógenos nas sementes foram a combinação de tiofanato de metila com produtos biológicos. Tanto o flutriafol quanto o GF 422 isolados e em tratamentos com misturas afetaram a qualidade fisiológica das sementes. O efeito protetor dos produtos foi observado no teste de transmissão, cuja incidência de Fop foi de 5 a 40% no hipocótilo e de 5 a 30% nas raízes do feijão comum.(AU)


Subject(s)
Seeds , Pest Control, Biological/methods , Fungicides, Industrial , Fusarium/pathogenicity , Fabaceae , Trichoderma , Pest Control
18.
Arq. Inst. Biol ; 87: e0612019, 2020. graf
Article in English | LILACS, VETINDEX | ID: biblio-1130105

ABSTRACT

The use of highly toxic pesticides to control soil pathogens, such as Fusarium spp. and Sclerotinia sclerotiorum has generated concern, due to the irreversible impacts caused on the environment, in addition to selecting resistant isolates. In this way, essential oils appear as an efficient alternative in control of diseases. Facing the problem of soil pathogens control and high antimicrobial fungicide that essential oils present, this work aimed to evaluate the in vitro fungicidal potential of essential oils in control of Fusarium spp. and S. sclerotiorum. A completely randomized design, factorial scheme 2×4×8 was used, with two isolates (Fusarium spp. and S. sclerotiorum), four essential oils (Aloysia citriodora, Cymbopogon winterianus, Lippia alba and Ocimum americanum), eight essential oil concentrations (0.0; 0.2; 0.4; 0.6; 0.8; 1.0; 1.2 and 1.4 ?L·mL-1), and ten replicates. The essential oils inhibited mycelial growth of the fungi in different concentrations, being their potential justified by the presence of antifungal chemical compounds. Essential oils of A. citriodora, C. winterianus, L. alba and O. americanum present high fungicidal potential, being viable alternatives for formulation of commercial products, boosting the pesticides industry.(AU)


O uso de pesticidas com alta toxicidade para controlar patógenos do solo, como Fusarium spp. e Sclerotinia sclerotiorum, tem gerado preocupação, devido aos impactos irreversíveis causados no meio ambiente, além de selecionar isolados resistentes. Dessa forma, os óleos essenciais surgem como uma alternativa eficiente no controle de doenças. Diante da problemática de controle de patógenos do solo e alto potencial antimicrobiano que os óleos essenciais possuem, este trabalho teve como objetivo avaliar o potencial fungicida de óleos essenciais no controle de Fusarium spp. e S. sclerotiorum, in vitro. Utilizou-se um delineamento inteiramente randomizado, esquema fatorial 2×4×8, com dois isolados (Fusarium spp. e S. sclerotiorum), quatro óleos essenciais (Aloysia citriodora, Cymbopogon winterianus, Lippia alba e Ocimum americanum) e oito concentrações de óleo essencial (0,0; 0,2; 0,4; 0,6; 0,8; 1,0; 1,2 e 1,4 ?L·mL-1), com dez repetições. Os óleos essenciais inibiram o crescimento micelial dos fungos em diferentes concentrações, sendo seu potencial justificado pela presença de compostos químicos antifúngicos. Os óleos essenciais de A. citriodora, C. winterianus, L. alba e O. americanum apresentam alto potencial fungicida, sendo alternativas viáveis para formulação de produtos comerciais, impulsionando a indústria de agrotóxicos.(AU)


Subject(s)
Pesticides/toxicity , Pesticide Utilization , Oils, Volatile , Noxae , Ascomycota , Soil , Ocimum canum , Environment , Fusarium , Antifungal Agents
19.
Arq. Inst. Biol ; 87: e0472019, 2020. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1145883

ABSTRACT

Fusarium wilt, caused by Fusarium oxysporum f. sp. lycopersici, is one of the most important diseases of tomato crop in Brazil. Several alternatives to fungicides have been evaluated in search for products that control this disease and have low environmental impact and toxicity to living beings. In this context, the use of Trichoderma spp. is an alternative to agrochemicals, since they are bioregulators and antagonists of several phytopathogens. This work aimed to evaluate the antagonistic and mycoparasitory action of the Trichodermil 1306 biofungicide against F. oxysporum, and its action in the control of fusarium wilt in tomato seeds and seedlings. The biofungicide was used at concentrations of 0, 50, 100, and 150% of the dose recommended for application of 20 L with a backpack sprayer. The experiment was conducted in a completely randomized design with five replications. Data were submitted to analysis of variance and mean compared by Tukey's test at 5% probability. The 100% Trichodermil concentration was the most efficient for treating tomato seeds. Although this concentration did not show differences in relation to the lowest dose used (50%) in the tomato seed antagonism, mycoparasitism and F. oxysporum incidence tests were recommended because that the lowest concentration resulted in 18% lower root protrusion than that observed with 100% dosage. The in vitro antagonistic and mycoparasitory action of this biological fungicide indicates its potential in the control of fusarium wilt in tomato crops.(AU)


A murcha-de-fusário, causada por Fusarium oxysporum f. sp. lycopersici, é uma das mais importantes doenças da cultura do tomate no Brasil. Várias alternativas aos fungicidas têm sido avaliadas na busca de produtos que controlem a doença e tenham baixo impacto ambiental e toxicidade aos seres vivos. Nesse contexto, o uso de Trichoderma spp. é uma alternativa a agrotóxicos, pois são biorreguladores e antagonistas de vários fitopatógenos. O objetivo do trabalho foi avaliar a ação antagonista e micoparasitória do biofungicida Trichodermil 1306 em F. oxysporum, e no controle da murcha-de-fusário em sementes e mudas de tomate. O biofungicida foi utilizado nas concentrações de 0, 50, 100 e 150% da dose recomendada para aplicação com pulverizador costal de 20 L. O experimento foi conduzido em delineamento inteiramente casualizado, com cinco repetições. Os dados foram submetidos à análise de variância e as médias foram comparadas pelo teste de Tukey a 5% de probabilidade. A concentração de Trichodermil 100% foi a mais eficaz para o tratamento de sementes de tomateiro. Embora essa concentração não tenha se diferenciado da menor dosagem utilizada (50%) para os testes de antagonismo, micoparasitismo e incidência de F. oxysporum em mudas de tomate, sua recomendação se justifica pelo fato da menor concentração ter propiciado protrusão radicular 18% menor do que a observada na concentração de 100%. A ação antagonista e micoparasitória in vitro do fungicida biológico testado no presente estudo indica potencialidade de uso para o controle de murcha-de-fusário em tomateiro.(AU)


Subject(s)
Trichoderma , Pest Control , Lycopersicon esculentum , Fusarium/pathogenicity , Seeds , In Vitro Techniques , Agrochemicals , Agricultural Pests , Environment , Environmental Pollution , Toxicity , Fungicides, Industrial/toxicity , Mycoses
20.
Med. infant ; 26(3): 272-275, sept. 2019. Tab, ilus
Article in Spanish | LILACS | ID: biblio-1026763

ABSTRACT

Introducción: En pacientes pediátricos quemados la osteomielitis fúngica es una complicación infrecuente que conduce a una significativa morbilidad. La información en la literatura está limitada a unos escasos reportes de casos. Objetivo: Describir las características clínicas, epidemiológicas y de evolución de niños quemados con osteomielitis fúngica. Métodos: Se llevo a cabo un estudio retrospectivo y descriptivo de pacientes mayores de 1 mes y menores de 18 años quemados con osteomielitis fúngica internados en el hospital Juan P. Garrahan, un hospital terciario en Buenos Aires, Argentina. Resultados: entre enero del 2007 y enero del 2017, de 600 niños quemados, 9 pacientes presentaron diagnóstico confirmado de osteomielitis fúngica. La mediana de edad fue de 42.5 meses (RIC, 27-118 meses) y la mediana de superficie quemada fue de 33.5% (RIC, 18.5-58%). La osteomielitis fue diagnosticada con una mediana de 30 días luego de la quemadura. Las localizaciones más frecuentes de osteomielitis fueron los miembros superiores y a nivel de calota. Los microorganismos aislados a partir del cultivo de hueso fueron: Fusarium spp. en tres pacientes, Mucor spp. en un paciente; Trichosporon asahii en un paciente; Cándida albicans en dos pacientes y Candida parapsilosis en dos pacientes. En dos casos la infección fúngica fue asociada con aislamientos bacteriano concomitante. Todos los pacientes presentaron hallazgos histopatológicos compatibles con osteomielitis. La mediana de tiempo de tratamiento fue de 44.5 días (RIC, 34.5- 65.5 días). Seis pacientes (67%) presentaron secuela motora. Conclusión: La osteomielitis fúngica fue infrecuente Candida spp. y Fusarium spp. fueron los hongos más comúnmente identificados. La secuela funcional fue frecuente (AU)


Introduction: In pediatric burn patients fungal osteomyelitis is a rare complication that leads to significant morbidity. Data in the literature are limited to sporadic case reports. Objective: To describe the clinical and epidemiological features and outcome in burned children with fungal osteomyelitis. Methods: A retrospective descriptive study was conducted in burn patients older than 1 month and younger than 18 years admitted to Hospital Juan P. Garrahan, a tertiary hospital in Buenos Aires, Argentina. Results: Between January 2007 and January 2017, of 600 burned children, nine had a confirmed diagnosis of fungal osteomyelitis. Median age was 42.5 months (IQR, 27-118 months) and median burn surface was 33.5% (IQR, 18.5-58%). Osteomyelitis was diagnosed at a median of 30 days after the burn. The most common location of osteomyelitis were the upper limbs and skull. The microorganisms isolated form bone cultures were Fusarium spp. in three patients, Mucor spp. in one patient; Trichosporon asahii in one patient; Candida albicans in two patients; and Candida parapsilosis in two patients. In two cases the funal infection was associated with concomitant bacterial isolation. In all patients, the histopathological findings were compatible with osteomyelitis. Median duration of treatment was 44.5 days (IQR, 34.5-65.5 days). Six patients (67%) had motor sequelae. Conclusion: Fungal osteomyelitis is a rare disease. Candida spp. and Fusarium spp. were most frequently identified fungi. Functional sequelae were common (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Osteomyelitis/diagnosis , Osteomyelitis/etiology , Osteomyelitis/epidemiology , Burns/complications , Mycoses/microbiology , Candida/isolation & purification , Miosis/drug therapy , Retrospective Studies , Fusarium/isolation & purification , Antifungal Agents/therapeutic use
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