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1.
Rev. chil. infectol ; 38(6): 811-815, dic. 2021. ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388310

ABSTRACT

Resumen La esporotricosis es una infección fúngica de evolución subagudacrónica causada por hongos dimórficos del Complejo Sporothrix schenckii. Es más frecuente en zonas tropicales. La prevalencia en Argentina se estima entre 0,01 y 0,02%. En la mitad de los pacientes se manifiesta como una esporotricosis linfocutánea, la cual se produce tras la inoculación del hongo en la piel luego de un trauma menor. La lesión inicial es una pápula o nódulo que se sucede con la aparición de una cadena ascendente de nódulos subcutáneos móviles, indoloros y eritematosos. El diagnóstico se realiza a partir del cultivo micológico. El antifúngico de elección es itraconazol y el pronóstico es usualmente favorable. Se presenta el caso de una niña de 4 años, previamente sana, que consultó por adenopatías axilares de evolución subaguda sin respuesta a múltiples esquemas antimicrobianos, confirmándose el diagnóstico de una esporotricosis linfocutánea por el cultivo de una biopsia ganglionar.


Abstract Sporotrichosis is a subacute-chronic fungal infection caused by dimorphic fungi of the Sporothrix schenckii Complex. It is more common in tropical areas. The prevalence in Argentina is estimated between 0.01 and 0.02%. In half of the patients it manifests as lymphocutaneous sporotrichosis, which occurs after inoculation of the fungus into the skin after minor trauma. The initial lesion is a papule or nodule that occurs with the appearance of an ascending chain of mobile, painless and erythematous subcutaneous nodules. The diagnosis is made from mycological culture. The antifungal of choice is itraconazole and the prognosis is usually favorable. We present the case of a healthy 4-year-old girl who consulted for subacute axillary lymphadenopathy without response to multiple antimicrobial regimens, arriving at the diagnosis of lymphocutaneous sporotrichosis from the culture of a lymph node biopsy sample.


Subject(s)
Humans , Male , Child, Preschool , Sporotrichosis/diagnosis , Sporotrichosis/microbiology , Sporotrichosis/drug therapy , Skin/pathology , Sporothrix , Itraconazole/therapeutic use , Antifungal Agents/therapeutic use
2.
Arq. bras. med. vet. zootec. (Online) ; 73(2): 431-437, Mar.-Apr. 2021. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1248922

ABSTRACT

Tracheal fungal infections in horses are rare. This case report describes surgical and clinical management of a filly with a Curvularia sp. infection within the trachea and skin that caused severe intraluminal granulomas and cutaneous nodules, respectively. The patient was successfully treated with itraconazole and surgical excision.(AU)


Infecções fúngicas traqueais em equinos são raras. Este relato de caso descreve condutas clínicas e cirúrgicas em uma égua com infecção por Curvularia sp. na traqueia e na pele, causando granulomas intraluminais severos e nódulos cutâneos, respectivamente. O animal foi tratado com sucesso com itraconazol e exérese cirúrgica.(AU)


Subject(s)
Animals , Tracheitis/veterinary , Itraconazole/therapeutic use , Phaeohyphomycosis/veterinary , Curvularia , Granuloma/veterinary , Horses/surgery
3.
An. bras. dermatol ; 95(6): 740-742, Nov.-Dec. 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1142120

ABSTRACT

Abstract Paracoccidoiomycosis is a systemic mycosis with a higher incidence in males with history of exposure to the rural environment; its classic clinical manifestation is an oro-pulmonary lesion. The authors report a case of a female, urban, 76-year-old patient with atypical clinical-dermatological presentation and diagnostic conclusion after histopathological examination. The clinical response was quick and complete after treatment with itraconazole 400 mg/day in the first month, decreased to 200 mg/day until the sixth month of treatment.


Subject(s)
Humans , Male , Female , Aged , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/drug therapy , Itraconazole/therapeutic use , Lung , Antifungal Agents/therapeutic use
4.
Rev. bras. ciênc. vet ; 27(4): 183-187, out./dez. 2020. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1369656

ABSTRACT

A esporotricose é uma zoonose causada por fungos do gênero Sporothrix. Os gatos doentes têm importante potencial zoonótico e frequentemente revelam uma apresentação disseminada da doença. O objetivo deste relato de caso é descrever as características clínicas e anatomopatológicas de um caso de esporotricose felina refratária ao tratamento com apresentação clínica cutânea disseminada e sistêmica. Um felino macho de 3 anos de idade foi tratado para esporotricose com itraconazol e obteve resolução completa das lesões cutâneas. Porém, um ano após alta clínica, o animal apresentou aumento e ulceração da região nasal. Após cultura fúngica positiva para Sporothrix spp foi instituído tratamento com itraconazol 100mg associado ao iodeto de potássio 20mg por via oral diariamente e transcorrido 3 meses de tratamento, foi observada piora progressiva do sinais clínicos com disseminação de lesões para outras regiões do corpo. O animal foi submetido à eutanásia e encaminhado para necrópsia no Serviço de Anatomia Patológica da Faculdade de Veterinária da Universidade Federal Fluminense. Amostras da língua, pulmão, fígado, baço, rim, cérebro, linfonodo e pele foram coletadas para evidência de disseminação do agente fúngico e avaliação de alterações microscópicas. A coloração de metenamina de prata de Grocott foi utilizada para facilitar a visualização de leveduras sugestivas de Sporothrix spp nos cortes histológicos. Leveduras foram visualizadas em amostras de pele, língua, linfonodo, rim, fígado, baço e cérebro. No presente relato a disseminação do Sporothrixspp para diversos órgãos sinaliza a necessidade de uma minuciosa investigação dos casos graves de esporotricose felina para o tratamento adequado.


Sporotrichosis is a zoonosis caused by fungi of the genus Sporothrix. Sick cats have an significant zoonotic potential and often show a widespread presentation of the disease. The purpose of this case report is to describe the clinical and anatomopathological characteristics of a case of feline sporotrichosis refractory to treatment with disseminated and systemic cutaneous clinical presentation. A 3-year-old male feline was treated for sporotrichosis with itraconazole and achieved complete resolution of the skin lesions. However, one year after clinical discharge, the animal presented an increase and ulceration of the nasal region. After a positive fungal culture for Sporothrix spp, treatment with itraconazole 100mg associated with potassium iodide 20mg was instituted orally daily and after 3 months of treatment, a progressive worsening of the symptoms was observed with the spread of lesions to other regions of the body. The animal was euthanized and sent for necropsy at the Pathological Anatomy Service of the Veterinary Faculty of Universidade Federal Fluminense. Samples of the tongue, lung, liver, spleen, kidney, brain, lymph node, and skin were collected for evidence of spread of the fungal agent and evaluation of microscopic changes. Grocott silver methenamine staining was used to facilitate the visualization of yeasts suggestive of Sporothrix spp in histological sections. Yeasts were visualized in samples of skin, tongue, lymph node, kidney, liver, spleen, and brain. In the present report, the spread of Sporothrix spp to different organs signals the need for a thorough investigation of severe cases of feline sporotrichosis for the proper treatment.


Subject(s)
Animals , Cats , Autopsy/veterinary , Sporotrichosis/veterinary , Sporothrix/pathogenicity , Cats/physiology , Itraconazole/therapeutic use , Immunodeficiency Virus, Feline , Leukemia Virus, Feline
5.
An. bras. dermatol ; 95(2): 241-243, Mar.-Apr. 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1130855

ABSTRACT

Abstract Sporotrichosis is a deep mycosis of subacute or chronic evolution, caused by the dimorphic fungus of the genus Sporothrix. The treatment is carried out with antifungal orally or intravenously. Therapeutic success can be affected by several factors, such as altered gastrointestinal physiology by surgery. More and more patients are submitted to bariatric surgeries and the literature for the alterations of the absorption of medications in this context is very scarce. We intend to contribute to a better understanding with this case report of cutaneous-lymphatic sporotrichosis in a patient after bariatric surgery without response to itraconazole treatment, even at high doses.


Subject(s)
Humans , Female , Adult , Sporotrichosis/drug therapy , Itraconazole/therapeutic use , Bariatric Surgery/adverse effects , Antifungal Agents/therapeutic use , Sporotrichosis/pathology , Treatment Failure , Gastrointestinal Absorption
6.
An. bras. dermatol ; 94(5): 574-577, Sept.-Oct. 2019. graf
Article in English | LILACS | ID: biblio-1054870

ABSTRACT

Abstract The authors report a case of 40-year-old male patient with a five-year history of chromoblastomycosis on his right leg. Diagnosis was performed by direct 40% KOH exam of skin scales, culture with micro- and macromorphologic analysis, and genotypic characterization (sequencing of a fragment of the ITS region and phylogenetic analysis) of the isolated fungus. Rhinocladiella aquaspersa was identified as the etiological agent. Initially, the treatment was with oral itraconazole 200 mg/day for one year. However, the presence of "sclerotic cells" with filaments ("Borelli spiders") resulted in a change of medical treatment: a higher dose of itraconazole (400 mg/day) and surgery, achieving clinical and mycological cure in one year. This is the first report of chromoblastomycosis caused by R. aquaspersa in Guatemala.


Subject(s)
Humans , Male , Adult , Ascomycota/isolation & purification , Chromoblastomycosis/microbiology , Ascomycota/ultrastructure , Chromoblastomycosis/pathology , Chromoblastomycosis/drug therapy , Treatment Outcome , Itraconazole/therapeutic use , Guatemala , Antifungal Agents/therapeutic use
7.
An. bras. dermatol ; 94(4): 470-472, July-Aug. 2019. graf
Article in English | LILACS | ID: biblio-1038288

ABSTRACT

Abstract: Paracoccidioidomycosis is a fungal infection that occurs in immunocompetent patients and are classified into two forms: the acute-subacute form, predominantly in young patients, and the chronic adult form that may present classic ulcerated lesions to rare sarcoid ones. We present the case of a boy whose infection began with sarcoid lesions but, after being mistakenly diagnosed with cutaneous sarcoidosis and treated (for three years) with prednisone, developed painful ulcerations throughout the body. After the correct diagnosis, with evidence of the fungus in histopathological and mycological examinations, the patient was properly treated with itraconazole for eight months and evolved with total remission of the disease.


Subject(s)
Humans , Male , Adolescent , Paracoccidioidomycosis/etiology , Paracoccidioidomycosis/pathology , Glucocorticoids/adverse effects , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/drug therapy , Sarcoidosis/diagnosis , Sarcoidosis/pathology , Prednisone/adverse effects , Treatment Outcome , Itraconazole/therapeutic use , Antifungal Agents/therapeutic use
8.
Arq. bras. med. vet. zootec. (Online) ; 71(3): 819-827, May-June 2019. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1011330

ABSTRACT

In this study, we described the antifungal activity of three Brazilian propolis extracts: brown, green and from jataí bees against Sporothrix brasiliensis. The extracts were obtained from ethanolic extraction and their chemical composition was determined by high-performance liquid chromatography coupled to mass spectrometry. The cellular toxicity was measured in MDBK (Madin-Darby Bovine Kidney) cells and quantified by the MTT assay (3- (4,5 dimethylthiazol-2yl -2,5-diphenyl-2H bromine tetrazolato). For antifungal activity, the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) were determined by broth microdilution. The results showed that cell toxicity was not observed at lower concentrations (0.097 to 0.39μg/ml) for all extracts in comparison to cell control. Among the chemical compounds identified, caffeic acid, p-coumaric acid, chlorogenic acid, ferulic acid and rutin were quantified. In antifungal activity, green and jataí did not exhibit activity against the isolates (MIC and MFC greater than 0.78mg/ml). However, all isolates of S. brasiliensis were sensitive to brown propolis (MIC of 0.09 to 0.78mg/ml), including the standard strain (P<0.001). Among the Brazilian propolis studied, the brown propolis showed activity against the S. brasiliensis isolates and more studies should be undertaken in order to evaluate its promising use in the treatment of sporotrichosis.(AU)


Neste estudo, descreveu-se a atividade antifúngica de três extratos de própolis brasileiras: marrom, verde e de abelhas jataí (Tetragonisca angustula), contra Sporothrix brasiliensis. Os extratos foram obtidos de extração etanólica, e a sua composição química foi determinada por cromatografia líquida de alta eficiência, acoplada à espectrometria de massa. A toxicidade celular foi medida em células MDBK (Madin-Darby Bovine Kidney), avaliada por observação microscópica e quantificada pelo ensaio MTT (3- (4,5-dimetiltiazol-2-ilo -2,5-difenil-2H bromo tetrazolato). Para a atividade antifúngica, determinou-se a concentração inibitória mínima (CIM) e a concentração fungicida mínima (CFM) por meio de microdiluição em caldo. Os resultados mostraram que a toxicidade celular não foi observada em concentrações menores (0,097 a 0,39μg/ml). Entre os compostos químicos identificados, foram quantificados o ácido cafeico, ácido p-cumárico, ácido clorogênico, ácido ferúlico e a rutina. Na atividade antifúngica, as própolis verde e jataí não apresentaram atividade contra os isolados (CIM e CFM maior que 0,78mg/ml), porém todos os isolados de S. brasiliensis foram sensíveis à própolis marrom (CIM de 0,09 a 0,78mg/ml), incluindo a cepa padrão (P<0,001). Entre as própolis brasileiras estudadas, a marrom mostrou atividade contra S. brasiliensis, e mais estudos devem ser realizados para avaliar seu uso promissor no tratamento da esporotricose.(AU)


Subject(s)
Humans , Animals , Propolis/analysis , Propolis/therapeutic use , Sporothrix/isolation & purification , Itraconazole/therapeutic use , Drug Resistance, Fungal , Apitherapy/veterinary , Antifungal Agents/analysis
9.
Autops. Case Rep ; 9(1): e2018046, Jan.-Mar. 2019. ilus
Article in English | LILACS | ID: biblio-987538

ABSTRACT

Oral involvement is rarely found in histoplasmosis, except in its disseminated form, which is mostly observed in the severely immunocompromised host. Herein, we presented the case of a 36-year-old female with a previous history of liver transplant, who was hospitalized due to fever, chills, night sweats, diarrhea, and painful oral lesions over the last 3 days. The oral examination revealed the presence of painful shallow ulcers lined by a pseudomembrane in the gingiva and the soft and hard palate. The initial working diagnosis comprised cytomegalovirus reactivation or herpes simplex virus infection. The diagnostic work-up included incisional biopsies of the gingiva and the sigmoid colon. Both biopsies confirmed the diagnosis of histoplasmosis. Intravenous itraconazole was administered with significant improvement after 7 days. Although oral involvement is rare, histoplasmosis should be included in the differential diagnosis of oral lesions, particularly when the patient is immunosuppressed. This study reports a rare presentation of histoplasmosis involving the mucosa of the oral cavity and the colon.


Subject(s)
Humans , Female , Adult , Diagnosis, Differential , Histoplasmosis/diagnosis , Immunosuppression Therapy , Liver Transplantation/adverse effects , Itraconazole/therapeutic use , Oral Ulcer/pathology , Histoplasmosis/pathology
10.
Rev. bras. oftalmol ; 78(1): 59-61, jan.-fev. 2019. graf
Article in Portuguese | LILACS | ID: biblio-990800

ABSTRACT

Resumo A esporotricose humana e animal é uma infecção subaguda a crônica causada pelo fungo dimórfico Sporothrix schenckii. A esporotricose ocular tem ganhado destaque em função da epidemia de esporotricose urbana enfrentada pelo estado do Rio de Janeiro na última década e se apresenta classicamente como conjuntivite granulomatosa, mas formas atípicas podem ocorrer. Este artigo tem por objetivo relatar 2 casos atípicos de esporotricose ocular em pacientes imunocompetentes, ambos apresentando quadro clínico compatível com a síndrome oculoglandular de Parinaud associada à dacriocistite em um caso e presumivelmente à coroidite no outro caso.


Abstract Human and animal sporotrichosis is an infection caused by the dimorphic fungus Sporothrix schenckii, which is classified from subacute to chronic. Ocular sporotrichosis has been highlighted due to the epidemic of urban sporotrichosis faced by the state of Rio de Janeiro in the last decade and presents classically as granulomatous conjunctivitis, but atypical forms may occur. This article aims to report two atypical cases of ocular sporotrichosis in immunocompetent patients, both presenting a clinical picture compatible with Parinaud oculoglandular syndrome associated with dacryocystitis in one case and presumably to choroiditis in the other case.


Subject(s)
Humans , Male , Female , Middle Aged , Sporotrichosis/diagnosis , Sporotrichosis/etiology , Ocular Motility Disorders/complications , Ocular Motility Disorders/diagnosis , Choroiditis/complications , Choroiditis/diagnosis , Itraconazole/therapeutic use , Dacryocystitis/complications , Dacryocystitis/diagnosis , Antifungal Agents/therapeutic use , Diagnosis, Differential
11.
An. bras. dermatol ; 93(6): 902-904, Nov.-Dec. 2018. graf
Article in English | LILACS | ID: biblio-1038284

ABSTRACT

Abstract: Molecular studies have shown more than one species of the genus Paracoccidioides to be the causal agent of paracoccidioidomycosis. Efforts have been made to correlate the identified species with epidemiological and clinical data of patients, aiming to determine the real meaning and impact of new species. Bearing this objective in mind, the authors report a clinical case of paracoccidioidomycosis, from São Paulo state, Brazil, that manifested as uncommon sarcoid-like cutaneous lesions and was caused by Paracoccidioides brasiliensis sensu stricto (S1a). The patient was treated with itraconazole 200mg/day for 12 months, with complete clinical remission.


Subject(s)
Humans , Male , Middle Aged , Paracoccidioides/classification , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/microbiology , Sarcoidosis/diagnosis , Paracoccidioides/isolation & purification , Paracoccidioidomycosis/drug therapy , Itraconazole/therapeutic use , Diagnosis, Differential , Antifungal Agents/therapeutic use
12.
Rev. bras. oftalmol ; 77(6): 369-372, nov.-dez. 2018. graf
Article in English | LILACS | ID: biblio-985308

ABSTRACT

Abstract The therapeutic impact is described with the combined use of two medications with different anti-corticosteroid actions in the clinical resolution of a patient with chronic central serous chorioretinopathy.


Resumo Descrevemos nesse artigo o impacto terapêutico do uso combinado de duas medicações anti-corticosteroides com diferentes mecanismos de ação, na resolução clínica de um paciente com coriorretinopatia serosa central crônica.


Subject(s)
Humans , Male , Adult , Spironolactone/therapeutic use , Combined Modality Therapy , Central Serous Chorioretinopathy/drug therapy , Terbinafine/therapeutic use , Retina/diagnostic imaging , Tinea Pedis/drug therapy , Fluorescein Angiography , Itraconazole/therapeutic use , Tomography, Optical Coherence , Diagnostic Techniques, Ophthalmological , Central Serous Chorioretinopathy/diagnostic imaging
13.
Biomédica (Bogotá) ; 38(3): 298-302, jul.-set. 2018. graf
Article in Spanish | LILACS | ID: biblio-973982

ABSTRACT

RESUMEN El linfoma linfocítico de células pequeñas es una neoplasia de células B maduras con un amplio espectro de presentaciones clínicas. Las infecciones por gérmenes oportunistas no asociadas con el tratamiento, incluso en estadios avanzados de la enfermedad, tienen baja incidencia. Se han reportado muy pocos casos de pacientes con linfoma linfocítico de células pequeñas asociado a histoplasmosis diseminada que no habían recibido quimioterapia en el momento del diagnóstico. Se presenta el caso de una paciente de 82 años que fue hospitalizada por presentar tos seca intermitente, astenia y adinamia de un mes de evolución. Se le practicaron múltiples estudios para detectar infecciones o compromiso inmunológico o reumático, y se diagnosticó un síndrome adenopático extenso con compromiso cervical, torácico y retroperitoneal. En la citometría de flujo y en la biopsia de ganglio linfático cervical, se reportaron los fenotipos CD19+, CD20dim, CD5+, CD45+, CD23+, CD43neg y CD10neg, con restricción de la cadena ligera kappa, lo cual confirmó un linfoma linfocítico de células pequeñas. En la histopatología del ganglio, se observaron granulomas epitelioides sin necrosis, pero las coloraciones especiales no mostraron la presencia de microorganismos, en tanto que el cultivo del ganglio fue positivo para Histoplasma capsulatum. Se inició el tratamiento antifúngico con anfotericina B e itraconazol, y la paciente tuvo una adecuada evolución. Dado que no se cumplían los criterios para el tratamiento oncológico, se continuó con su observación mediante controles periódicos. Las infecciones oportunistas pueden ser la manifestación clínica inicial en pacientes con síndromes linfoproliferativos de bajo grado. Este caso demuestra que pueden desarrollarse, incluso, en ausencia de quimioterapia.


ABSTRACT The small lymphocytic lymphoma is a mature B cell neoplasm with a broad spectrum of clinical presentations. Opportunistic infections that are not related to the treatment, even in advanced stages, have a low incidence rate. There are few case reports in the medical literature of patients who have not received immunosuppressive therapy and present with small lymphocytic lymphoma associated with disseminated histoplasmosis at diagnosis. A female 82-year-old patient was admitted due to an intermittent dry cough, asthenia, and adynamia that had persisted for one month. Multiple studies to detect infections and immuno-rheumatic conditions were performed and an extensive cervical, thoracic and peritoneal adenopathic syndrome was diagnosed. A flow cytometry and a cervical lymph node biopsy were performed reporting CD19+, CD20dim, CD5+, CD45+, CD23+, CD43neg, and CD10neg phenotypes with restriction in the light kappa chain compatible with a small lymphocytic lymphoma. Epithelioid granulomas without necrosis were observed in the lymph node histopathology and special colorations showed no microorganisms. The culture from the lymph node was positive for Histoplasma capsulatum. We initiated treatment with amphotericin B and itraconazole with an adequate response. In the absence of compliance with oncology treatment criteria, the patient was managed on a "watch and wait" basis. Opportunistic infections could be the initial clinical manifestation in patients with low-grade lymphoproliferative syndromes. This case report shows that they can develop even in the absence of chemotherapy.


Subject(s)
Aged, 80 and over , Female , Humans , Opportunistic Infections/complications , Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis , Histoplasmosis/complications , Opportunistic Infections/diagnosis , Opportunistic Infections/drug therapy , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Amphotericin B/therapeutic use , Itraconazole/therapeutic use , Diabetes Mellitus, Type 2/complications , Watchful Waiting , Alzheimer Disease/complications , Histoplasma/isolation & purification , Histoplasmosis/diagnosis , Histoplasmosis/drug therapy , Hypertension/complications , Lymph Nodes/microbiology , Lymph Nodes/pathology , Lymph Nodes/diagnostic imaging , Antifungal Agents/therapeutic use
14.
Rev. chil. infectol ; 35(4): 377-385, ago. 2018. tab
Article in Spanish | LILACS | ID: biblio-978048

ABSTRACT

Resumen Introducción: Se desconocen los factores asociados a la candidiasis oral en población pediátrica con infección por VIH de los países en desarrollo. Objetivo: Identificar los factores asociados a la colonización por Candida, candidiasis oral y la susceptibilidad in vitro a antifúngicos, en niños y adolescentes con infección por VIH institucionalizados en la ciudad de Tijuana, México. Materiales y Métodos: Se examinó la cavidad oral de 30 niños y adolescentes con infección por VIH, se obtuvo una muestra de la mucosa oral para identificar las especies de Candida mediante cultivo y auxonograma. La susceptibilidad a los antifúngicos se determinó de acuerdo al CLSI. Los indicadores del estado inmunológico y falla virológica se clasificaron conforme a la OMS. Resultados: Se identificaron seis especies de Candida, 53% colonizantes y 47% causantes de candidiasis. Los factores asociados a candidiasis fueron alta carga viral (p = 0,001), menor recuento de LTCD4+ (p = 0,002) y esquema TARAA (p ≤ 0,014). La especie prevalente fue C. glabrata (33%); sin embargo, C. albicans (27%) fue más resistente a fluconazol (p = 0,001). Las especies resistentes a itraconazol se identificaron en esquemas que incluyen un INNTR (p = 0,041). Conclusiones: Los niños y adolescentes con infección por VIH institucionalizados mostraron una prevalencia elevada de Candida spp. colonizante y resistencia a los antifúngicos relacionada con los INNTR .


Background: Factors associated with candidiasis and colonization in HIV-positive children and adolescents in developing countries are not well understood. Aim: To identify the factors associated with oral Candida colonization and candidiasis in institutionalized HIV-positive children and adolescents in Tijuana, México, as well as the response of the isolates to antifungals. Materials and Methods: Sample of the oral mucosa of 30 HIV positive children and adolescents were obtained to isolate and identify Candida species by culture and metabolic profile. Antifungal drugs susceptibility was determined according to CLSI. Indicators of immunological and virologic failure were classified in accordance to WHO criteria. Results: Six Candida species were identified from oral mucosa, 53% colonizers and 47% in candidiasis. Factors associated with candidiasis and oral colonization were viral load (p = 0,001), CD4+ counts (p = 0,002) and HAART regimen (p ≤ 0,014). The most prevalent species was C. glabrata (33%), but C. albicans (27%) was more resistant to fluconazole (p = 0,001). Itraconazol resistant species were identified in regimens that include an NNRTI (p = 0,041). Conclusion: HIV-positive children and adolescents living in an orphanage showed high prevalence of colonizing Candida spp. and resistance to antifungals, related to NNRTI.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Candida albicans/isolation & purification , Candidiasis, Oral/microbiology , HIV Infections/complications , AIDS-Related Opportunistic Infections/microbiology , Mouth Mucosa/microbiology , Candida albicans/classification , Candidiasis, Oral/classification , Candidiasis, Oral/drug therapy , Fluconazole/therapeutic use , HIV Infections/drug therapy , Cross-Sectional Studies , Prospective Studies , Risk Factors , AIDS-Related Opportunistic Infections/drug therapy , Itraconazole/therapeutic use , Viral Load , Drug Resistance, Fungal , Mexico , Antifungal Agents/therapeutic use
15.
An. bras. dermatol ; 93(3): 462-464, May-June 2018. tab
Article in English | LILACS | ID: biblio-1038269

ABSTRACT

Abstract: The number of new cases of emerging fungal infections has increased considerably in recent years, mainly due to the large number of immunocompromised individuals. The objective of this study was to evaluate the susceptibility of emerging fungi to fluconazole, itraconazole and amphotericin B by disk diffusion method. In 2015, 82 emerging fungi were evaluated in IPB-LACEN/RS and 13 (15.8%) were resistant: 10/52 were from superficial mycoses and 3/30 from systemic mycoses. The data from the study point to the need for permanent vigilance regarding the careful evaluation in the prescription and clinical and laboratory follow-up of patients affected by fungal infections.


Subject(s)
Humans , Male , Female , Adult , Aged , Drug Resistance, Fungal , Fungi/drug effects , Antifungal Agents/therapeutic use , Microbial Sensitivity Tests , Fluconazole/therapeutic use , HIV Infections/complications , Amphotericin B/therapeutic use , Itraconazole/therapeutic use , Fungi/isolation & purification , Mycoses/microbiology , Mycoses/drug therapy , Antifungal Agents/pharmacology
16.
Prensa méd. argent ; 104(2): 59-63, 20180000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1370592

ABSTRACT

Leishmaniasis, a parasitic disease produced by a protozoan of the genus Leishmania, is triggered by the bite of an infected sandfly. It is endemic in tropical and subtropical areas of the Americas, places of poor socioeconomic health conditions and malnutrition. These conditions favor the entry of other pathogens such as the dimorphic fungus Paracoccidioides brasiliensis, responsible for Paracoccidioidomycosis (PCM), deep mycosis of inhalatory entry that initially affects the lungs; then skin, mucous membranes, lymph nodes and adrenal glands. The association of reported cases of Leishmaniasis and Paracoccidiodoimicosis in the same patient is infrequent. We point out the importance of the multidisciplinary approach for the correct diagnosis and treatment.


Subject(s)
Humans , Male , Aged , Paracoccidioidomycosis/diagnosis , Socioeconomic Factors , Leishmaniasis, Mucocutaneous/immunology , Amphotericin B/therapeutic use , Itraconazole/therapeutic use , Endemic Diseases/prevention & control , Malnutrition
17.
An. bras. dermatol ; 93(2): 279-281, Mar.-Apr. 2018. graf
Article in English | LILACS | ID: biblio-887199

ABSTRACT

Abstract: Lobomycosis or lacaziosis is a chronic granulomatous fungal infection caused by Lacazia loboi. Most cases are restricted to tropical regions. Transmission is believed to occur through traumatic inoculation in the skin, mainly in exposed areas. It is characterized by keloid-like nodules. There are only a few hundred cases reported. The differential diagnoses include many skin conditions, and treatment is difficult. The reported case, initially diagnosed as keloid, proved to be refractory to surgical treatment alone. It was subsequently approached with extensive surgery, cryotherapy every three months and a combination of itraconazole and clofazimine for two years. No signs of clinical and histopathological activity were detected during follow-up.


Subject(s)
Humans , Male , Adult , Ear Diseases/pathology , Ear Diseases/therapy , Lobomycosis/pathology , Lobomycosis/therapy , Keloid/pathology , Biopsy , Treatment Outcome , Clofazimine/therapeutic use , Itraconazole/therapeutic use , Cryotherapy/methods , Diagnosis, Differential , Ear Diseases/diagnosis , Lobomycosis/diagnosis , Keloid/diagnosis , Antifungal Agents/therapeutic use
18.
Rev. chil. infectol ; 35(1): 83-87, 2018. graf
Article in Spanish | LILACS | ID: biblio-899780

ABSTRACT

Resumen La esporotricosis es la micosis subcutánea o por implantación más frecuente en México. Se comunica el caso de una esporotricosis cutánea-fija preauricular que simuló una celulitis bacteriana atípica, en una paciente anciana sin antecedente de traumatismo. La biopsia mostró un granuloma supurativo con presencia de levaduras escasas. En el cultivo se identificó Sporothrix schenckii que se confirmó por biología molecular. Se trató con itraconazol obteniéndose una curación clínica y micológica. Se presenta el caso de presentación atípica, proveniente de una zona semidesértica con clima extremo.


Sporotrichosis is the most common subcutaneous or implantation mycosis in Mexico. The case of a preauricular cutaneous-fixed sporotrichosis simulating atypical bacterial cellulitis is reported in an elderly patient with no history of trauma. The biopsy showed a suppurative granuloma with scarce yeast. Sporothrix schenckii was identified in the culture and confirmed by molecular biology. She was treated with itraconazole and a clinical and mycological cure was obtained. The case of atypical presentation is presented, coming from a semi-arid zone with extreme weather.


Subject(s)
Humans , Female , Aged, 80 and over , Sporotrichosis/pathology , Cellulitis/microbiology , Cellulitis/pathology , Ear Diseases/microbiology , Ear Diseases/pathology , Sporotrichosis/drug therapy , Sporothrix/isolation & purification , Biopsy , Treatment Outcome , Itraconazole/therapeutic use , Diagnosis, Differential , Ear Diseases/drug therapy , Antifungal Agents/therapeutic use
19.
Prensa méd. argent ; 103(7): 394-400, 20170000. tab, fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1372368

ABSTRACT

La Paracoccidioidomicosis es la micosis endémica más frecuente en América latina en enfermos HIV negativos. Objetivo: analizar las características clínicas, epidemiológicas, evolución y tratamiento de los pacientes con diagnóstico de paracoccidioidomicosis asistidos en un hospital de referencia en enfermedades infecciosas en un período de 10 años. Materiales y métodos: Estudio descriptivo y retrospectivo. Se analizaron las historias clínicas de 70 pacientes con diagnóstico de paracoccidioidomicosis en el período comprendido entre Enero de 2001 y Diciembre de 2010. Resultados: se incluyeron 70 pacientes. Cincuenta y nueve presentaron la forma crónica de la enfermedad, siete la infanto-juvenil y solo cuatro resultaron positivos para el HIV. La mayoría de los enfermos fueron de nuestro país y habían nacido en Chaco y Misiones. Veintiséis eran oriundos de Paraguay. El 81,4% de los casos tuvieron compromiso pulmonar y el patrón radiológico hilio-fugal, en "alas de mariposa", fue el más frecuente. Se observaron lesiones cutáneo-mucosas en 38,57% de los enfermos. El examen directo en fresco de esputo y la escarificación de las lesiones mucocutáneas resultó ser la prueba más útil para el diagnóstico de esta micosis endémica. La serología fue positiva en el 81,3 % de los pacientes con formas crónicas y en el 42,8% de la forma infanto-juvenil. La mayoría de los enfermos fueron tratados con itraconazol; sólo dos fallecieron. Conclusión: El diagnóstico de la paracoccidioidomicosis se basa principalmente en el examen microscópico directo; los cultivos de muestras clínicas pueden fallar. La paracoccidioidomicosis debe incluirse en el diagnóstico diferencial de los pacientes que provengan de áreas endémicas y presenten compromiso de piel, mucosas o del aparato respiratorio asociado a un síndrome infeccioso inespecífico


Paracoccidioidomycosis is the most frequent endemic mycosis in Latin America in HIV negative patients. Objective: to analyze the clinical, epidemiological and treatment characteristics and the evolution of patients with diagnosis of paracoccidioidomycosis. Materials and methods: Descriptive and retrospective study. The clinical records of 70 patients with paracoccidioidomycosis were analyzed in the period between January 2001 and December 2010. Results: 70 patients were included. Fifty-nine presented the chronic form, seven had the juvenile (acute) clinical picture and only four were HIV positive. The majority of the Argentinian patients had been born in Chaco and Misiones provinces. Twenty-six were from Paraguay. 81.4% of the patients had lung involvement, the "butterfly wing" pattern was the most frequent. Muco cutaneous lessions were observed in 38.57% of the patients. Wet mount microscopy examination of sputum and mucocutaneous scarification proved to be the most useful tests for the disease diagnosis Serology tests were positive in 81.3% of patients with the chronic form and in 42.8% of those with the juvenile clinical presentation. Most of the patients were treated with itraconazole. Only two deceased. Conclusion: The diagnosis of paracoccidiodomycosis is mainly based on direct microscopic examination of clinical smears. Cultures of clinical samples may fail. Paracoccidioidomycosis should be included in the differential diagnosis of patients who come from the endemic area and present skin, mucous membranes or respiratory system compromise associated with a non-specific infectious syndrome


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Paracoccidioidomycosis/therapy , Epidemiology, Descriptive , Retrospective Studies , HIV/immunology , Itraconazole/therapeutic use , Endemic Diseases/prevention & control , Mycoses/therapy , Diagnosis, Differential
20.
An. bras. dermatol ; 92(4): 478-483, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-886989

ABSTRACT

Abstract: Background: Histological and mycological changes during itraconazole use have not been totally established in chromoblastomycosis. Objectives: To evaluate tissue modifications in chromoblastomycosis carriers under itraconazole treatment. Methods: A histological retrospective study of 20 cases of chromoblastomycosis seen at the university hospital at the south of Brazil, during itraconazole 400 mg daily treatment. Patients were classified into two groups: plaque or tumor lesions, and underwent periodic evaluations every four months during three years. Hematoxylin-eosin stain was used to analyze epidermal modifications, inflammatory infiltrate and fibrosis, and Fontana-Masson stain for parasite evaluation. Results: Fontana-Masson stain was superior to hematoxylin-eosin stain in fungal count in the epidermis (mean difference=0.14; p<0.05). The most distinct mycosis tissue responses were registered in the dermis. Epidermal thinning, granulomatous infiltrate decrease or disappearance, fibrosis increase and quantitative/morphological changes occurred during treatment. Study limitations: Patients could not be located to have their current skin condition examined. Conclusion: Parasitic and tissue changes verified in this study can reflect the parasite-host dynamics under itraconazole action.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Skin/pathology , Chromoblastomycosis/drug therapy , Itraconazole/therapeutic use , Agricultural Workers' Diseases/microbiology , Agricultural Workers' Diseases/drug therapy , Antifungal Agents/therapeutic use , Silver Nitrate , Skin/microbiology , Biopsy , Retrospective Studies , Chromoblastomycosis/microbiology , Chromoblastomycosis/pathology , Subcutaneous Tissue , Agricultural Workers' Diseases/pathology , Fungi/physiology , Host-Parasite Interactions/physiology
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