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Rev. Col. Bras. Cir ; 48: e20202633, 2021. tab, graf
Article in English | LILACS | ID: biblio-1155374


ABSTRACT Objective: to compare the use of 0.5% alcoholic chlorhexidine and 70% alcohol in skin antisepsis for neuraxial blocks. Method: this is a non-inferiority randomized clinical trial, with two parallel arms. Seventy patients who were candidates for neuraxial block were randomly allocated to group A (n = 35), in whom antisepsis was performed with 0.5% alcoholic chlorhexidine, or to group B (n = 35), in whom we used 70% hydrated ethyl alcohol. Swabs were harvested for culture at three times: before antisepsis, two minutes after application of the antiseptic, and immediately after puncture. The samples were sown in three culture media and the number of colony forming units (CFU) per cm² was counted. Results: there was no difference between the groups regarding age, sex, body mass index, time to perform the block or type of block. There were no differences between groups in the CFU/cm² counts before antisepsis. There was less bacterial growth in group B two minutes after application of the antiseptic (p = 0.048), but there was no difference between the groups regarding the number of CFU/cm² at the end of the puncture. Conclusion: 70% alcohol was more effective in reducing the number of CFU/cm² after two minutes, and there was no difference between the two groups regarding skin colonization at the end of the procedure. These results suggest that 70% alcohol may be an option for skin antisepsis before neuraxial blocks. Trial registration:, NCT02833376.

RESUMO Objetivo: comparar o uso de solução alcoólica de clorexidina 0,5% e de álcool 70% na antissepsia da pele para bloqueios do neuroeixo. Método: ensaio clínico randomizado de não inferioridade, com dois braços paralelos. Foram selecionados 70 pacientes candidatos à bloqueio do neuroeixo, randomicamente alocados para o grupo A (n=35), em que a antissepsia foi realizada com clorexidina alcoólica 0,5%, ou para o grupo B (n=35), em que se utilizou álcool etílico hidratado 70%. Foram coletadas, com swab, amostras para cultura em três momentos: antes da antissepsia, dois minutos após aplicação do antisséptico, e imediatamente após a punção. As amostras foram semeadas em três meios de cultura e foi contabilizado o número de unidades formadoras de colônias (UFC) por cm². Resultados: não houve diferença entre os grupos quanto à idade, ao sexo, ao índice de massa corporal, ao tempo para realização do bloqueio ou tipo de bloqueio. Também não houve diferenças entre os grupos na contagem de UFC/cm² antes da antissepsia. Constatou-se menor crescimento bacteriano no grupo B dois minutos após aplicação do antisséptico (p=0,048), mas não houve diferença entre os grupos quanto ao número de UFC/cm² ao final da punção. Conclusão: o álcool 70% mostrou-se mais efetivo em reduzir o número de UFC/cm² após dois minutos, e não houve diferença entre os dois grupos quanto à colonização da pele ao final do procedimento. Esses resultados sugerem que o álcool 70% pode ser opção para antissepsia da pele antes de bloqueios do neuroeixo. Registro ensaio clínico:, NCT02833376.

Humans , Skin/microbiology , Surgical Wound Infection/prevention & control , Chlorhexidine/pharmacology , Antisepsis/methods , Ethanol/pharmacology , Anti-Infective Agents, Local/pharmacology , Ethanol/administration & dosage , Anesthesia, Epidural , Anesthesia, Spinal , Anti-Infective Agents, Local/administration & dosage
An. bras. dermatol ; 94(5): 527-531, Sept.-Oct. 2019. tab
Article in English | LILACS | ID: biblio-1054860


Abstract Background Malassezia, a skin saprophyte, is frequently isolated from patients with seborrheic dermatitis, which is one of the most common dermatoses in HIV-infected patients. Its role in pathophysiology has not been defined. Objective To determine whether patients living with HIV and seborrheic dermatitis have more Malassezia than those without seborrheic dermatitis. Method This is an descriptive, observational, prospective cross-sectional study to which all adult patients living with HIV that attend the infectious disease outpatient clinic at the Dr. Manuel Gea González General Hospital were invited. Patients presenting with scale and erythema were included in Group 1, while patients without erythema were included in Group 2. Samples were taken from all patients for smear and culture. Results Thirty patients were included in each group. All patients with seborrheic dermatitis had a positive smear, with varying amounts of yeasts. In the control group, 36.7% of patients had a negative smear. The results are statistically significant, as well as the number of colonies in the cultures.Study limitations The study used a small sample size and the subspecies were not identified. Conclusions Patients with clinical manifestations of seborrheic dermatitis have larger amounts of Malassezia. Further studies need to be performed to analyze if the greater amount is related to imbalances in the microbiota of the skin.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , HIV Infections/microbiology , Dermatitis, Seborrheic/microbiology , Malassezia/isolation & purification , Skin/microbiology , Colony Count, Microbial , Cross-Sectional Studies , Prospective Studies , Sex Distribution , CD4 Lymphocyte Count
Rev. cuba. med. mil ; 48(2): e208, abr.-jun. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126619


Introducción: El lupus eritematoso sistémico tiene múltiples formas de presentarse; entre las manifestaciones cardíacas, es frecuente la afectación pericárdica, pero es poco frecuente que su forma de debut sea el derrame pericárdico. Objetivo: Destacar la importancia del diagnóstico precoz de una de las formas menos frecuentes de debut del lupus eritamatoso sistémico. Caso clínico: Se presenta el caso de una paciente de 50 años, que ingresó porque desde hacía 3 meses sufría dolor torácico, disnea, tos, síntomas articulares, dermatológicos y generales. Luego de la sospecha y el estudio clínico, hematológico, imagenológico y biopsia de piel, se diagnosticó precozmente derrame pericárdico por lupus eritematoso sistémico. Se impuso tratamiento oportuno con esteroides, y la evolución fue favorable. Conclusiones: A pesar del bajo índice de sospecha, se tuvo en cuenta al lupus eritematoso sistémico y se procedió a las determinaciones analíticas que confirmaron el diagnóstico(AU)

Introduction: Systemic lupus erythematosus has multiple ways of presentation; among cardiac manifestations, pericardial involvement is frequent, but it is rare that its debut form is the pericardial effusion. Objective: To emphasize the importance of early diagnosis of one of the less frequent forms of systemic lupus erythematosus. Clinical case: We present the case of a 50-year-old patient, who had been admitted for 3 months because of chest pain, dyspnea, cough, joint, dermatological and general symptoms. After the suspicion and the clinical, hematological, imaging and skin biopsy, pericardial effusion was diagnosed early due to systemic lupus erythematosus. Timely treatment with steroids was imposed, and the evolution was favorable. Conclusions: Despite the low index of suspicion, the systemic lupus erythematosus was taken into account and the analytical determinations that confirmed the diagnosis were made(AU)

Humans , Male , Middle Aged , Pericardial Effusion/blood , Skin/microbiology , Cough/drug therapy , Lupus Erythematosus, Systemic/complications , Pericardial Effusion/diagnostic imaging , Biopsy
An. bras. dermatol ; 93(5): 726-729, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-949959


Abstract: Fusariosis is due to inhalation or direct contact with conidia. Clinical presentation depends on host's immunity and can be localized, focally invasive or disseminated. Given the severity of this infection and the possibility for the dermatologist to make an early diagnosis, we report six cases of patients with hematologic malignancies, who developed febrile neutropenia an skin lesions suggestive of cutaneous fusariosis. All patients had skin cultures showing growth of Fusarium solani complex, and they received amphotericin B and voriconazole. As this infection can quickly lead to death, dermatologists play a crucial role in diagnosing this disease.

Humans , Middle Aged , Young Adult , Skin/microbiology , Leukemia, Myelomonocytic, Acute/complications , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/complications , Fusariosis/complications , Fusarium/isolation & purification , Multiple Myeloma/complications , Antifungal Agents/therapeutic use , Skin/pathology , Fatal Outcome , Fusariosis/pathology , Fusariosis/prevention & control , Neutropenia/etiology
An. bras. dermatol ; 93(3): 454-456, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-1038271


Abstract: Leprosy can be classified according to its operational form as paucibacillary or multibacillary. Bacilloscopy integrates its diagnostic armamentarium. Patients with the disease may present leprosy reactions. This study describes the association of bacilloscopy results and the type of operational classification of leprosy in patients with leprosy reactions. Medical records were analyzed at a reference center between 2010 and 2015. Reactions occurred in almost half of the patients, making their identification important. The bacilloscopic and operational characterization indicates a greater occurrence of leprosy reactions in patients with positive bacilloscopy and also in multibacillary.

Humans , Leprosy/microbiology , Skin/microbiology , Bacteriological Techniques/methods , Leprosy/classification , Leprosy/diagnosis , Mycobacterium leprae/isolation & purification
Rev. chil. infectol ; 35(2): 195-197, abr. 2018. graf
Article in Spanish | LILACS | ID: biblio-959430


Resumen El ántrax, es una zoonosis causada por una bacteria generadora de esporas, llamada Bacillus anthracis. En forma natural tiene una distribución global, con una predilección en zonas agrícolas con pocas normativas de sanidad pública veterinaria. El contagio humano ocurre por el consumo de carnes de animales enfermos, por contacto a través de una puerta de entrada en la piel o por la inhalación de esporas de productos derivados del animal afectado (lana, cuero, huesos). La infección en los seres humanos compromete con mayor frecuencia la piel, seguido por el tracto gastrointestinal y los pulmones. El control de la enfermedad se basa en la prevención, de allí la importancia de la vigilancia en la detección de casos y brotes. Presentamos el último brote de ántrax cutáneo diagnosticado en Chile con descripción de dos primeros casos clínicos del brote.

Anthrax is a zoonosis caused by a spore-forming bacterium, called Bacillus anthracis. Naturally it is of global distribution, with a predilection in agricultural zones with few norms of public veterinary health. Human contagion occurs through the consumption of diseased animal's meat or through a doorway into the skin or through the spores inhalation of products derived from the affected animal (wool, leather, bones). The most frequent infection in humans occurs in the skin, followed by the gastrointestinal tract and lungs. We present the last outbreak of cutaneous anthrax diagnosed in Chile with a description of the first two clinical cases of the outbreak. Control disease is based on prevention, hence the importance of surveillance in detecting cases and outbreaks.

Humans , Animals , Adult , Middle Aged , Bacillus anthracis/isolation & purification , Skin Diseases, Bacterial/diagnosis , Skin Diseases, Bacterial/microbiology , Anthrax/diagnosis , Anthrax/microbiology , Penicillin G/therapeutic use , Skin/microbiology , Chile/epidemiology , Disease Outbreaks , Skin Diseases, Bacterial/drug therapy , Skin Diseases, Bacterial/epidemiology , Anthrax/drug therapy , Anthrax/epidemiology , Anti-Bacterial Agents/therapeutic use
Arq. bras. med. vet. zootec. (Online) ; 69(6): 1443-1450, nov.-dez. 2017. tab
Article in English | ID: biblio-909839


The purpose of the present work was to evaluate the accuracy of quantitative polymerase chain reaction (qPCR) performed on samples of fresh frozen tissue (FT) and formalin-fixed, paraffin-embedded (FFPE) healthy skin. This is a validation study conducted with samples from 46 dogs from an endemic area in Brazil. After sample collection, DNA extractions were conducted using commercial kits and qPCR was oriented to kinetoplast DNA (kDNA) targets of the Leishmania infantum species. The results obtained for the FFPE samples showed 63.6% sensitivity and 77.1% specificity, whereas those obtained for the FT samples showed 100% and 48.6%, respectively. Poor agreement was observed for the results of the qPCR technique with FT and FFPE samples. Our results suggest freezing as the most suitable conservation method for the formation of sample databases considering DNA recovery.(AU)

O objetivo deste trabalho foi avaliar a acurácia da PCR quantitativa (qPCR) realizada em amostras de pele íntegra congelada (FT) e parafinada (FFPE). Trata-se de um estudo de validação, com amostras provenientes de 46 cães de uma área endêmica no Brasil. Após as coletas de amostras, as extrações de DNA foram realizadas utilizando-se kits comerciais, e a qPCR foi orientada para alvos do kDNA da espécie Leishmania infantum. Os resultados obtidos para as amostras FFPE foram 63,6% de sensibilidade e 77,1% de especificidade; para as amostras FT, 100% e 48,6%, respectivamente. A concordância dos resultados da técnica de qPCR com amostras FT e FFPE foi pobre. Os resultados sugerem que o congelamento é o método mais adequado de conservação para banco de amostras para recuperação de DNA.(AU)

Animals , Dogs , Data Accuracy , Leishmania infantum/isolation & purification , Leishmaniasis, Visceral/diagnosis , Polymerase Chain Reaction/veterinary , Skin/microbiology , Paraffin
Bol. micol. (Valparaiso En linea) ; 32(2): 1-7, dic. 2017.
Article in Spanish | LILACS | ID: biblio-907569


Antecedentes: Las especies del género Malassezia forman parte de la biota cutánea normal humana y pueden ser aisladas en áreas ricas en glándulas sebáceas. Su colonización es alta durante edad prepuberal y puberal debido al aumento de actividad de dichas glándulas. Objetivo: Determinar la colonización por especies del género Malassezia en piel sana de niños y adolescentes con VIH/SIDA. Metodología: Las muestras fueron tomadas mediante el método de la impronta con cinta adhesiva transparente, en cuero cabelludo, pabellón auricular, pecho, espalda, muslo, antebrazo, palma de la mano e inoculadas en el medio con base de goma Spondia dulcis. La identificación de las especies se realizó siguiendo las claves descritas por Guého et al. Se realizó el test de difusión en tween propuesto por Guillot et al, la prueba de la catalasa, y la utilización de triptófano como fuente única de nitrógeno. Resultados: De un total de 80 niños y adolescentes, solo 23(28.75 por ciento) de ellos se les aisló Malassezia. 10 (43.48 por ciento) de sexo masculino y 13 (56.52 por ciento) de sexo femenino. Solo se encontró, Malassezia sympodialis con un predominio del 100 por ciento. Correspondiendo al mayor porcentaje de positividad al grupo etario de 4-7 años (56.52 por ciento). Las localizaciones anatómicas predominantes fueron: pabellón auricular (25.5 por ciento) seguida de pecho (21.3 por ciento) y espalda (19.1 por ciento). Conclusiones: En niños con HIV/SIDA se observa un patrón de colonización por M. sympodialis.

Background: Malassezia species are part of the normal human skin biota and can be isolated from different body areas, mainly those rich in sebaceous glands. Colonization is high during prepuberal and puberal for the increased activity of the sebaceous glands. Aims: Determine the colonization by Malassezia species in healthy skin of children and teenagers with HIV/AIDS. Methods: Samples were taken using imprint method with transparent adhesive tape, were taken from scalp, ear, chest, back, thigh, forearm and palm; were inoculated in Spondias dulcis medium. The species identification was performed according the instructions described by Guého et al, Tween diffusion test proposed by Guillot et al, catalase test, and the use of tryptophan as only source of nitrogen. Results: From a total of 80 children and teenagers, only 23 (28.75 percent) of them were isolated Malassezia. 10 (43.48 percent) were from males and 13 (56.52 percent) from females. Found only Malassezia sympodialis with a prevalence of 100 percent. Corresponding to the higher percentage of positivity the age group 4-7 years (56.52 percent). The predominant anatomical locations were: ear (25.5 percent) followed by chest (21.3 percent) and back (19.1 percent) respectively. Conclusions: In children with HIV / AIDS colonization pattern observed is the present of M. sympodialis.

Male , Female , Humans , Adolescent , Infant , Child, Preschool , Child , Acquired Immunodeficiency Syndrome , Colony Count, Microbial/statistics & numerical data , Malassezia/isolation & purification , Malassezia/pathogenicity , Skin/microbiology , Prevalence
Rev. chil. infectol ; 34(5): 487-490, oct. 2017. tab
Article in Spanish | LILACS | ID: biblio-899746


Resumen Introducción: El principal microorganismo implicado en las infecciones de piel y tejidos blandos (IPTB) es Staphylococcus aureus, con incremento en las cepas resistentes a meticilina en los últimos años. Objetivo: Identificar la frecuencia de S. aureus resistente a meticilina (SARM) en IPTB en niños que consultaron a un hospital de cuarto nivel en la ciudad de Medellín. Métodos: Estudio descriptivo, retrospectivo, a partir de la revisión de historias clínicas. Se incluyeron pacientes menores de 18 años con IPTB causadas por S. aureus que no cumplieran con criterios de enfermedad invasora. Resultados: La prevalencia de SARM en esta población fue de 31%. El principal diagnóstico fue absceso cutáneo (68%), seguido por infección de sitio quirúrgico (15%) y celulitis no purulenta (6%). Tenían alguna co-morbilidad 85% de los pacientes. Todos los aislados fueron sensibles a rifampicina y cotrimoxazol. Ocho por ciento de los aislados fueron resistentes a clindamicina. Se encontró mayor prevalencia de SARM en lactantes comparado con los mayores de 2 años (60 vs 23%, p = 0,0109). Conclusión: Ante la alta prevalencia de SARM en IPTB se recomienda incluir en el tratamiento empírico antimicrobianos con cobertura para estas cepas, principalmente para lactantes.

Background: Skin and soft tissue infections (SSTI) are very common in children and Staphylococcus aureus is the main agent, with an increase of methicillin resistant strains (MRSA) in recent years. Aim: To identify the frequency of MRSA in skin and soft tissue infections (SSTI) in children from a high complex hospital in Medellin, Colombia. Methods: This is a descriptive, retrospective study, information was obtained from medical records. We included patients younger than 18 years with SSTI due to S. aureus who did not meet criteria for invasive disease. Results: The prevalence of MRSA in this population was 31%. The main diagnosis was cutaneous abscess (68%), followed by surgical site infection (15%) and non-purulent cellulitis (6%). Eighty five percent of the patients had at least 1 comorbidity. All isolates were sensitive to rifampicin and cotrimoxazole and 8% of the isolates were resistant to clindamycin. There was a higher prevalence of MRSA in patients under 2 years compared to older (60 vs 23%, p = 0,0109). Conclusion: In view of the high prevalence of MRSA in SSTI, empirical treatment with adequate coverage for MRSA is recommended, especially for patients under 2 years of age.

Humans , Male , Female , Child, Preschool , Child , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Staphylococcal Skin Infections/epidemiology , Soft Tissue Infections/epidemiology , Skin/microbiology , Staphylococcal Infections/microbiology , Staphylococcal Infections/drug therapy , Staphylococcus aureus/drug effects , Staphylococcal Skin Infections/microbiology , Staphylococcal Skin Infections/drug therapy , Prevalence , Retrospective Studies , Methicillin Resistance/drug effects , Age Factors , Sex Distribution , Colombia/epidemiology , Soft Tissue Infections/microbiology , Soft Tissue Infections/drug therapy , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin-Resistant Staphylococcus aureus/drug effects , Hospitals , Anti-Bacterial Agents/therapeutic use
An. bras. dermatol ; 92(4): 478-483, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-886989


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.

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
Braz. j. infect. dis ; 21(1): 71-78, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-839189


Abstract Leprosy, whose etiological agent is Mycobacterium leprae, is a chronic infectious disease that mainly affects the skin and peripheral nervous system. The diagnosis of leprosy is based on clinical evaluation, whereas histopathological analysis and bacilloscopy are complementary diagnostic tools. Quantitative PCR (qPCR), a current useful tool for diagnosis of infectious diseases, has been used to detect several pathogens including Mycobacterium leprae. The validation of this technique in a robust set of samples comprising the different clinical forms of leprosy is still necessary. Thus, in this study samples from 126 skin biopsies (collected from patients on all clinical forms and reactional states of leprosy) and 25 slit skin smear of leprosy patients were comparatively analyzed by qPCR (performed with primers for the RLEP region of M. leprae DNA) and routine bacilloscopy performed in histological sections or in slit skin smear. Considering clinical diagnostic as the gold standard, 84.9% of the leprosy patients were qPCR positive in skin biopsies, resulting in 84.92% sensitivity, with 84.92 and 61.22% positive (PPV) and negative (NPV) predictive values, respectively. Concerning bacilloscopy of histological sections (BI/H), the sensitivity was 80.15% and the PPV and NPV were 80.15 and 44.44%, respectively. The concordance between qPCR and BI/H was 87.30%. Regarding the slit skin smear, 84% of the samples tested positive in the qPCR. Additionally, qPCR showed 100% specificity, since all samples from different mycobacteria, from healthy individuals, and from other granulomatous diseases presented negative results. In conclusion, the qPCR technique for detection of M. leprae using RLEP primers proved to be specific and sensitive, and qPCR can be used as a complementary test to diagnose leprosy irrespective of the clinical form of disease.

Humans , Skin/microbiology , Real-Time Polymerase Chain Reaction/methods , Leprosy/microbiology , Mycobacterium leprae/isolation & purification , Reference Values , Skin/pathology , Biopsy , DNA, Bacterial/isolation & purification , Reproducibility of Results , Sensitivity and Specificity , DNA Primers/isolation & purification , Leprosy/pathology , Mycobacterium leprae/genetics
Arch. argent. pediatr ; 115(1): 65-70, feb. 2017. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1038349


Las infecciones asociadas al cuidado de la salud son un tema de gran importancia en los recién nacidos, teniendo en cuenta su alta carga de morbilidad, mortalidad y secuelas a largo plazo. En prematuros, se ha demostrado que la colonización de la piel y del tracto gastrointestinal sufre variaciones respecto a neonatos a término y sanos, con un riesgo de mayor exposición a microorganismos intrahospitalarios por la mayor probabilidad de ingresar a unidades de cuidado intensivo neonatal por aspectos inherentes a su prematurez. El presente documento revisa la colonización normal, los cambios que se observan con la hospitalización, la prematurez y el potencial papel de la clorhexidina en la prevención de la transmisión de microorganismos resistentes, así como sus efectos secundarios en los neonatos en Cuidado Intensivo Neonatal.

Healthcare-associated infections are a major problem in newborn infants, considering their high morbidity, mortality, and long-term sequelae. In preterm infants, it has been shown that skin and gastrointestinal tract colonization undergoes variations compared to healthy term infants, and that preterm infants are more exposed to nosocomial microorganisms given their higher probability of being admitted to the neonatal intensive care unit where they are cared for. This document reviews normal colonization, the changes observed during hospitalization, prematurity, and the potential role of chlorhexidine in the prevention of resistant microorganism transmission, as well as its side effects in newborn infants admitted to the neonatal intensive care unit.

Humans , Infant, Newborn , Chlorhexidine/therapeutic use , Cross Infection/prevention & control , Anti-Infective Agents, Local/therapeutic use , Skin/microbiology , Gastrointestinal Tract/microbiology
Rev. argent. microbiol ; 48(4): 303-307, dic. 2016. ilus, tab
Article in Spanish | LILACS | ID: biblio-1041766


La especie Dermabacter hominis está constituida por bacilos gram positivos corineformes, anaerobios facultativos, que forman parte de la microbiota residente de la piel. Excepcionalmente se ha asociado a estos microorganismos con infecciones en pacientes inmunocomprometidos o muy debilitados. Se describe el caso de una mujer adulta joven, inmunocompetente, con un quiste sebáceo en el cuello, infectado por D. hominis como único agente etiológico. Se logró la identificación fenotípica del agente causal mediante pruebas simples basadas en el esquema originalmente propuesto por Funke y Bernard, factibles de ser realizadas en un laboratorio hospitalario de microbiología. Características fenotípicas como la morfología cocoide, el olor acre/espermático, la hidrólisis de la esculina, la producción de pirrolidonil arilamidasa y de lisina y ornitina descarboxilasas son pruebas claves en la identificación de D. hominis. La espectrometría de masas (MALDI-TOF MS) confirmó la identificación fenotípica.

Dermabacter hominis species is constituted by Gram positive facultative anaerobic coryneform rods being part of the resident microbiota human skin, and exceptionally associated to infections in immunocompromised or severely debilitated patients. An immunocompetent young adult woman with a neck sebaceous cyst infected by D. hominis as unique etiologic agent is presented. Phenotypic identification of the causative agent was achieved through simple tests, based on the originally scheme proposed by Funke and Bernard, and feasible to be performed in a hospital Microbiology Laboratory. Phenotypic characteristics as coccoid morphology, the acrid/spermatic odor, esculin hydrolysis, the production of pyrrolidonyl-arylamidase, lysine and ornithine decarboxylase, are key tests to identify D. hominis. The matrix-asisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) confirmed the phenotypic identification.

Humans , Female , Middle Aged , Skin/microbiology , Epidermal Cyst/microbiology , Skin/physiopathology , Mass Spectrometry/methods
An. bras. dermatol ; 91(6): 832-834, Nov.-Dec. 2016. graf
Article in English | LILACS | ID: biblio-837990


Abstract Cryptococcosis is a fungal infection of opportunistic behavior that is unusual in immunocompetent patients. We report a rare case of disseminated cryptococcosis with cutaneous involvement in an immunocompetent individual. During hospitalization, Cryptococcus gattii was isolated from skin lesions, lung and spinal fluid. The diagnosis of disseminated cryptococcosis was confirmed and treatment was established. The patient showed improvement. Due to the probable clinical severity of the disease and the possibility that skin lesions may be the first manifestation of this illness, prompt diagnosis must be established and treatment provided.

Humans , Male , Adult , Cryptococcosis/immunology , Cryptococcosis/pathology , Dermatomycoses/immunology , Dermatomycoses/pathology , Cryptococcus gattii/isolation & purification , Immunocompetence , Skin/microbiology , Skin/pathology , Treatment Outcome , Cryptococcosis/drug therapy , Dermatomycoses/drug therapy , Lymphocytosis/complications , Lung/microbiology , Antifungal Agents/therapeutic use
An. bras. dermatol ; 91(6): 823-825, Nov.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-838000


Abstract Dermatophytosis caused by Microsporum gypseum is rare, especially in infants, with few published cases. Diagnosis in this age group is frequently delayed. We review the literature and report 4 new cases of tinea of glabrous skin caused by M. gypseum mimicking eczema in infants. Considering new and previously reported cases, half of patients were exposed to sand, emphasizing the importance of this transmission vehicle in this age group. In conclusion, although rare, dermatophytosis by M. gypseum should be part of the differential diagnosis of inflammatory dermatosis in infants. A clinical suspicion and the availability of culture are keys to the diagnosis.

Humans , Male , Female , Infant , Child, Preschool , Tinea/microbiology , Tinea/pathology , Microsporum/isolation & purification , Skin/microbiology , Skin/pathology , Time Factors , Tinea/drug therapy , Treatment Outcome , Antifungal Agents/therapeutic use
An. bras. dermatol ; 91(5,supl.1): 29-31, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837926


Abstract Cryptococcosis is a fungal infection caused by Cryptococcus neoformans that tends to affect immunocompromised individuals. The fungi are mostly acquired by inhalation, which leads to an initial pulmonary infection. Later, other organs - such as the central nervous system and the skin - can be affected by hematogenous spread. In addition, cutaneous contamination can occur by primary inoculation after injuries (primary cutaneous cryptococcosis), whose diagnosis is defined based on the absence of systemic involvement. The clinical presentation of cutaneous forms typically vary according to the infection mode. We report an unusual case of disseminated cryptococcosis in an immunocompetent patient with cutaneous lesions similar to those caused by primary inoculation. This clinical picture leads us to question the definition of primary cutaneous cryptococcosis established in the literature.

Humans , Male , Aged , Immunocompromised Host , Cryptococcosis/pathology , Dermatomycoses/pathology , Skin/microbiology , Skin/pathology , Biopsy , Opportunistic Infections/microbiology , Cryptococcosis/immunology , Cryptococcosis/microbiology , Cryptococcus neoformans/isolation & purification , Dermatomycoses/immunology , Dermatomycoses/microbiology
An. bras. dermatol ; 91(5,supl.1): 92-94, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837965


Abstract Despite advances in diagnosis and treatment, infective endocarditis still shows considerable morbidity and mortality rates. The dermatological examination in patients with suspected infective endocarditis may prove very useful, as it might reveal suggestive abnormalities of this disease, such as Osler’s nodes and Janeway lesions. Osler’s nodes are painful, purple nodular lesions, usually found on the tips of fingers and toes. Janeway lesions, in turn, are painless erythematous macules that usually affect palms and soles. We report a case of infective endocarditis and highlight the importance of skin examination as a very important element in the presumptive diagnosis of infective endocarditis.

Humans , Male , Adult , Skin/microbiology , Skin/pathology , Skin Diseases, Bacterial/microbiology , Skin Diseases, Bacterial/pathology , Endocarditis, Bacterial/complications , Staphylococcus aureus , Telangiectasia, Hereditary Hemorrhagic/microbiology , Telangiectasia, Hereditary Hemorrhagic/pathology , Biopsy , Fatal Outcome
Mem. Inst. Oswaldo Cruz ; 111(4): 241-251, Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-779002


Localised cutaneous leishmaniasis (LCL) is the most common form of cutaneous leishmaniasis characterised by single or multiple painless chronic ulcers, which commonly presents with secondary bacterial infection. Previous culture-based studies have found staphylococci, streptococci, and opportunistic pathogenic bacteria in LCL lesions, but there have been no comparisons to normal skin. In addition, this approach has strong bias for determining bacterial composition. The present study tested the hypothesis that bacterial communities in LCL lesions differ from those found on healthy skin (HS). Using a high throughput amplicon sequencing approach, which allows for better populational evaluation due to greater depth coverage and the Quantitative Insights Into Microbial Ecology pipeline, we compared the microbiological signature of LCL lesions with that of contralateral HS from the same individuals.Streptococcus, Staphylococcus,Fusobacterium and other strict or facultative anaerobic bacteria composed the LCL microbiome. Aerobic and facultative anaerobic bacteria found in HS, including environmental bacteria, were significantly decreased in LCL lesions (p < 0.01). This paper presents the first comprehensive microbiome identification from LCL lesions with next generation sequence methodology and shows a marked reduction of bacterial diversity in the lesions.

Humans , Male , Female , Adult , Middle Aged , Young Adult , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Leishmaniasis, Cutaneous/microbiology , Skin/microbiology , Gram-Negative Bacteria/classification , Gram-Positive Bacteria/classification , Skin/parasitology
An. bras. dermatol ; 90(6): 907-908, Nov.-Dec. 2015. graf
Article in English | LILACS | ID: lil-769519


Abstract: Chromoblastomycosis is a chronic subcutaneous fungal infection caused by traumatic implantation of dematiaceous fungi in the skin. The clinical presentation is usually a verrucous plaque lesion and the diagnosis is confirmed by the visualization of muriform bodies at direct examination or at the histologic study. This report describes a rare case of tumoral chromoblastomycosis confirmed by histologic study and whose agent was identified by culture and micromorphology.

Aged , Humans , Male , Ascomycota/isolation & purification , Chromoblastomycosis/microbiology , Chromoblastomycosis/pathology , Cladosporium/isolation & purification , Biopsy , Photography , Skin/microbiology