Entomoftoromicosis por Conidiobolus coronatus en un paciente joven proveniente de área rural / Entomophthoromycosis due to Conidiobolus coronatus in a young patient from a rural area

La conidiobolomicosis es una micosis subcutánea causada por un hongo saprofito, Conidiobulus spp. perteneciente a la clase Zigomicetos, orden Entomoftorales, que habita en regiones tropicales. La manifestación clínica clásica es la deformidad progresiva de estructuras faciales y su diagnóstico se basa en cultivos de la zona afectada y el estudio histopatológico, siendo el "fenómeno de Splendore-Hoeppli" el hallazgo más característico. Dada su baja frecuencia de presentación, no existe consenso sobre la mejor opción y tiempo de tratamiento. Aquí presentamos un caso de entomoftoromicosis rinofacial causada por Conidiobolus coronatus en un paciente inmunocompetente de la región sur de Colombia.

Conidiobolomycosis is a subcutaneous mycosis caused by a saprophytic fungus, Conidiobulus, belonging to the class of Zygomycetes, an order of Entomophtorales that inhabits tropical regions. Its most frequent clinical manifestation is the progressive deformity of facial midline structures, and the diagnosis is based on cultures taken from the affected area and the histopathological study, being the "Splendore-Hoeppli phenomenon" the most characteristic finding. Due to its low frequency of presentation, there is no consensus about the best option and treatment time. We present a case of rhinofacial entomophthoromycosis caused by Conidiobolus coronatus in an immunocompetent patient from the southern region of Colombia.

A first-line antiretroviral therapy-resistant HIV patient with rhinoentomophthoromycosis

The Conidiobolus coronatus-related rhinoentomophthoromycosis in immunocompetent and immunocompromised (HIV negative) individuals has been treated successfully with antifungal drugs. However, C. coronatus infections in first-line antiretroviral therapy (ART)-resistant (HIV infected) individuals particularly with rhinoentomophthoromycosis have not been reported previously. Here, we describe a case of itraconazole non-responding rhinoentomophthoromycosis in an HIV-infected patient with first-line antiretroviral (ART) drug resistance which was successfully managed through systematic diagnostic and therapeutic approaches in dermatologic setting. A 32-year-old HIV-1-infected man presented with painless swelling, nasal redness and respiratory difficulty. The patient was receiving first-line ART and had a history of traumatic injury before the onset of nasopharyngeal manifestations. The patient's previous history included oral candidiasis and pulmonary tuberculosis.

Epidemiological, clinical and diagnostic aspects of sheep conidiobolomycosis in Brazil / Aspectos epidemiológicos, clínicos e de diagnóstico da conidiobolomicose ovina no Brasil

ABSTRACT: Conidiobolomycosis is an emerging disease caused by fungi of the cosmopolitan genus Conidiobolus. Particular strains of Conidiobolus coronatus, Conidiobolus incongruus and Conidiobolus lamprauges, mainly from tropical or sub-tropical origin, cause the mycosis in humans and animals, domestic or wild. Lesions are usually granulomatous and necrotic in character, presenting two clinical forms: rhinofacial and nasopharyngeal. This review includes the main features of the disease in sheep, with an emphasis on the epidemiology, clinical aspects, and diagnosis of infections caused by Conidiobolus spp. in Brazil. In this country, the disease is endemic in the Northeast and Midwest, affecting predominantly woolless sheep breeds and occasioning death in the majority of the studied cases. The species responsible for infections of sheep are C. coronatus and C. lamprauges and the predominant clinical presentation is nasopharyngeal. These fungal infections are very important, since they compromise the health status of the sheep flock and cause serious economic losses to the sheep industry. Thus, research is needed to investigate faster tools for diagnosis and effective methods for the control and treatment of conidiobolomycosis.

RESUMO: Conidiobolomicose é uma enfermidade emergente causada por fungos cosmopolitas do gênero Conidiobolus. Isolados de Conidiobolus coronatus, Conidiobolus incongruus e Conidiobolus lamprauges, principalmente de origem tropical e subtropical, afetam humanos, animais domésticos e silvestres. As lesões da conidiobolomicose normalmente são de caráter granulomatoso e necrótico, apresentando-se sob duas formas clínicas: rinofacial e nasofaríngea. O presente artigo tem como objetivo revisar as principais características da doença em ovinos, particularizando a epidemiologia, assim como os aspectos clínicos e o diagnóstico das infecções causadas por Conidiobolus spp. no Brasil. Neste País, a enfermidade é endêmica nas regiões nordeste e centro-oeste, afetando ovinos predominantemente de raças deslanadas, ocasionando a morte na grande maioria dos casos estudados. As espécies do fungo responsáveis pelas infecções em ovinos são C. coronatus e C. lamprauges e a forma clínica predominante é a nasofaríngea. Tais infecções fúngicas são muito importantes, uma vez que comprometem o status sanitário do rebanho ovino e acarretam sérios prejuízos econômicos à ovinocultura. Dessa forma, pesquisas são necessárias para investigar ferramentas rápidas de diagnóstico e métodos eficazes de controle e tratamento da conidiobolomicose.

Infección orofacial por Conidiobolus coronatus / Orofacial infection by Conidiobolus coronatus

La entomoftoromicosis es un tipo de micosis subcutánea en el cual se incluyen la basidiobolomicosis y la conidiobolomicosis; esta última es causada principalmente por Conidiobolus coronatus , un hongo saprobio que habita el suelo en países tropicales y genera una afección rinofacial que compromete los tejidos blandos de la cara, los senos paranasales y la orofaringe, y tiene la capacidad de deformar el rostro en personas sin inmunodeficiencia aparente. La infección tiene un curso crónico con tendencia a la formación de granulomas que se pueden observar en el estudio histopatológico. Se presenta el caso de un agricultor de 28 años con un cuadro clínico de tumefacción rinofacial, obstrucción nasal y escurrimiento posterior, de seis meses de evolución, a quien se le diagnosticó conidiobolomicosis a partir de un cultivo de tejido después de múltiples biopsias de tejidos del área facial. El paciente recibió tratamiento antifúngico con anfotericina B y posteriomente con itraconazol, con lo cual su mejoría fue notable, por lo que no requirió tratamiento quirúrgico. El tratamiento con itraconazol se extendió por un año, al cabo del cual no había evidencia de recaída. Dada la poca frecuencia de esta enfermedad, no hay una estrategia de tratamiento establecida; sin embargo, el uso de azoles, como el itraconazol, se señala cada vez más en los diferentes reportes de caso, haya habido tratamiento quirúrgico adyuvante o no. En este reporte de caso se describe, además, la respuesta clínica y terapéutica a largo plazo de esta micosis infrecuente en Colombia.

Entomophtoramycosis is a type of subcutaneous mycosis which includes both basidiobolomycosis and conidiobolomycosis; the latter is caused by Conidiobolus coronatus , a saprophytic fungus which lives in tropical soils. This mycosis characteristically affects the paranasal sinuses and oropharynx, with the potential to deform the face in patients without apparent immunodeficiency. It has a chronic course of infection with a tendency to form granulomas visible using histology. We present the case of a 28 year-old male agricultural worker, with a clinical profile of 6 months´ evolution of rhinofacial tumefaction, nasal obstruction and post-nasal drip who was diagnosed with conidiobolomycosis by means of tissue culture after multiple biopsies of the facial area. The patient received antifungal treatment with amphotericin B and subsequently with itraconazol, resulting in a dramatic improvement without the need for surgical treatment; itraconazol was administered for one year and there was no evidence of relapse at the end of this period. Due to the low frequency of this disease there is no established treatment strategy; however, the use of azoles such as itraconazol with or without adjuvant surgical treatment is increasingly seen in case reports. The present report adds to the clinical experience in Colombia of this rare mycosis and also describes the long-term clinical and therapeutic response.

Rhinofacial conidiobolomycosis in a 16-year-old girl

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To present the case of a 16-year-old girl with progressive facial disfigurement spanning 11 months due to conidiobolomycosis<br /><strong>METHODS:</strong><br /><strong>Design</strong>: Case Report<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Patient:</strong> One<br /><strong>RESULTS:</strong> A 16-year-old girl presented with a severe facial deformity of 11 months duration. The lesion started as a swelling in the right nasal vestibule, which later involved the entire nose, forehead, cheeks, upper and lower lip. A series of tissue biopsies revealed varied results-- chronic inflammation, chronic granulomatous inflammation with foreign body type giant cells, and eosinophilic granuloma- resulting in delayed provision of appropriate treatment. On the fourth biopsy using the Grocott methenamine silver staining technique, septate fungal hyphae were identified. With a diagnosis of rhinofacial conidiobolomycosis, she was started on Itraconazole 100mg three times daily for eight months. Her facial swelling subsided gradually during the course of treatment and no systemic drug-related complications were observed. <br /><strong>CONCLUSION:</strong> Rhinofacial conidiobolomycosis is a rare chronic localized fungal infection that usually affects midline facial structures in immunocompetent hosts. Early detection and diagnosis, and appropriate medication can give rapid resolution. To the best of our knowledge, this may be the first documented case of rhinofacial conidiobolomycosis in the Philippines.</p>

Doenças da cavidade nasal em pequenos ruminantes no Distrito Federal e no Estado de Goiás / Nasal cavity diseases of small ruminants in Federal District and Goiás State, Brazil

As enfermidades que acometem a cavidade nasal de pequenos ruminantes podem causar prejuízos aos rebanhos de ovinos e caprinos na região central do Brasil. Foi realizado estudo retrospectivo dos laudos de necropsia do Laboratório de Patologia Veterinária da Universidade de Brasília (LPV-UnB) nos anos de 2003 a 2014 para verificar a ocorrência das doenças que acometeram a cavidade nasal de pequenos ruminantes. Foram analisados 463 protocolos de ovinos e 75 de caprinos totalizando 538 casos. Seis ovinos (6/463 1,29%) foram necropsiados com rinite granulomatosa micótica ou oomicótica e 22 animais do estudo (22/538; 4,08%) tiveram o diagnóstico de oestrose, sendo 86,36% ovinos e 13,64% caprinos. As rinites piogranulomatosas em ovinos ocorreram em áreas alagadas, com abundante material vegetal em decomposição. Os ovinos com pitiose rinofacial apresentaram como principais alterações aumento de volume na região nasal devido a extensas lesões granulomatosas associadas a necrose tecidual, caracterizadas por inúmeros macrófagos e polimorfonucleares circundando centros necróticos contendo o agente envolto por reação de Splendore-Hoeppli. Os ovinos com conidiobolomicose exibiram extensas áreas de necrose e inflamação piogranulomatosa, associadas à presença de hifas fúngicas na nasofaringe e também na região peribulbar e exoftalmia. A maioria dos animais com oestrose não apresentou alterações clínico-patológicas significativas, apesar de serem encontradas larvas principalmente nos seios e conchas nasais, traqueia e seio paranasal. A importância dessas enfermidades ainda é pouco conhecida na região, sendo de grande relevância que as condições clínico-patológicas e epidemiológicas sejam elucidadas para o diagnóstico, o controle e a prevenção, para evitar a expansão e prejuízos para os rebanhos...

Nasal cavity diseases that affect small ruminants can cause losses to sheep and goat herds in Central Brazil. A retrospective study of the University of Brasilia´s Veterinary Pathology Laboratory autopsy reports from 2003 to 2014 was conducted to verify the occurrence of small ruminants nasal cavity diseases. Six necropsied sheep (6/463 1.29%) showed mycotic or oomicotic granulomatous rhinitis and 22 animals (22/538, 4.08%) presented oestrosis diagnosis, affecting 86.36% of sheep and 13.64% of goats. The pyogranulomatous rhinitis in sheep occurred in flooded areas with abundant plant material decomposing. Rhinofacial pythiosis infection in animals showed as major changes swelling in the nasal region due to extensive granulomatous lesions associated with tissue necrosis, characterized by numerous macrophages and polymorphonuclear cells surrounding necrotic centers containing the agent surrounded by Splendore-Hoeppli reaction. Sheep with conidiobolomycosis showed extensive areas of necrosis and pyogranulomatous inflammation associated with fungal hyphae, localized in the nasopharynx and also in peribulbar region and exophthalmia. Most animals with oestrosis showed no significant clinical and pathological changes, even with the presence of larvae mainly in the sinuses and nasal turbinates, trachea and paranasal sinus. The importance of such diseases is still unknown in the region, and the knowledge of the clinical-pathological and epidemiological conditions is of great relevance for the diagnosis, control and prevention to avoid the expansion and losses to livestock...

Proteínas imunorreativas de Conidiobolus lamprauges isoladas de ovinos infectados naturalmente / Immunoreactive proteins of Conidiobolus lamprauges isolated from naturally infected sheep

O estudo de conidiobolomicose ovina tem sido realizado nos seus aspectos clínicos, epidemiológicos, patológicos e moleculares. Informações, entretanto, sobre a resposta imune do hospedeiro na infecção por Conidiobolus lamprauges são inexistentes. Este estudo teve por objetivo a identificação de proteínas imunorreativas que possam desempenhar papel importante na resposta imune de ovinos naturalmente infectados por C. lamprauges. Para a caracterização protéica e imunológica foi utilizada a cepa de C. lamprauges (FIOCRUZ-INCQS 40316) isolada de ovino com sinais clínicos de conidiobolomicose no Estado do MT e cinco amostras de soro de ovinos infectados naturalmente pelo fungo. A presença de anticorpos IgG foi observada em todos os animais doentes com títulos reagentes em diluições de até 1:1.600. Na técnica do immunoblot, o perfil antigênico frente aos soros ovinos com a doença apresentou doze bandas reativas, com massas moleculares variando de 35 a 198 kDa. Dentre estas, a proteína de 198 kDa foi reativa em 3 soros de ovinos e a de 53 kDa apresentou a maior intensidade comparativamente com outras bandas, sendo provavelmente imunodominante. Amostras de soro de animais sadios não apresentaram reatividade demostrando a especificidade da técnica. A presença de proteínas antigênicas de C. lamprauges e IgG específicos em soros de ovinos observados no presente trabalho poderá auxiliar no desenvolvimento de métodos de diagnóstico precoces e na utilização de proteínas candidatas a vacinas para o controle e prevenção da infecção em animais e humanos.(AU)

The study of sheep conidiobolomycosis has been carried out in its clinical, epidemiological, pathological and molecular aspects. Information, however, about the host immune response in infection Conidiobolus lamprauges is absent. This study aimed to identify immunoreactive proteins that may play an important role in the immune response of sheep naturally infected by C. lamprauges. For protein and immunological characterization, C. lamprauges (strain FIOCRUZ-INCQS 40316) isolated from a sheep with clinical signs of conidiobolomycosis in the MT state and five sera samples of naturally infected sheep were used. The presence of IgG antibody was observed in all patients with reagent titers in dilutions up to 1:1600. In immunoblot technique, the antigenic profile against infected sheep sera showed twelve reactive bands with molecular weights ranging from 35 to 198 kDa. Among them, the 198 kDa protein was reactive against sera from three sheep and the 53 kDa showed increased intensity compared to other bands probably being immunodominant. Healthy animal serum samples showed no reactivity demonstrating the specificity of the technique. The presence of antigenic proteins of C. lamprauges and specific IgG in sheep sera observed in this study may assist in the development of early diagnostic methods and the use of protein as candidate vaccines for the control and prevention of infection in animals and human.(AU)

Aspectos epidemiológicos da conidiobolomicose em ovinos na região semiárida do Nordeste do Brasil / Epidemiological aspects of conidiobolomycosis in sheep in the Northeastern Brazilian semiarid region

Com o objetivo de determinar aspectos epidemiológicos da conidiobolomicose dos ovinos, foi realizado um estudo caso-controle em 27 propriedades (16 com casos e 11 controles) nos estados da Paraíba e do Rio Grande do Norte. Das 16 propriedades com casos, em nove (56,3%), ocorreu apenas um foco e em sete (43,8%) aconteceram dois, totalizando 23 focos no período do estudo. Em 20 focos, foi diagnosticada somente conidiobolomicose e, em três, além de casos de conidiobolomicose, ocorreram casos de pitiose rinofacial. Nos focos de conidiobolomicose, a morbidade variou de 0,7% a 73,3% e a letalidade foi de 100%. Treze focos (56,5%) aconteceram no período chuvoso (janeiro a maio), seis (26,1%) ocorreram no período seco (junho a dezembro) e, em quatro, não foi determinada a época de ocorrência. Em todas as propriedades com casos, os animais tinham acesso a açudes, durante todo o ano ou por períodos de 2-8 meses. Na análise univariada dos fatores de risco referentes aos focos de conidiobolomicose, as variáveis associadas foram: pastejo dos animais às margens dos açudes; período de pastejo às margens dos açudes; presença de matéria vegetal constituída por plantas aquáticas; pressão de pastejo; e raça, afetando predominantemente a raça Santa Inês. Conclui-se que a associação de fatores como pastejo constante em áreas úmidas com matéria vegetal decomposta e solo rico em matéria orgânica expõe os animais à infecção por Conidiobolus spp. e predispõe à ocorrência de focos. A implantação de pastagens para corte, nas margens dos açudes, pode ser uma medida eficaz de controle da conidiobolomicose.

With the objective to determine the epidemiological aspects of conidiobolomycosis and rhinofacial pythiosis in sheep, a case-control study was conducted in 27 farms (16 cases and 11 controls) in the states of Paraíba and Rio Grande do Norte. In nine (56.3%) farms only one outbreak was observed and in seven, two outbreaks occurred, totaling 23 outbreaks. In 20 farms only cases of conidiobolomycosis occurred and in three farms cases of conidiobolomicosis occurred together with cases of pythiosis. In conidiobolomycosis, morbidity ranged from 0.7% to 73.3% and lethality rate was 100%. Thirteen outbreaks (56.3%) occurred in the rainy season (January to May), six (26.1%) in the dry season (June to December) and in four it was not informed. In all farms with cases, sheep had access to ponds for the whole year or for periods of 2-8 months. In the univariate analysis of risk, the variables associated with the occurrence of conidiobolomycosis were: animal grazing on the borders of the ponds; presence of vegetable matter consisting mainly of aquatic plants in the pond borders; period of grazing on the pond borders; high grazing pressure; and predominant breed of sheep, being the Santa Inês breed the most affected. It was concluded that the combination of factors such as continuous grazing in wetlands with decomposed vegetable matter and soil rich in organic matter exposes the animals to Conidiobolus spp. and predisposes to the occurrence of conidiobolomycosis. The establishment of pastures for cutting at the borders of the ponds can be an effective measure to control conidiobolomycosis.

Development and application of polymerase chain reaction test for detection of Conidiobolus lamprauges / Desenvolvimento e aplicação da reação em cadeia da polimerase para detecção de Conidiobolus lamprauges

Conidiobolomycosis is a granulomatous disease caused by the fungus Conidiobolus spp. in humans and animals. Traditional technique for diagnosis of the disease is isolation of the agent associated with the presence of typical clinical signs and pathological conditions. The aim of this study was to describe the development of a specific polymerase chain reaction (PCR) test for Conidiobolus lamprauges to detect the fungus in clinical samples. Samples from suspected animals were collected and submitted to isolation, histopathological analysis and amplification by PCR. DNA from tissues was subjected to PCR with fungi universal primers 18S rDNA gene, and specific primers were designed based on the same gene in C. lamprauges that generated products of about 540 bp and 222 bp respectively. The culture was positive in 26.6% of clinical samples. The PCR technique for C. lamprauges showed amplification of DNA from fresh tissues (80%) and paraffin sections (44.4%). In conclusion, the PCR technique described here demonstrated a high sensitivity and specificity for detection of fungal DNA in tissue samples, providing a tool for the rapid diagnosis of C. lamprauges.

A conidiobolomicose é uma doença granulomatosa causada pelo fungo Conidiobolus spp., observada em humanos e animais. As técnicas tradicionais de diagnóstico da doença são o isolamento do agente associado à presença de sinais clínicos típicos e condições patológicas. O objetivo deste trabalho é descrever o desenvolvimento de um teste da reação em cadeia da polimerase (PCR) específico para Conidiobolus lamprauges em amostras clínicas. As amostras de animais suspeitos foram coletadas e submetidas ao isolamento, análise histopatológica e amplificação pela PCR. O DNA de tecidos foi submetido a PCR com os iniciadores universais de fungos baseados no gene 18S rDNA e iniciadores específicos foram concebidos com base no mesmo gene em C. lamprauges que gerou produtos de aproximadamente 540 pb e 222 pb, respectivamente. A cultura foi positiva em 26,6% das amostras clínicas. A técnica de PCR para C. lamprauges mostrou a amplificação de DNA a partir de tecidos frescos (80%) e secções de parafina (44,4%). Em conclusão, a técnica de PCR aqui descrita demonstrou elevada sensibilidade e especificidade na detecção de DNA de fungos em amostras de tecido, proporcionando uma ferramenta rápida para o diagnóstico de C. lamprauges.

Descripción clíiica e histopatológica de la rintis micótica granulomatosa en oovinos de córdoba, Colombia / Clinicand histoppathological description of granulomatus fungal rhiniitis in sheep of cordoba, Colombia

El objetivo de este estudio fue describir clínica e histopatológicamente la rinitis micótica granulomatosa causada por Conidiobolus spp. en ovinos del departamento de Córdoba, Colombia. Fueron analizados siete ovinos criollos, hembras, con edades comprendidas entre 2 y 4 años, los cuales recibieron diagnóstico clínico e histopatológico de conidiobolomicosis. Se observaron manifestaciones clínicas similares en todos los ovinos: dificultad respiratoria debido a la obstrucción parcial de los orificios nasales, intolerancia al ejercicio, respiración ruidosa, secreción puro-sanguinolenta bilateral y aumento de volumen de la cavidad nasal. A la necropsia, las cabezas fueron seccionadas longitudinalmente sobre la línea media y se observaron masas de coloración amarillenta irregular con áreas focalizadas de color café oscuro, friable y con coágulos de sangre en la región rinofacial y conchas nasales. En la coloración de H-E, la mucosa de la cavidad nasal presentó necrosis piogranulomatosa multifocal, conteniendo estructuras semejantes a hifas escasamente coloreadas y circundadas por infiltrado de neutrófilos, macrófagos y células gigantes, además de tejido conjuntivo fibroso organizados de forma paralela al rededor del área de necrosis y rodeados por material de Splendore-Hoeppli. En la coloración de Grocott, se observaron hifas irregulares, filamentosas y raramente septadas, cuya morfología es característica de conidiobolomicosis. El diagnóstico se fundamentó en las características clínicas y en los hallazgos histopatológicos, siendo el primer reporte de esta enfermedad en ovinos del departamento de Córdoba y en Colombia.

The objective of this study was to describe clinic and histopathological granulomatous fungal rhinitis caused by Conidiobolusspp. in sheep of the department of Cordoba, Colombia. Seven native sheep were analyzed, females, aged between 2 and 4 years, who were diagnosed clinically with conidiobolomycosis and correlated with histopathological aspects. In describing cases similar clinical manifestations were observed in all animals, difficulty breathing due to partial obstruction of the nostrils, exercise intolerance, noisy breathing, bloody purulent bilateral, similarly showed increased volume of nasal cavity. At necropsy, the heads were sectioned longitudinally on the midline and observed masses of irregular yellowing targeted areas dark brown, friable and blood clots in the nasal region and shells rhinofacial. In the HE stain, the mucosa of the nasal cavity showed multifocal necrosis pyogranulomatous containing hyphae like structures slightly colored and surrounded by infiltration of neutrophils, macrophages and giant cells, and fibrous connective tissue arranged in parallel around the area of necrosis and surrounded by Splendore-Hoeppli material. In the Grocott stain, irregular, filamentous and rarely septate hyphae were observed, suggesting the morphology of the hyphae in the tissue, which is characteristic of conidiobolomycosis. The diagnosis was based on the clinic and histopathological findings, the first report of the disease in sheep of department of Córdoba and Colombia.

Rhinocerebral and rhinopharyngeal conidiobolomycosis in sheep / Conidiobolomicose rinocerebral e rinofaríngea em ovinos

The present study aimed to report the occurrence as well as the clinical, laboratorial, pathological and mycological findings of three outbreaks of rhinocerebral and rhinopharyngeal conidiobolomycosis in sheep from Rio Grande do Norte state, Brazil. A total of six sheep with clinical signs of conidiobolomycosis were evaluated, and information on history was obtained from ranchers. Clinical signs included depression, progressive emaciation, sero-sanguinolent nasal discharge, tachycardia, dyspnea, miosis and unilateral exophthalmia with increased ocular globe volume, corneal ulceration and nervous system signs. The main hematological alteration was neutrophilia. Serum biochemical evaluation revealed increased values for AST, GGT, creatinine, urea, and glucose, and decreased total proteins and albumin levels. Cerebrospinal fluid analysis showed the presence of fibrin reticules and pleocytosis. Upon necropsy, longitudinal sections of the head revealed the presence of a nodular mass with a friable consistency and a white-yellowish coloration. Microscopic findings included meningitis, cortex necrosis and encephalitis with the presence of eosinophilic Splendore-Hoeppli substance. Histopathology of the lungs revealed a Splendore-Hoeppli-like material and hyperplasia of alveolar and bronchiolar epithelium. Renal lesions were suggestive of amyloidosis.

O presente estudo objetivou relatar a ocorrência e os achados clínicos, laboratoriais, patológicos e micológicos de três surtos de conidiobolomicose rinocerebral e rinofaríngea em ovinos do estado do Rio Grande do Norte, Brasil. Um total de seis ovinos com sinais clínicos de conidiobolomicose foi avaliado, e informações sobre o histórico foram obtidas dos proprietários. Os sinais clínicos incluíram depressão, emaciação progressiva, descarga nasal serossanguinolenta, taquicardia, dispneia, miosite e exoftalmia unilateral com aumento do volume do globo ocular, ulceração da córnea e sinais nervosos. A principal alteração hematológica foi neutrofilia. A avaliação bioquímica sérica revelou aumento nos valores de AST, GGT, creatinina, ureia e glicose, e redução nos níveis de proteínas totais e albumina. A análise do fluido cerebrospinal revelou presença de retículos de fibrina e pleocitose. À necropsia, secções longitudinais da cabeça revelaram presença de uma massa nodular com consistência friável e coloração branco-amarelada. Os achados microscópicos incluíram meningite, necrose do córtex e encefalite com presença da substância eosinofílica de Splendore-Hoeppli. A histopatologia dos pulmões revelou uma substância similar à de Splendore-Hoeppli e hiperplasia do epitélio alveolar e bronquiolar. As lesões renais foram sugestivas de amiloidose.

Conidiobolomicose causada por conidiobolus lamprauges em ovinos no estado de Santa Catarina / Conidiobolomycosis caused by conidiobolus lamprauges in sheep in the state of Santa Catarina, Brazil

Descreve-se um surto de conidiobolomicose em ovinos no Estado de Santa Catarina. O surto ocorreu entre os meses de dezembro e março de 2006, no município de Santo Amaro da Imperatriz, região litorânea do Estado. A propriedade possuía 75 ovinos da raça Santa Inês e seis desses animais adoeceram. Clinicamente os animais doentes apresentavam dificuldade respiratória, corrimento nasal seroso a mucossanguinolento e, por vezes exolftalmia. Na necropsia verificou-se uma massa amarelada na região etmoidal e adjacências que, às vezes, atingia os linfonodos regionais, cérebro, globo ocular e pleura. Microscopicamente a massa caracterizava-se por infiltrado inflamatório granulomatoso com áreas necróticas associadas a hifas largas pouco ramificadas. Através de exame molecular detectou-se DNA de Conidiobolus lamprauges. Os aspectos clínicos, epidemiológicos, macroscópicos, microscópicos e moleculares caracterizam a conidiobolomicose causada por Conidiobolus lamprauges em ovinos.

An outbreak of conidiobolomycosis affecting sheep in the State of Santa Catarina, Southern Brazil is reported. The disease occurred in six Santa Inês breed sheep from a flock of 75 during the rainy season. Common clinical signs were noisy respiration and dyspnea, serous to mucosanguineous nasal discharge and exophthalmus. At necropsy there was a dense yellow mass in the nasopharyngeal area affecting the ethmoidal region, turbinate bones and occasionally limph nodes, central nervous system and pleura. Histopathologycally there was multifocal granulomas whith an eosinophilic necrotic reaction containing ribbon type hyphae similar to zygomycetous fungi. At molecular examination Conidiobolus lamprauges DNA was detected. The clinical, epidemiological, macroscopical, microscopical and molecular aspects characterize conidiobolomycosis caused by Conidiobolus lamprauges in sheep.

Conidiobolomicose em ovinos no Estado de Mato Grosso / Conidiobolomycosis in sheep in the state of Mato Grosso, Brazil

Relatam-se os achados epidemiológicos, clínicos, patológicos e micológicos de conidiobolomicose em ovinos no Estado de Mato Grosso. A doença ocorreu em uma propriedade no município de Nobres, em um rebanho com 40 ovelhas adultas, entre os meses de janeiro a junho de 2007. Aproximadamente 30 por cento dos ovinos da propriedade adoeceram e todos os doentes morreram em curso clínico de 2-5 semanas. O quadro clínico foi caracterizado por apatia, emagrecimento, dificuldade respiratória com dispnéia, respiração ruidosa e oral, secreção nasal mucosa ou sero-sanguinolenta, exoftalmia unilateral, por vezes com cegueira, e morte. Havia desaparecimento de etmoturbinados com substituição por tecido bran-cacento, finamente granular, multilobulado e friável infil-trando-se na lâmina cribiforme, no septo nasal e nas coa-nas em todos os ovinos necropsiados. Lesões similares foram encontradas em linfonodos regionais (2 casos), pulmões (3), encéfalo (2) e em linfonodos do abomaso (1). Microscopicamente havia inflamação granulomatosa da região rinocerebral, caracterizada por necrose, proliferação de tecido conjuntivo, infiltrado de neutrófilos, eosinófilos, células epitelióides e células gigantes multinucleadas freqüentemente circundando material Splendori-Hoeppli, onde havia imagens negativas de hifas. Na impregnação pela Prata-Metenamina, as hifas tinham septos e ramificações escassas e irregulares, com dilatação balonosa terminal e com forte demarcação de contornos. Iso-lou-se de tecido nasal de quatro ovinos Conidiobolus sp.

The epidemiological, clinical, pathological and mycological findings of an outbreak of conidiobolomycosis in a flock of 40 Santa Ines sheep, in the state of Mato Grosso, Brazil, are reported. The illness occurred in the municipality of Nobres during January-June, 2007, resulting in death of about 30 percent of the affected sheep within 2-5 weeks. The clinical signs were characterized by apathy, weight loss, labored and noisy breathing with dyspnea, and mucous or serohemorrhagic nasal discharge. In three sheep there was unilateral exophthalmia, keratitis and corneal ulceration. A firm whitish, multi-lobulated, friable growth was evident in the ethmoturbinate region at the coronal sections of the head from six affected sheep. In all sheep the choana had similar nodular infiltration which resulted in local obstruction. In three of those there was exophthalmia. There was infiltration in the cribiform plate and brain (2 cases), regional lymph nodes (2), lungs (3), and abomasums (1). Microscopic findings were granulomatous inflammation of the rhinoetimoidal region, with necrosis, lymphocytic infiltration, epithelioid multinucleated giant cells and fibrovascular tissue, surrounding Splendore-Hoeppli material wich contained unstained ghost images of hyphae. The methenamine-silver stain uncover fungi hyphae, rarely ramified with bulbous dilatation in their extremities. Conidiobolus sp. was isolated from nasal tissue lesions of four sheep.

Zigomicose nasofacial no Estado do Pará: registro de dois casos / Nasofacial zygomycosis in the state of Pará: the registration of 2 cases

São descritos dois casos de zigomicose nasofacial, procedentes de Belém, PA. O achado indica não ser tão rara, como se poderia supor, pela falta de registros, a ocorrência dessa micose na Região Norte do Brasil. Em ambos os pacientes, o tratamento pelo cetoconazol determinou involução rápida das manifestações clínicas, principalmente a obstrução nasal. Com o presente relato, sobe para cinco o número de casos da infecção referidos até agora do Estado do Pará.

Two new cases of nasofacial zygomycosis from the state of Pará, Brazil, are reported. Both cases were treated with ketoconazole and the response to the drug was considered to be good; the patients improved rapidly and the nasal obstruction was the first manifestation to disappear. As five cases have been described in recent years from the state of Pará, this form of zygomycosis can no longer be considered as a rare disease in northern Brazil.