Résumé
Abstract This communication reports the second known case of oral phaeohyphomycosis in a patient with squamocellular carcinoma of the lip. The patient, an 82-year-old black woman, a former smoker (for more than 30 years), suffering from an ulcerous vegetative lesion in the middle third of the lower lip for approximately 12 months. The result of the histopathological analysis indicated carcinoma, with well-differentiated keratinized squamous cells and the presence of septate mycelial filaments. In the direct mycological examination, thick and dematiaceous septate mycelial filaments were observed. After the resection surgery, the patient did not need to use an antifungal drug to treat the phaeohyphomycosis, and no follow-up radiotherapy was needed to treat the squamocellular carcinoma. We stress that the presence of the squamocellular lesion of the lip was a possible contributing factor to the infection.
Sujets)
Humains , Femelle , Sujet âgé de 80 ans ou plus , Tumeurs de la lèvre/complications , Carcinome épidermoïde/complications , Phaeohyphomycose/diagnostic , Phaeohyphomycose/anatomopathologie , Lèvre/anatomopathologie , Brésil , Tumeurs de la lèvre/chirurgie , Carcinome épidermoïde/chirurgie , Techniques microbiologiques , Résultat thérapeutique , Phaeohyphomycose/chirurgie , Histocytochimie , Lèvre/chirurgie , MicroscopieRésumé
Abstract Phaeohyphomycosis is an infection caused by a filamentous fungus that contains pigment melanin in its cell wall. We report two cases caused by Exophiala sp. emphasizing the clinical variability of the disease, as well as diagnostic and therapeutic difficulties of this opportunistic infection in immunosuppressed patients (kidney transplant).
Sujets)
Humains , Mâle , Adulte d'âge moyen , Exophiala/isolement et purification , Transplantation rénale/effets indésirables , Phaeohyphomycose/anatomopathologie , Antifongiques/usage thérapeutique , Sujet immunodéprimé , Immunosuppresseurs/effets indésirables , Infections opportunistes/immunologie , Infections opportunistes/anatomopathologie , Infections opportunistes/thérapie , Phaeohyphomycose/immunologie , Phaeohyphomycose/thérapie , Peau/anatomopathologieRésumé
Phaeohyphomycosis is a disease caused by dematiaceous fungi with a worldwide geographic distribution and broad spectrum. It is most commonly found in adult individuals of both genders and all races. We report the case of a 57-year-old woman with phaeohyphomycosis in the ungual apparatus.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Onychopathies/microbiologie , Phaeohyphomycose/microbiologie , Peau/microbiologie , Antifongiques/usage thérapeutique , Onychopathies/traitement médicamenteux , Onychopathies/anatomopathologie , Phaeohyphomycose/traitement médicamenteux , Phaeohyphomycose/anatomopathologie , Peau/anatomopathologie , Résultat thérapeutiqueRésumé
Subcutaneous phaeohyphomycosis is an infection caused by dematiaceous fungi which mainly affects immunosuppressed patients. We report a case of subcutaneous phaeohyphomycosis on the back of the left hand in a kidney transplant patient who had been taking prednisone, tacrolimus, and azathioprine daily for 3 years.
Sujets)
Humains , Femelle , Adulte d'âge moyen , Phaeohyphomycose/anatomopathologie , Dermatoses de la main/anatomopathologie , Biopsie , Immunosuppression thérapeutique/effets indésirables , Transplantation rénale , Sujet immunodéprimé , Phaeohyphomycose/chirurgie , Dermatoses de la main/chirurgieRésumé
The goal of this study was to review 18 cases of phaeohyphomycosis in Rio Grande do Sul. The records of all of the patients with a diagnosis of phaeohyphomycosis between 1995-2010 were reviewed. Twelve of the 18 patients (66.6%) were male. The average age of the patients was 50 years old (range: 16-74 years). Eleven patients (61%) presented with subcutaneous lesions. Seven patients (38.8%) had received a solid organ transplant. In all of the cases, the presence of melanin in the fungal cells was determined by Fontana-Masson staining of tissue sections and documented. Among the 18 patients, a total of 11 different fungal species were isolated. The causative organisms included Exophiala jeanselmei, Alternaria, Curvularia, Cladophialophora and Colletotrichum gloeosporioides. To our knowledge, this review reports the first case of subcutaneous phaeohyphomycosis caused by C. gloeosporioides in a lung transplant patient. The number of reported cases of phaeohyphomycosis has increased in the last decade. In a number of cases, this increased incidence may be primarily attributed to iatrogenic immunodeficiency.