ABSTRACT
The authors report aspects of paracoccidioidomycosis, acute-subacute clinical form, juvenile type, in a 19-year-old female patient. Paracoccidioidomycosis, juvenile type, classically occurs in young patients, both sexes, with lymphoma-like aspects as initial presentation. However, following the natural history of the disease the lymph nodes assume patterns of infectious disease, as an abscess and fistulae. Systemic dissemination of the disease can occur and lethality and morbidity are significant in this clinical presentation.
Subject(s)
Dermatomycoses/diagnosis , Paracoccidioidomycosis/diagnosis , Acute Disease , Dermatomycoses/microbiology , Female , Humans , Lymphangitis/complications , Neck , Paracoccidioidomycosis/complications , Photography , Young AdultABSTRACT
Abstract: The authors report aspects of paracoccidioidomycosis, acute-subacute clinical form, juvenile type, in a 19-year-old female patient. Paracoccidioidomycosis, juvenile type, classically occurs in young patients, both sexes, with lymphoma-like aspects as initial presentation. However, following the natural history of the disease the lymph nodes assume patterns of infectious disease, as an abscess and fistulae. Systemic dissemination of the disease can occur and lethality and morbidity are significant in this clinical presentation.
Subject(s)
Humans , Female , Young Adult , Paracoccidioidomycosis/diagnosis , Dermatomycoses/diagnosis , Paracoccidioidomycosis/complications , Acute Disease , Dermatomycoses/microbiology , Photograph , Lymphangitis/complications , NeckABSTRACT
No disponible
Subject(s)
Aged , Humans , Male , Histoplasmosis/diagnosis , Dermatomycoses/diagnosis , Fungemia/diagnosis , Genital Diseases, Male/diagnosisABSTRACT
É descrita uma infestação por ácaros hematófagos aviários, que se manifesta em ambientes humanos através da colonização por pombos e seus ninhos. Descrição de caso: A paciente pernoitou em ambiente rural com ninhos de pombos e, no retorno, queixou-se de dermatite e prurido intenso, inicialmente nos antebraços, região anteromedial das coxas e região poplítea. O exame dermatológico mostrou múltiplas pápulas eritematosas, pruriginosas e escoriadas, com cerca de 2 mm de diâmetro. Medicada para escabiose, trouxe os ácaros em uma segunda consulta (identificados como sendo da espécie Dermanyssus gallinae) e obteve resolução do quadro após terapêutica para prurigo agudo. Discussão: A gamasoidose é uma doença disseminada por todo o mundo. Atualmente, com a proliferação de pombos nas cidades, ocorre na zona urbana, a partir de ninhos construídos em telhados ou em nichos para ar-condicionado. Os principais agentes são os ácaros Dermanyssus gallinae, D. avium, Ornithonyssus sylviarum e Ornithonyssus bursa. Estes são ectoparasitas hematófagos temporários de aves domésticas e selvagens, mas também podem se alimentar da espécie humana. Em humanos, os sintomas são cutâneos, não havendo relato de transmissão de doenças infecciosas ou quadros graves. As lesões são maculopapulares e eritematosas, podendo ser confundidas com a pediculose e a escabiose. Conclusões: A infestação por ácaros aviários não está restrita apenas à área rural ou silvestre, sendo cada vez mais comum nas regiões urbanas. Assim, é de grande importância que não só os dermatologistas como os médicos de formação geral conheçam e saibam como suspeitar e tratar adequadamente esta entidade...
Subject(s)
Dermatitis , MitesABSTRACT
Histoplasmosis is a systemic mycosis endemic in extensive areas of the Americas. The authors report on an urban adult male patient with uncommon oral-cutaneous lesions proven to be histoplasmosis. Additional investigation revealed unnoticed HIV infection with CD4+ cell count of 7/mm3. The treatment was performed with amphotericin B, a 2065 mg total dose followed by itraconazole 200mg/daily plus antiretroviral therapy with apparent cure. Histoplasmosis is an AIDS-defining opportunistic disease process; therefore, its clinical diagnosis must drive full laboratory investigation looking for unnoted HIV-infection.
Subject(s)
AIDS-Related Opportunistic Infections/pathology , Dermatomycoses/pathology , Histoplasmosis/pathology , AIDS-Related Opportunistic Infections/complications , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Biopsy , Dermatomycoses/drug therapy , Histoplasmosis/drug therapy , Humans , Itraconazole/therapeutic use , Male , Middle AgedABSTRACT
White piedra is a superficial mycosis caused by the genus Trichosporon. It is characterized by nodules on the hair shaft. Pediculosis capitis is caused by Pediculus humanus var. capitis of the suborder Anoplura. Whereas pediculosis is a common infestation, clinical reports of white piedra are rare. Molecular biology procedures identified T. inkin as the agent of white piedra in this case report. The authors present associations between the two diseases in the same patient in order to highlight their clinical differences.
Subject(s)
Lice Infestations/complications , Piedra/complications , Female , Humans , Young AdultABSTRACT
White piedra is a superficial mycosis caused by the genus Trichosporon. It is characterized by nodules on the hair shaft. Pediculosis capitis is caused by Pediculus humanus var. capitis of the suborder Anoplura. Whereas pediculosis is a common infestation, clinical reports of white piedra are rare. Molecular biology procedures identified T. inkin as the agent of white piedra in this case report. The authors present associations between the two diseases in the same patient in order to highlight their clinical differences.
Piedra branca é micose superficial causada pelo gênero Trichosporon e caracterizada por nódulos aderidos à haste do pelo. Pediculose capitis é causada pelo Pediculus humanus var. capitis pertencente à subordem Anoplura. Enquanto que a pediculose é enfermidade comum, relatos clínicos de piedra branca são raros. Técnicas de biologia molecular identificaram o agente de piedra branca do presente relato como T.inkin. Os autores apresentam associação de ambas as infestações no mesmo paciente para salientar seus aspectos clínicos distintos.
Subject(s)
Female , Humans , Young Adult , Lice Infestations/complications , Piedra/complicationsABSTRACT
INTRODUCTION: White piedra is a superficial mycosis caused by the genus Trichosporon and characterized by nodules on hair shaft. METHODS: The authors report a family referred to as pediculosis. Mycological culture on Mycosel® plus molecular identification was performed to precisely identify the etiology. RESULTS: A Trichosporon spp. infection was revealed. The molecular procedure identified the agent as Trichosporon inkin. CONCLUSIONS: White piedra and infection caused by T. inkin are rarely reported in Southern Brazil. The molecular tools are essentials on identifying the Trichosporon species.
Subject(s)
Piedra/diagnosis , Scalp Dermatoses/diagnosis , Scalp Dermatoses/microbiology , Trichosporon/genetics , Adult , Child , Child, Preschool , Female , Humans , Male , Piedra/microbiology , Trichosporon/classification , Trichosporon/isolation & purificationABSTRACT
Malassezia folliculitis is an inflammatory disorder observed in both immunocompetent and immunosuppressed patients. The authors describe an unusual and exuberant presumed case affecting the face, trunk and upper limbs of a 12-year-old nonimmunosuppressed patient. Although the agent was not identified by culture, the clinical and histopathological aspects plus the response to specific treatment support the diagnosis of Malassezia folliculitis. The only possible predisponent cause observed on the patient was greasy skin. Repetitive cultures were negative. Treatment with itraconazol promoted apparent cure, however, the patient relapsed twelve months later.
Subject(s)
Dermatomycoses/microbiology , Folliculitis/microbiology , Malassezia/isolation & purification , Antifungal Agents/therapeutic use , Child , Dermatomycoses/pathology , Folliculitis/pathology , Humans , Itraconazole/therapeutic use , Male , Severity of Illness IndexABSTRACT
Malassezia folliculitis is an inflammatory disorder observed in both immunocompetent and immunosuppressed patients. The authors describe an unusual and exuberant presumed case affecting the face, trunk and upper limbs of a 12-year-old nonimmunosuppressed patient. Although the agent was not identified by culture, the clinical and histopathological aspects plus the response to specific treatment support the diagnosis of Malassezia folliculitis. The only possible predisponent cause observed on the patient was greasy skin. Repetitive cultures were negative. Treatment with itraconazol promoted apparent cure, however, the patient relapsed twelve months later.
Foliculite por Malassezia é processo inflamatório observado em pacientes imunocompetentes e imunossuprimidos. Os autores relatam um provável caso exuberante e incomum comprometendo a face, tronco e membros superiores de paciente de 12 anos de idade, não imunossuprimido. Embora o agente não tenha sido cultivado, os achados clínicos e histopatológicos aliados à resposta terapêutica sugerem o diagnóstico de foliculite por Malassezia. A única possivel causa predisponente demonstrada no paciente foi a pele oleosa. Tentativas de cultivo do agente foram negativas. O tratamento com itraconazol promoveu cura aparente, entretanto, houve recaída após 12 meses.
Subject(s)
Child , Humans , Male , Dermatomycoses/microbiology , Folliculitis/microbiology , Malassezia/isolation & purification , Antifungal Agents/therapeutic use , Dermatomycoses/pathology , Folliculitis/pathology , Itraconazole/therapeutic use , Severity of Illness IndexABSTRACT
BACKGROUND: Paracoccidioidomycosis is a systemic mycosis of dermatological interest due to the frequency of cutaneous and mucosal lesions. The involvement of the external genitalia is extremely rare and few cases have been reported. OBJECTIVE: To study the prevalence of external genitalia lesions in paracoccidioidomycosis patients, identify clinical characteristics and compare with what is observed in the specific literature. METHODS: This is a cross-sectional, descriptive study, with focus on paracoccidioiodomycosis patients with external genitalia lesions. The demographic and clinical aspects of cases were compared with what has been reported so far on LILACS, SciELO e MEDLINE data bases. RESULTS: Data of 483 cases of paracoccidioidomycosis were studied in a 42-year period. Six (1.2%) patients showed specific lesions on external genitalia. Five patients were male with mean age of 47.2 years and all of them presented with the chronic multifocal clinical form. Only one, a 15-year-old female patient was observed who showed a subacute clinical form, juvenile type. CONCLUSION: Compromise of the genitourinary tract among paracoccidioidomycosis patients is rare and even rarer when only the external genitalia are considered. As observed in the classical picture of paracoccidioidomycosis patients, the male gender and the chronic multifocal clinical form prevailed in the present study.
Subject(s)
Genital Diseases, Female/pathology , Genital Diseases, Male/pathology , Paracoccidioidomycosis/pathology , Adult , Cross-Sectional Studies , Diagnosis, Differential , Female , Genital Diseases, Female/diagnosis , Genital Diseases, Male/diagnosis , Humans , Male , Middle Aged , Paracoccidioidomycosis/diagnosisABSTRACT
BACKGROUND: Paracoccidioidomycosis is a systemic mycosis of dermatological interest due to the frequency of cutaneous and mucosal lesions. The involvement of the external genitalia is extremely rare and few cases have been reported. OBJECTIVE: To study the prevalence of external genitalia lesions in paracoccidioidomycosis patients, identify clinical characteristics and compare with what is observed in the specific literature. METHODS: This is a cross-sectional, descriptive study, with focus on paracoccidioiodomycosis patients with external genitalia lesions. The demographic and clinical aspects of cases were compared with what has been reported so far on LILACS, SciELO e MEDLINE data bases. RESULTS: Data of 483 cases of paracoccidioidomycosis were studied in a 42-year period. Six (1.2%) patients showed specific lesions on external genitalia. Five patients were male with mean age of 47.2 years and all of them presented with the chronic multifocal clinical form. Only one, a 15-year-old female patient was observed who showed a subacute clinical form, juvenile type. CONCLUSION: Compromise of the genitourinary tract among paracoccidioidomycosis patients is rare and even rarer when only the external genitalia are considered. As observed in the classical picture of paracoccidioidomycosis patients, the male gender and the chronic multifocal clinical form prevailed in the present study.
FUNDAMENTOS: Paracoccidioidomicose é micose sistêmica de interesse dermatológico pela freqüência de lesões tegumentares. Sua localização em genitália externa é extremamente rara e pouco descrita. OBJETIVOS: estudar a prevalência de lesões de paracoccidioidomicose de localização genital, identificar suas características clínicas e compará-las com a literatura específica. MÉTODOS: estudo descritivo, transversal, de série de casos, com inclusão de casos com lesões específicas de paracoccidioidomicose de localização genital externa, estudo das características demográficas e clínicas dos casos, confrontados com dados de revisão da literatura nas bases LILACS, SciELO e MEDLINE. RESULTADOS: foram revisados de 483 pacientes de paracoccidioidomicose diagnosticados no período de 42 anos. Seis (1,2%) pacientes apresentavam lesão específica de genitália externa. Cinco eram do sexo masculino com idade média de 47,2 anos e todos com a forma crônica multifocal da doença, O único caso do sexo feminino, de 15 anos de idade, apresentava a forma subaguda, tipo juvenil. CONCLUSÕES: o comprometimento do trato geniturinário na paracoccidioidomicose é raro e mais ainda quando se considera apenas as localizações de genitália externa. Como na paracoccidioidomicose clássica, o sexo masculino e a forma crônica da doença predominaram na amostragem estudada.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Genital Diseases, Female/pathology , Genital Diseases, Male/pathology , Paracoccidioidomycosis/pathology , Cross-Sectional Studies , Diagnosis, Differential , Genital Diseases, Female/diagnosis , Genital Diseases, Male/diagnosis , Paracoccidioidomycosis/diagnosisABSTRACT
1. Mucormicose (zigomicose) é micose oportunística causada por fungos da ordem Mucorales, gêneros Rhizopus spp., Mucor spp., Rhizomucor spp. e Absidia spp., entre outros. 2. Mucormicose é enfermidade mais incidente em diabéticos em cetoacidose, pacientes com doenças linfoproliferativas, pós-transplantados e naqueles sob corticoterapia prolongada. 3. O subtipo clínico rinocerebral é o mais frequente e manifesta-se, em geral, por edema e dor periorbital, necrose cutâneo-mucosa e rápida evolução para comprometimento do sistema nervoso central. 4. O diagnóstico precoce é fundamental para que as chances de sobrevida sejam maiores. 5. Terapia antifúngica com anfotericina B, desbridamento cirúrgico precoce e reversão dos predisponentes sistêmicos são as condutas recomendadas.
Subject(s)
Humans , Male , Adult , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/pathology , Lupus Erythematosus, Systemic/therapy , Mucormycosis/complications , Mucormycosis/diagnosis , Mucormycosis/mortality , DermatomycosesABSTRACT
The authors report a case of paracoccidioidomycosis misinterpreted as tuberculoid leprosy, both on clinical and histological examination. Sarcoid-like cutaneous lesion as the initial presentation is rare in young patient with paracoccidioidomycosis and can simulate other infectious or inflammatory diseases. On histology, tuberculoid granuloma presented similar difficulties. Treatment with dapsone, a sulfonamide derivative, could have delayed the presumed natural clinical course to the classical juvenile type of paracoccidioidomycosis, observed only 24 months after the patient had been treated for leprosy.
Subject(s)
Leprosy, Tuberculoid/diagnosis , Paracoccidioidomycosis/diagnosis , Adult , Diagnosis, Differential , Diagnostic Errors , Female , Humans , Paracoccidioidomycosis/drug therapy , Paracoccidioidomycosis/pathologyABSTRACT
The authors report a case of paracoccidioidomycosis misinterpreted as tuberculoid leprosy, both on clinical and histological examination. Sarcoid-like cutaneous lesion as the initial presentation is rare in young patient with paracoccidioidomycosis and can simulate other infectious or inflammatory diseases. On histology, tuberculoid granuloma presented similar difficulties. Treatment with dapsone, a sulfonamide derivative, could have delayed the presumed natural clinical course to the classical juvenile type of paracoccidioidomycosis, observed only 24 months after the patient had been treated for leprosy.
Os Autores relatam um caso de paracoccidioidomicose diagnosticado como se fora hanseníase tuberculóide, tanto do ponto de vista clínico como histopatológico. Lesão cutânea de padrão sarcoídico é raramente observada como lesão inicial da paracoccidioidomicose em jovens e pode simular outras dermatoses infecciosas ou inflamatórias. O achado histológico de granuloma tuberculóide apresenta dificuldade diagnóstica similar. O tratamento realizado com dapsone, um derivado sulfamídico, pode ter retardado a evolução clínica esperada para o padrão clássico da paracoccidioidomicose tipo juvenil, o qual apenas se materializou 24 meses após a paciente ter iniciado tratamento como hanseníase.
Subject(s)
Adult , Female , Humans , Leprosy, Tuberculoid/diagnosis , Paracoccidioidomycosis/diagnosis , Diagnosis, Differential , Diagnostic Errors , Paracoccidioidomycosis/drug therapy , Paracoccidioidomycosis/pathologyABSTRACT
Descreve-se caso clínico de paciente do sexo masculino, jovem, imunocompetente, portador de melanoníquia fúngica no terceiro pododáctilo causado por Scytalidium dimidiatum. Discutem-se a semiotécnica diagnóstica, seus diferenciais e a terapêutica adequada. Os autores destacam que a etiologia fúngica deva ser considerada no diagnóstico das melanoníquias.
The authors report the case of a young, immunocompetent male, affected by fungal melanonychia in the third toe, caused by Scytalidium dimidiatum. The Diagnostic procedures, the differential diagnosis and adequate treatment are also discussed. The authors remark that a fungal etiology should be considered in the diagnosis of melanonychia.
