ABSTRACT
La Zigomicosis es una infección infrecuente causada por hongos oportunistas integrantes del orden Mucorales, que se presenta en pacientes de alto riego como en: leucemia, linfomas con neutropenia prolongada, cetoacidosis diabética, malnutrición severa, ruptura de la integridad de la barrera cutánea y terapia inmunosupresora. Se presenta un caso de Zigomicosis cutánea en una paciente pediátrica con leucemia linfoblástica aguda de tipo B, con severa neutropenia y tratamiento con corticoides. A los cinco días de su hospitalización desarrolló en el antebrazo (zona de punción venosa), una lesión indurada, eritematosa, que progresó y ulceró. A partir de exudados y biopsias del tejido subcutáneo se realizaron exámenes microscópicos directos con KOH, cultivos en agar Sabouraud y estudio histológico a través de técnicas convencionales de hematoxilinaeosina y PAS. Los análisis de los materiales clínicos revelaron la presencia de hifas hialinas, no tabicadas, gruesas, compatibles con un Zygomycete. En todos los tubos se obtuvo abundante desarrollo de un hongo filamentoso, identificado como Rhizopus oryzae. Posteriormente a la escisión quirúrgica y tratamiento con anfotericina B se obtuvo una evolución favorable del paciente hasta el presente.
Zygomycosis is an infrequent infection caused by opportunistic fungi which belong to the order Mucorales and which is present in high risk patients diagnosed with : leukemia, lymphomas with prolonged neutropenia, diabetic cetoacidosis, severe malnutrition, rupture of the entire cutaneous barrier and immunesuppressing therapy. This paper deals with a case of cutaneous Zygomycosis in a pediatric patient diagnosed with acute lymphoblastic leukemia B type, suffering a severe neutropenia and corticosteroid treatment. On the fifth day of hospitalization, her forearm (venous puncture zone) showed an indured, erimatose lesion which progressed and ulcerated. Collection of exudates and biopsies of subcutaneous tissue served to carry out direct microsco-pic examinations with KOH, cultures in Sabouraud Agar and a histologic study through conventional hematoxilin-eosin and PAS techniques. Analyses of the clinical materials revealed the presence of hyaline, not septated and broad hyphae suitable to a Zygomycete. In all the tubes there was an abundant development of filamentous fungus identified as Rhizopus oryzae. After the surgical scission and treatment with anfotericine B, the patient showed a favorable evolution up to now.
Subject(s)
Humans , Female , Child, Preschool , Mucorales , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Zygomycosis/classification , Zygomycosis/diagnosis , Zygomycosis/etiology , Zygomycosis/microbiology , Zygomycosis/therapy , FungiABSTRACT
The interactions between health and the environment are at the heart of the concerns of the political actors in Villeurbanne. Their participation in the network "Villes-Santé" and the adoption of the Municipal Plan for the Environment, has incited them to promote a local approach based on the identification of the health problems linked to the environment that are expressed and felt by the inhabitants. The study, carried out among 567 individuals (1/150 of the inhabitants of Villeurbanne), showed that overall, 73% complain of two important environmental problems linked to their state of health: air pollution (48% of inhabitants), and noise (district noise 37%, and noise from the neighbours 24%). Traffic is the main source of these urban nuisances. Despite this, the environment is not very important in the minds of many people (36.5%) when compared to unemployment (68.1%), drugs (48.5%), and violence (58%).
