Dermatophytosis caused by Trichophyton raubitschekii. Report of the first case in São Paulo, Brazil.

The authors report the first case of dermatophytosis caused by Trichophyton raubitschekii in a patient from the State of São Paulo with Tinea corporis lesions localized on the buttocks. Culture on Sabouraud-agar with cycloheximide permitted the isolation and identification of the fungus, and the diagnosis was confirmed by Dr. Lynne Sigler, University of Alberta, Canada. Systemic treatment with fluconazole, 150 mg/week for 4 weeks, in combination with topical treatment with isoconazole initially yielded favorable results, with recurrence of the lesions after the medication was discontinued. This is the fifth case of this dermatophytosis published in the Brazilian medical literature.

Onychomycosis caused by Scytalidium dimidiatum. Report of two cases. Review of the taxonomy of the synanamorph and anamorph forms of this coelomycete.

The authors report two cases of onychomycosis in the dystrophic form, one of them involving an HIV-positive patient, provoked by Scytalidium dimidiatum, previously called Scytalidium lignicola. The subject is reviewed from the taxonomic viewpoint, considering the anamorph Hendersonula toruloidea as a synonym of Nattrassia mangiferae, and having Scytalidium dimidiatum as the major synanamorph. According to many mycologists, Scytalidium hyalinum may be a separate species or a hyaline mutant of Scytalidium dimidiatum. Scytalidium lignicola Pesante 1957 was considered to be the type-species of the genus by ELLIS (1971)13 and later to be a "conidial state" of Hendersonula toruloidea by the same author, today known as Nattrassia mangiferae. The microorganism lives only on the roots of certain plants (mainly Platanus and Pinus). It produces pycnidia and is not considered to be a pathogen, although it is considered as a possible emerging agent capable of provoking opportunistic fungal lesions. The importance of this topic as one of the most outstanding in fungal taxonomy, so likely to be modified over time, as well as its interest in the field of dermatologic mycology, are emphasized.

Paracoccidioides brasiliensis. A mycologic and immunochemical study of two strains.

The authors conducted a mycologic, immunochemical and molecular biology study on two strains of Paracoccidioides brasiliensis, one of them, called IBIA, isolated from soil in the municipality of IBIA (Minas Gerais) by Silva-Vergara et al. (1996, 1998), and the other, BAT, cultivated from a human case of paracoccidioidomycosis in Ribeirão Preto (São Paulo/Brazil) by Freitas Da Silva (1996). Both strains showed cotton-like (M) and yeast-like (Y) forms and were pathogenic for testicularly inoculated guinea pigs, producing granulomatous and/or suppurative orchitis. Immunochemically was demonstrated the presence of gp43 by double immunodiffusion, immunoelectrophoresis and immunoblotting.

Paracoccidioides cerebriformis Moore, 1935. Mycologic and immunochemical study.

The present study concern on mycologic and immunochemical data obtained from two samples of a fungus considered as belonging to the species Paracoccidioides cerebriformis described by Moore in 1935, and maintained since then on Sabouraud's agar in the mycology collection of the Instituto de Medicina Tropical de São Paulo. After 60 years, the samples exhibited the same characteristics described by MOORE (1935). However, experimental lesions did not resulted in guinea-pigs inoculated intratesticularly. The dominant antigen in Paracoccidioides brasiliensis, 43 kDa glicoprotein (gp43), could not be demonstrated by SDS PAGE and Western blotting. Immunoelectrophoresis did not demonstrated the E arch of cathodic migration using a policlonal anti gp43 serum. According to these findings, it is concluded that the fungus described by MOORE (1935) as P. cerebriformis does not belong to the genus Paracoccidioides. Paracoccidioidomycosis should therefore be considered as resulting from infection by a single species, Paracoccidioides brasiliensis (Splendore, 1912) as asserted by ALMEIDA (1930). Further studies, through molecular biology methods, could identify the mentioned fungus.

Reactivity of anti-gp43 antibodies from Paracoccidioides brasiliensis antiserum with extracts from cutaneous lesions of Lobo's disease. Preliminary note.

We demonstrated through several immunochemical tests the presence of gp43 from P. brasiliensis in extracts of cutaneous lesions from Jorge Lobo's disease. This glicoprotein is one of the immunodominant antigens in this species, and is used to identify it. The demonstration of gp43 tissues infected by the agent of Jorge Lobo's disease is an additional evidence for classifying it in the genera Paracoccidioides, species loboi.

Basidiomycosis: a review of the literature.

The basidiomycosis, fungal infections provoked by basidiomycetes or agaric fungi have been recorded at growing frequencies in the medical literature, especially after the advent of AIDS in 1991. The basidiospores of these fungi, scattered in the atmosphere and transported by winds or air currents, reach the maxillary sinuses through the nasal route, most of the times causing signs and symptoms of chronic sinusitis. Basidiomycetes have also been isolated from sputum, especially Schizophyllum commune. Lesions of the buccal mucosa, brain abscesses, onychomycosis and endocarditis have been described, with a growing interest in this type of deep mycosis on the part of mycologists and infectologists. The present paper reports descriptions of mycetism as well as infectious processes caused by basidiomycetes, such as Schizophyllum commune, Ustilago maydis (= Ustilago zeae) and Coprinus cinereus.

Paracoccidioides brasiliensis. A mycologic and immunochemical study of a sample isolated from an armadillo (Dasipus novencinctus).

A sample of P. brasiliensis isolated from the spleen and the liver of an armadillo (Dasipus novencinctus) has been analysed under a mycological and immunochemical viewpoint. The armadillo was captured in an area of Tucuruí (State of Pará, Brazil), the animal being already established as an enzootic reservoir of P. brasiliensis at that region of the country. This sample maintained in the fungal collection of the Tropical Medicine Institute of São Paulo (Brazil) numbered 135, has got all the characteristics of P. brasiliensis, with a strong antigenic power and low virulence for guinea-pigs and Wistar rats. The specific exoantigen of P. brasiliensis--the glycoprotein with a molecular weight of 43 kDa--was easily demonstrated with double immunodiffusion, immunoelectrophoresis, SDS-PAGE and immunobloting techniques.

Aspergillosis in immunocompromised children with acute myeloid leukemia and bone marrow aplasia. Report of two cases.

Two cases of Aspergillosis in immunocompromised children are reported. Both were caused by Aspergillus flavus. Early diagnosis and treatment led to the remission of the process. One patient had acute myeloid leukemia; the fungus was isolated from the blood. The other patient with bone marrow aplasia, presented an invasive aspergillosis of the paranasal sinuses with dissemination of fungal infection; the diagnosis was obtained by histology and culture of biopsied tissue from a palatal ulceration.

[Neurocryptococcosis caused by nonencapsulated Cryptococcus neoformans]. / Neurocriptococose por Cryptococcus neoformans não capsulado.

The case of a patient with meningoencephafalitis due to a nonencapsulated strain of Cryptococcus neoformans is reported; he had no risk factors for the disease or AIDS. Clinical examination showed a chronic meningoencephalitis first diagnosed as tuberculosis. In the second cerebrospinal fluid (CSF) examination after a week from admission yeasts appeared inside macrophage cells. CSF culture in Sabouraud medium disclosed nonencapsulated Cryptococcus neoformans (biochemical identification). Sample inoculation in mouse (intraperitoneal) evidenced a capsule that disappeared in several consecutive cultures. The morphology of the yeast was studied by electronic microscopy. After treatment with amphotericin B and 5-fluorocytosine the patient had a favorable evolution. The significance of capsular material is discussed.

[Cryptococcus neoformans chemotyping. Review of the literature. New epidemiologic data on cryptococcosis. Our experience with the use of C.G.B. media in the study of this yeast]. / Quimiotipagem do Cryptococcus neoformans. Revisão da literatura. Novos dados epidemiológicos sobre a criptococose. Nossa experiência com o emprego do meio de C.G.B. no estudo daquela levedura.

The purpose of this work was to collect the main information from the literature about the biotyping of Cryptococcus neoformans. The more up-to date research concerning the epidemiology of cryptococcosis comprising quite a few articles, mainly after the advent of AIDS, was also reviewed. The Cryptococcus neoformans varieties neoformans and gattii are well defined biochemically nowadays chiefly through the C.G.B. medium, according to Kwon-Chung et al. (1982). The isolation of C. neoformans var. gattii from flowers and leaves of Eucalyptus camaldulensis and Eucalyptus tereticornis, specially in Australia, through the works of Ellis & Pfeiffer (1990) and Pfeiffer & Ellis (1992) permitted very interesting epidemiological investigations on C. neoformans, a capsulated yeast by which Sanfelice, in Italy (1894; 1895) attracted attention of medical class. Busse, in 1894, described the first human case of cryptococcosis under the presentation of a bone lesion simulating sarcoma. In this paper, the Brazilian researchers focused on this subject were pointed out, followed by the Author's experience with the C.G.B. medium (L-canavanine, glycine and bromothymol blue) proposed by Kwon-Chung et al. (1982) with very good results. It was possible with such medium the study of 50 C.N.S. liquor samples, being 39 from AIDS patients (78%) and 11 from non-AIDS ones (22%). Thirty-seven out of the 39 HIV-positive patients (74%) were identified as C. neoformans var. gattii. From the negative HIV, 8 (16%) were classified as C. neoformans var. neoformans and 3 (6%) as C. neoformans var. gattii. We could not perform the serotyping of the above referred samples. It is evident anyway that in Brazil there exist both varieties gattii and neoformans, agents of neurocryptococcosis, including AIDS patients. The importance of neurocryptococcosis, mainly among AIDS patients, is stressed here, showing once more the value of C.G.B. medium in the typing of C. neoformans in its two varieties. Also, it is of relevant importance the demonstration that some species of eucalyptus may act as "host-trees" of C. neoformans var. gattii.

[Paracoccidioides brasiliensis, a new sample isolated from feces of a penguin (Pygoscelis adeliae)]. / Paracoccidioides brasiliensis, nova amostra isolada de fezes de um pinguim (Pygoscelis adeliae).

The Authors show the results obtained through the study of a Paracoccidioides strain isolated from a penguin in the Uruguaian Antartide by GEZUELE et al. (1989). From the fecal mater it was isolated a fungus which was recently considered as a new species of the genus Paracoccidioides--P. antarcticus. However, the mycological and immunochemical studies including the demonstration of the 43 kDa glycoprotein by immunodiffusion test, SDS-PAGE and immunoelectrophoresis disclosed that such strain is similar to P. brasiliensis. Other studies, based on molecular taxonomy, including karyotyping, are the only tools to confirm the possibility of such strain to be a variant of P. brasiliensis. The Authors report the epidemiological significance of that finding and suggest a review in the knowledge of the ecological "niche" of P. brasiliensis.

[Black-grain eumycetoma due to Madurella grisea. A report of 2 cases]. / Eumicetoma de grãos pretos por Madurella grisea. Registro de dois casos.

Two cases of black grains eumycotic mycetoma, occurring on a foot, are reported. Both proceeded from the state of Bahia (Brazil), and in both the etiologic agent was Madurella grisea Mackinnon et al., 1949. The grains structure as well as the micromorphologic characteristics of the fungus in saprophytic life were studied. It is the author's belief that these observations correspond to the 7th and 8th cases reported in the Brazilian medical literature. The authors do consider the following Madurella species as nomen dubium or nomina confusa: M. ramiroi, M. oswaldoi, M. bovoi, M. tozeuri, M. mansonii, M. brumpti, M. reynieri, M. americana, M. lackawanna e M. ikedae and the same for Rubromadurella mycetomi. The only valid species must be Madurella mycetomatis McGinnis, 1980 (= Madurella mycetomi Brumpt, 1905) and Madurella grisea Mackinnon et al., 1949. Treatment with itraconazole in both reported cases, for a 3 month duration, did not produce any regression of the lesions, the clinical improvement being meager.

[Bone marrow involvement and eosinophilia in paracoccidioidomycosis]. / Comprometimento da medula óssea e eosinofilia na paracoccidioidomicose.

The authors described three acute paracoccidioidomycosis patients with bone marrow involvement. P. brasiliensis yeast forms were observed in bone marrow smears of all them, and in one case, culture also revealed fungus growth. The mononuclear phagocytic system involvement, the blood eosinophilia and the negative skin hypersensibility responses were emphasized in all of them, as well as the severity of the disease in one case, with disseminated bone lesions and 20.260 eosinophils/mm3 in peripheral blood. The authors discuss the possible role of eosinophil in the host-parasite interaction in paracoccidioidomycosis, suggesting that TH 2 subpopulation activation and increased IL 5 and GM-CSF secretions may be responsible by eosinophilia in the most severe case.

In vitro action of some disinfectants on Paracoccidioides brasiliensis yeast forms

Descreveu-se a acao fungicida do hipoclorito de sodio (0,3; 1; 2,5; 5 e 10 por cento); do formaldeido (em solucao aquosa a 2,5 e 10 por cento); e alcool etilico a 70,0 por cento sobre formas leveduriformes de 2 cepas de Paraccoccidioides brasiliensis: Pb 18 e cepa Goiana, recentemente isolada. A incubacao do fungo e desinfetantes foi realizada a temperatura ambiente por periodos de 1, 2, 24, 48 e 72 horas. A viabilidade foi avaliada pelo tratamento com diacetato de fluoresceina-brometo de etideo; pela cultura em meios solidos e liquidos a 36 graus Celsius e 26 graus Celsius; transformacao de levedura em micelio a temperatura ambiente; e estudo radiometrico da atividade metabolica. Todas as concentracoes de todos os desinfetantes estudados foram capazes de inativar ambas as cepas, exceto na incubacao com formaldeido a 2 por cento por 1 hora, em que o tratamento por diacetato de fluoresceina-brometo de etideo revelou 40 por cento e 27 por cento de celulas viaveis, respectivamente, para a cepa Pb 18 e Goiana. A transformacao de levedura em micelio foi considerada um metodo rapido, com resultados semelhantes ao cultivo em meios solidos e liquidos.

In vitro action of some disinfectants on Paracoccidioides brasiliensis yeast forms.

The fungicidal action of sodium hypochlorite (0.3, 1, 2.5, 5 and 10%); formaldehyde (2, 5, and 10%); and ethyl alcohol (70%) on yeast forms of Paracoccidioides brasiliensis Pb 18 and a newly-isolated Goiana strain was described. Contact between the fungus and the disinfectants was maintained for 1, 2, 24, 48 and 72 hours at room temperature. Viability was evaluated by the fluorescein diacetate-ethidium bromide treatment, culture in solid and liquid media (36 degrees C and 26 degrees C); yeast to mycelial germination at room temperature; and radiometric study of metabolic activity. All concentrations of disinfectants were found to be effective in inactivating Pb 18 and Goiana strains, except for the 1-hour contact with 2% formaldehyde, in which fluorescein diacetate-ethidium bromide treatment was found to reveal 40 and 27% of viable cells, respectively. The yeast to mycelial germination method was considered to reveal faster and similar results as compared to culture in solid and liquid media.

Isolation and characterization of a Paracoccidioides brasiliensis strain from a dogfood probably contaminated with soil in Uberlândia, Brazil.

We report the isolation of a strain of Paracoccidioides brasiliensis from a dogfood, probably contaminated with soil, in a Brazilian city. The fungus was isolated on appropriate culture media, and when inoculated into a guinea-pig testis produced orchitis with abundant fungal elements. Histopathology of sections of the testicle showed an inflammatory reaction with P. brasiliensis inside monocytes. Immunological identification confirmed the identity of the isolate.

Cutaneous and ungual phaeohyphomycosis caused by species of Chaetomium Kunze (1817) ex Fresenius, 1829.

Two cases of cutaneous and ungual phaeohyphomycosis caused by species of Chaetomium are reported. The patients showed no clinical signs of immunodeficiency. In Case 1 there was a small, ulcerated, crusted lesion on the right forearm. Direct microscopical examination of material from this lesion showed light-brown hyphae with thick-walled cells. The fungus isolated was identified as Chaetomium globosum. Case 2 had lesions of the fingernails. Direct microscopy showed dematiaceous septate hyphae in the nail. The isolate from the nails was identified as Chaetomium perpulchrum. Identification of the fungi was based on the classification of Ames (1963) as adapted by Cooke (1986). Such infections due to Chaetomium species are rare.

Acao in vitro do ketoconazol e Bay n 7133 sobre a Malassezia furfur. / In vitro action of Ketoconazole and Bay n 7133 on Malassezia furfur

Os autores estudaram a acao in vitro do ketoconazol e do BAY n 7133 sobre a Malassezia furfur, usando oito amostras desta levedura lipofilica. Dados da literatura registram bons resultados clinicos com o emprego do ketoconazol por via oral no tratamento da pitiriase versicolor. Os resultados obtidos mostram que a sensibilidade ao ketoconazol foi ligeiramente superior aquela ao Bay n 7133. Assim, este ultimo fungicida foi ativo in vitro em concentracao que oscilou entre 0,25 a 2,0 micros/ml. Quanto ao Ketoconazol, as variacoes de sensibilidade foram de 0,06 micros/ml (uma amostra) a 0,25 micros/ml

Actinomicetoma por Actinomadura madurae, com extensas lesoes osseas. Registro de um caso. / Actinomycetoma with extensive lesions caused by actinomadura madurae. Report of a case

Os autores descrevem um caso de actinomicetoma da mao e antebraco, em mulher de 32 anos, cujo processo teve inicio em 1973, provocado por actinomiceto identificado como Actinomadura madurae. Em 1982, como o processo evoluia com extensas lesoes osseas, foi indicada amputacao, devido a progressao da infeccao para o antebraco. O exame histopatologico revelou graos parasitarios basofilicos, com a tipica franja periferica eosinofilica (fenomeno de Splendore-Hoeppli). O cultivo do material permitiu o isolamento de um actinomiceto, identificado como Actinomadura madurae (graos branco-amarelados). Tudo faz crer que o presente caso represente o 11o. publicado na literatura nacional