[Evaluation of the possible influence of Montenegro's intradermal reaction on a serological assay for the diagnosis of American cutaneous leishmaniasis]. / Avaliação de eventual influência da intradermorreação de Montenegro sobre prova sorológica para o diagnóstico da Leishmaniose tegumentar americana.

Influence of Montenegro skin test for American tegumentar leishmaniasis was evaluated to verify possible interference in serological diagnosis for this disease, performed by immunoenzymatic assay (ELISA). If this interference could occur, it would hamper scientific, epidemiological and patient care; happily we did not find any interference on serological diagnosis by performance of skin testing.

[Subcutaneous phaeohyphomycose due to Exophiala jeanselmir. Report of 3 cases in patients with a kidney transplant]. / Feo-hifomicose subcutânea por Exophiala jeanselmei. Registro de três casos em transplantados renais.

We report three cases of subcutaneous phaeohyphomycosis due to Exophiala jeanselmei (Langeron) McGinnis et Padhye 1977, in kidney transplant patients. Exophiala jeanselmei is a dematious fungus having also ability to rarely procedure eumycetoma (black grains). According to KWON-CHUNG & BENNETT (1992) such fungus is antigenically very heterogeneous, since so far three serotypes have been identified; each serotype including subgroups. Subcutaneous phaeohyphomycosis is becoming more and more frequent in kidney transplant patients submitted to an immunosuppressive treatment. As Exophiala jeanselmei has already been isolated from the environment it becomes difficult to explain the pathogenicity of these cases by a reactivation of quiescent processes. The authors suggest an occasional fungistatic action of cyclosporine A upon Exophiala jeanselmei.

African histoplasmosis. Report of the first case in Brazil and treatment with itraconazole.

We report the first case of African histoplasmosis diagnosed in Brazil. The patient was an immigrant from Angola who had come to Brazil six months after the appearance of the skin lesion. The skin of the right retroauricular area was the only site of involvement. The diagnosis was established by direct mycologic examination, culture and by histopathologic examination of the lesion. The patient was successfully treated with Itraconazole 100mg a day for 52 days. No recurrent skin lesions were observed during the ten month follow-up period.

Mycetoma: a retrospective study of 41 cases seen in São Paulo, Brazil, from 1978 to 1989.

Clinical and epidemiological aspects of 41 cases of mycetoma seen in São Paulo city from January 1978 to December 1989 are presented. Twenty-eight cases (68%) were caused by actinomycetes, while 13 (32%) were caused by true fungi. In only 22 (78%) actinomycetoma cases was it possible to identify the agent. Nocardia brasiliensis, by far the commonest actinomycete isolated, was responsible for 13 cases. Among eumycetomata, Madurella grisea was isolated from 3 cases, Scedosporium apiospermum from 2 cases, and Madurella mycetomatis from 1 case, and in 7 cases the agent was not identified. Distribution by sex and age was similar to that reported in the literature. Feet and legs were the commonest sites affected. The mean age of actinomycetoma patients was 33.2 years, while patients with eumycetomata were an average of 32.8 years. Mean duration of the disease was 6.8 and 9.8 years respectively. Most patients came from rural areas in the north-eastern region of the country and worked as field labourers. Bone involvement was frequent for both actinomycetomata and eumycetomata and was characterized by osteoporosis, periostal reaction and cavitation. The authors' elected treatment consists of combining sulfamethoxazole (800 mg) and trimethoprim (100 mg) with prednisone (10 mg) orally, daily.

[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.

[Rhinofacial entomophthoromycosis due to Conidiobolus coronatus. A report of a case treated successfully with fluconazole]. / Entomoftoromicose rinofacial por Conidiobolus coronatus. Registro de um caso tratado com sucesso pelo fluconazol.

A case of rhinofacial entomophthoromycosis caused by Conidiobolus coronatus is reported in a 30-years-old male from São Paulo, Brazil. The patient was successfully treated with oral fluconazole in a prolonged regimen. The diagnosis was confirmed by histopathological and mycological data.

Ultrastructure of black piedra.

Black piedra or nodular trichomycosis is a superficial mycosis of the hair shaft, prevalent in the tropical areas of South America and Asia and caused by the fungus Piedraia hortai. By scanning electron microscopy the invasion of the hair keratin and the elimination of spores through canals was seen. Transmission electron microscopy showed a complex, well-organized microsystem, in which cement-producing hyphae constitute the pseudoparenchyma. Both sexual and asexual reproduction were found. Sexual reproduction gives rise to ascospores and asexual reproduction to arthrospores. The ascospores were found in thick-walled bags, the asci; the arthrospores, that undergo gemmation, are eliminated through canals, disseminating the disease.

Hyalohyphomycosis by Paecilomyces lilacinus in a renal transplant patient and a review of human Paecilomyces species infections.

A case of hyalohyphomycosis caused by Paecilomyces lilacinus is described in a renal transplant patient. Infection was localized on the left forearm. Two separate cultures of the lesions yielded the same organism. Histological sections disclosed hyaline elements in the tissue. The infection responded well to therapy with oral griseofulvin (500 mg daily) and the patient was cured within 45 days. Forty-six cases of human infection due to Paecilomyces species have been reported previously in the literature, most of them occurring in conjunction with prosthesis implants or immunosuppression. The antifungal sensitivity of Paecilomyces varies widely among the species but the general trend is for Paecilomyces variotii isolates to be almost universally sensitive to amphotericin B and 5-fluorocytosine, while P. lilacinus and Paecilomyces marquandii isolates are resistant to these antifungals but sensitive to the imidazoles.

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.

[Tinea favosa. Report of a familial occurrence in Itapecerica da Serra (municipality of Greater São Paulo)]. / Tinha favosa. Relato de ocorrência familiar em Itapecerica da Serra (município da grande São Paulo).

Four cases of Tinea favosa occurred in the same family are reported in a small city of Brazil (Itapecerica da Serra--State of São Paulo). Trichophyton schoenleinii was isolated from all four cases. Treatment consisted of oral griseofulvin (10 mg/kg/day) for at least three months.

[Botryomycosis]. / Botriomicose.

Four cases of botryomycosis are presented. All patients had fistulous and ulcerated lesions of the lower limbs. Diagnosis was based on the clinical and laboratory findings (presence of grains on direct microscopy examination and positive bacterial cultures). All patients had osteomyelitis. Three were treated with antibiotics or sulfonamides (orientated by the antimicrobial susceptibility test) and were cured.

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

Cromomicosis. Estudio de 37 casos. / Chromomycosis. Study of 37 cases

Se presenta un estudio de 37 casos de cromomicosis examinados en el Departamento de Dermatologia del Hospital de Clinicas de los 30 y 49 anos (5l%). El mas joven tenia cientes, 28 provenian de areas rurales. La mayor incidencia de casos se observo entre los30 y 49 anos (51%). El mas joven tenia 16 anos y el mayor 63. Solo 2 fueron mujeres. El principal sitio de infeccion fue el miembro inferior (89.1%), el miembro superior fue afectado en el 10.9%. Ninguno de los enfermos tenia lesiones en cara o tronco. La complicacion mas frecuente fue la infeccion bacteriana. Se observo en 22 casos linfedema y/o elefantiasis. Un paciente portador de una ulcera cronica desarrollo un epitelioma (directo y cultivo) e histologico. La especie fungica Fonsecaea pedrosi fue cultivada en 36 de los 37 pacientes. La combinacion de 5-fluorocitosina y anfotericina B fue considerada el tratamiento de eleccion de la cromomicosis

Cromomicosis. Estudio de 37 casos. / Chromomycosis. Study of 37 cases

Se presenta un estudio de 37 casos de cromomicosis examinados en el Departamento de Dermatologia del Hospital de Clinicas de los 30 y 49 anos (5l%). El mas joven tenia cientes, 28 provenian de areas rurales. La mayor incidencia de casos se observo entre los30 y 49 anos (51%). El mas joven tenia 16 anos y el mayor 63. Solo 2 fueron mujeres. El principal sitio de infeccion fue el miembro inferior (89.1%), el miembro superior fue afectado en el 10.9%. Ninguno de los enfermos tenia lesiones en cara o tronco. La complicacion mas frecuente fue la infeccion bacteriana. Se observo en 22 casos linfedema y/o elefantiasis. Un paciente portador de una ulcera cronica desarrollo un epitelioma (directo y cultivo) e histologico. La especie fungica Fonsecaea pedrosi fue cultivada en 36 de los 37 pacientes. La combinacion de 5-fluorocitosina y anfotericina B fue considerada el tratamiento de eleccion de la cromomicosis

Reacao intradermica ao antigeno EP-1 de Fonsecaea pedrosoi. / Skin test with EP-1 antigen of Fonsecaea pedrosoi

Utilizando antigeno fornecido pelo Prof.Tokio Iwatsu, da Escola de Medicina da Universidade de Chiba (Japao), obtido atraves da precipitacao pelo etanol, de um filtrado de cultura de Fonsecaea pedrosoi (antigeno EP-1), os autores obtiveram reacoes intradermicas negativas em cinco pacientes de paracoccidioidomicose (paracoccidioidino-positivos) e em sete individuos normais. Em nove doentes com dermatite verrucosa, provocada pela Fonsecaea pedrosoi, seis reacoes se mostraram positivas (66,6%). Em um paciente com lesao cicatricial no dorso da mao E, antigo doente de cromomicose, no qual a prova intradermica mostrou-se positiva, o exame direto e as culturas foram negativas, demostrando este dado que a hipersensibilidade do tipo tardio persiste mesmo apos a cura clinica e micologica. Em tres pacientes nos quais se praticou biopsia da reacao positiva, o quadro histopatologico foi compativel com hipersensibilidade do tipo tardio. Os dados obtidos em um numero limitado de pacientes demonstraram a especificidade do antigeno e sua relativa sensibilidade. Uma pesquisa encontra-se em andamento, para se detectar eventuais casos de cromomicose-infeccao

Botriomicose. / Botryomycosis

Os autores apresentam um caso de botriomicose tegumentar, no qual os agentes etiologicos identificados foram Staphylococcus aureus e Escherichia coli e constataram, em revisao bibliografica, apenas 68 casos humanos publicados na literatura mundial e o primeiro na nacional. O doente foi tratado um ano com antibiotico e quimioterapia associados e obteve-se cicatrizacao total das lesoes