Cyphellophora laciniata: A new etiological agent of chromoblastomycosis.

Chromoblastomycosis is a chronic subcutaneous mycosis caused by traumatic inoculation of dematiaceous fungi especially in tropical and subtropical areas. Cyphellophora genus include melanized fungi reported as etiological agents of skin and nail infections. We report a 60-year-old male from the south of Mexico with a 40-year history of chromoblastomycosis caused by Cyphellophora laciniata. The isolated fungus was identified by sequencing of the internal transcribed spacer region of rDNA. The patient was treated with itraconazole and cryosurgery with unsatisfactory results.

Phaeohyphomycosis Caused by a Novel Species, Pseudochaetosphaeronema martinelli.

Among the opportunistic mycoses that are emerging in patients with immunosuppression or severe underlying illness, many isolates lack of characteristic sporulation and until recently could not be identified. Clinical signs are mostly nonspecific and therefore such infections have often been disregarded. In the present paper we describe a novel, nonsporulating fungal species causing subcutaneous phaeohyphomycosis in two patients of different origin. One is a 73-year-old female from Martinique who suffered from rheumatoid arthritis, while the other case concerns a 72-year-old male from Mexico who had a history of type 2 diabetes mellitus. Sequencing of the partial ribosomal operon revealed that in both cases a member of the order Pleosporales was concerned which could not be affiliated to any family within this order. Multilocus analysis revealed that the fungus was related to another, unaffiliated agent of human mycetoma, Pseudochaetosphaeronema larense, and therefore the name Pseudochaetosphaeronema martinelli was introduced.

Nocardia harenae, an uncommon causative organism of mycetoma: report on two patients.

Mycetoma is the most frequently diagnosed deep mycosis in Mexico and is caused, in 86% of cases, by Nocardia brasiliensis. Worldwide, Nocardia harenae has not been previously reported as a causative agent of human mycetoma. Herein we report, to our knowledge, the first two human cases of mycetoma due to N. harenae in a clinical setting. The strains were identified by phenotypic and molecular techniques. Both cases were characterized by long-lasting mycetoma that had previously been failed to be cured and had shown resistance to therapy. However, in our hospital, a multidrug therapy proved to be effective in these cases.

Onychomycosis. A Mexican survey.

Onychomycosis is a nail infection caused by dermatophytes, Candida and molds. We aimed to obtain an estimated frequency of onychomycosis in out-patients in private practice through a survey in ten representative cities of Mexico. 12,637 ambulatory patients voluntarily agreed to participate in this National Survey, answering 17 questions on onychomycosis, regardless if they had or did not have any clinical suspicion of onychomycosis. 53% of them were seen for the first time and their main complaint was not onychomycosis. The study was performed in the private offices of 300 physicians in different cities. 48% were clinically diagnosed with onychomycosis. Toenails were affected in 88%, fingernails in 5% and both in 7%. Onychomycosis was diagnosed more frequently in the nails of the first toes and of the thumbs. The main complaint was nail thickening and aesthetic changes. Other associated diseases were diabetes (22%) and arterial hypertension (21%). This survey showed the high frequency of onychomycosis. An intentional search with mycological confirmation is needed in out-patients attending general practice with other complaints, to detect undiagnosed cases.

Ulceras por complejo vásculo-cutáneo de pierna. Seguridad y eficacia en el tratamiento con peentoxifilina: estudio doble ciego en 30 pacientes / Leg ulcers treated with pentoxifylline: double blind trial in 30 patients

La pentoxifilina es un agente hemorreológico que aumenta la flexibilidad de los eritrocitos, disminuye la viscosidad sanguínea y la adhesividad plaquetaria. Se realizó un estudio en pacientes con úlcera por complejo vasculocutáneo de pierna, doble ciego al azar comparativo con placebo en 30 pacientes. Cinco abandonaron el tratamiento. Se evaluaron cada cuatro semanas por seis meses con 1,200 mg. al día de pentoxifilina repartidos tres veces al día, después de las comidas. Con pentoxifilina se presentó mejoría en un 74.9% mientras que con el placebo sólo un 30%, con el medicamento la curación fue del 25%, con placebo sólo 10%. Hay efectos colaterales que consistieron en anorexia, náuseas y pirosis. Se ha encontrado también disminución rápida y notable del dolor y mejoría de linfoestasis.