[Chromoblastomycosis in Gabon. Study of 64 cases]. / La chromoblastomycose au Gabon. Etude de 64 cas.

During the last 25 years, 64 cases of chromoblastomycosis were diagnosed in Gabon. They came from the entire territory, where living in rural zones men as well as women were affected. The evolution of the disease has lasted for more than 10 years for the majority of the cases. The preferential location is the lower limb for 78.5% of the patients, with a double localization for one case and an exceptional malignant transformation for another case. Two clinical aspects emerged, despite an apparent polymorphism: extensive patches and warty nodules, spread apart from or adjacent to the others. The histological images were classical and the fumagoid cells, sometimes budding and filamentous, were easily detected during examination of the squama and scabs. Fonsecaea pedrosoï was the only identified species. The 5-fluorocytosine treatment constantly led to an improvement of the lesions. The major problem for these destitute patients is economic, concerning the cost of the therapy.

White piedra and Trichosporon species in equatorial Africa. I. History and clinical aspects: an analysis of 449 superficial inguinal specimens.

White piedra is a hair infection characterized by nodules composed of fungal elements which envelop the hair shaft. Classically, this infection was considered to be produced by an asexual yeast-like fungus, Trichosporon beigelii. At present, in accordance with studies carried out previously, this species is subdivided into six newly defined distinct species (T. asahii, T. ovoides, T. inkin, T. mucoides, T. asteroides and T. cutaneum), all belonging to the class Basidiomycetes. Although widespread, white piedra has not previously been described in tropical regions of Africa. The present study, carried out in Libreville (Gabon), an equatorial region of Africa, shows that the incidence of this infection is quite high (18% of 449 inguinal specimens) in the female population aged 15-60 years, with a predominance in young patients (15-44 years). The relationship between the clinical manifestations and the specific hair lesions is also detailed. Three species belonging to the genus Trichosporon were identified: T. mucoides, T. asahii and T. inkin.

White piedra and Trichosporon species in equatorial Africa. III. Identification of Trichosporon species by slide agglutination test.

Fifty-two Trichosporon strains isolated from Gabonese female patients 15-60 years, were studied. The identity of these strains was established by two different methods: the method proposed by Guého et al. (1992), based on mycological criteria, and a slide agglutination method performed with monospecific antisera prepared in our laboratory. The final results show a perfect correlation between the two methods, which allowed us to identify 25 strains of T. mucoides, 21 strains of T. inkin and seven strains of T. asahii. The results of the agglutination tests performed with 24-h-old subcultures grown on Sabouraud glucose agar are available in less than 15 mins. In the light of these results, it appears that this method, which is rapid and easy to perform and reproduce, may readily be used in hospital laboratories. In addition, this method allowed us to verify the presence of antigens common to the genera Cryptococcus and Trichosporon, which were easily shown by the use of crude sera. The fact that the anti-Trichosporon monospecific sera lose their capacity to agglutinate Cryptococcus neoformans proves their high specificity.

White piedra and Trichosporon species in equatorial Africa. II. Clinical and mycological associations: an analysis of 449 superficial inguinal specimens.

Eighty-one of 449 Gabonese female patients examined were found to be positive for genitopubic white piedra. The association with trichobacteriosis is frequent (53 cases), and mostly seen with inguinal intertrigo. Fifty-two strains belonging to the genus Trichosporon were isolated from genital hairs as well as from inguinal intertrigo lesions. These strains were identified in accordance with previously defined morphological and biochemical criteria. Three species were recognized: T. mucoides (25 strains), T. inkin (20 strains) and T. asahii (seven strains). Their macroscopic and microscopic morphological properties, as well as their ability to reduce tetrazolium, were determined. In addition, the study of the clinical and pathogenic associations in which each of these strains was involved revealed some of their particular properties.

Hendersonula toruloidea as an agent of mycotic foot infection in Gabon.

Pathogenic fungi were isolated from 149 of 210 Gabonese patients with clinical signs of tinea pedis. Hendersonula toruloidea was isolated from 51 patients (34.2%), either alone (in 25%) or in association with a dermatophyte species or Candida albicans. Clinical signs of H. toruloidea infection closely resembled those of dermatophyte infection except that hyperkeratinization of the soles was most often associated with infection by H. toruloidea. H. toruloidea mycelium could be readily distinguished from dermatophyte mycelium on direct examination of skin scrapings. All the H. toruloidea isolates closely resembled the Type 1 isolates described by Moore, both microscopically and macroscopically. The importance of establishing a mycological diagnosis of this infection and the therapeutic implications of infection with H. toruloidea are discussed. This fungus was isolated from 34% of our patients from Gabon with clinical tinea pedis.

[Fungal otitis in Libreville. Study of 83 cases]. / Les otites mycosiques à Libreville. Etude de 83 cas.

83 cases of mycotic otitis of external ear are reported during a period of 27 months from three departments of otorhinolaryngology in Libreville (Gabon, Central Africa) Prevalence is estimated at about 25% among all infectious otitis. The main functional signs are pruritus, otorrhea, pain and hypoacousia. The physical examination shows masse of white, grey, black or creamy caseous debris, invading the external auditory meatus (EAM) which is sometimes inflammatory. Fungal species responsible of otitis are Aspergillus (54%), yeasts (45%) mainly Candida, infrequently Fusarium (1%). A niger (26%), A. flavus (17%), Candida parapilosis (18%), Candida albicans (9%) are predominant species isolated (70%) among all the 21 species of identified fungi from otomycosis in Gabon. Therapy, done by thorough washing of the ear followed by insertion into the EAM of a wick soaked in Econazole or Amphotericin B, is quickly effective.

[Superficial mycoses in a wooded region of Gabon: results of fungus isolation]. / Les mycoses superficielles en zone forestière gabonaise: bilan des champignons isolés.

The authors draw up an inventory of the dermatophytes in Gabon (13 species isolated from 593 people in the wet and hot forest). They show the clear prevalence of Microsporum langeroni, Trichophyton soudanense, Trichophyton rubrum, and Epidermophyton floccosum, Trichophyton violaceum also is fairly often isolated. More infrequently, they find T. mentagrophytes, T. mentagrophytes var. interdigitale, T. gourvili, M. canis, M. audouini, T. yaoundei, M. gypseum.

[Five cases of chromomycosis in Gabon (author's transl)]. / A propos de cinq cas récents de chromomycose au Gabon.

Five cases of chromomycosis were studied in the parasitological and mycological department of the National Laboratory and C.U.S.S. in Libreville (Gabon). Different types of lesions were observed which were more often maculous than verrucous. In one case, it was localized on the upper limb, and in four cases on the lower limbs. They all were diagnosed after a 2 to 25 years evolution. Fonsecaea pedrosoï was isolated in every case. Direct examinations always recovered the classical scleratic cells : in one case it was budding, and in two cases abundant mycelium was seen. No epidemiological argument can explain the geographical distribution.