Alberto Salebian

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.

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 Sao Paulo, Brazil. The patient was successfully treated with oral fluconazole in a prolonged regimen. The diagnosis was confirmed by histopathological and mycological data.

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 Authors 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.Os Autores registram dois casos de eumicetoma de graos pretos, com localizacao podal, procedentes da Bahia, provocados por Madurella grisea Mackinnon et al., 1949. Sao estudadas a estrutura dos graos, bem como as caracteristicas micromorfologicas do fungo em vida saprofitica. Acreditam os Autores que estas observacoes correspondem ao setimo e oitavo casos registrados na literatura do pais, provocadas por este fungo. Os Autores consideram nomen dubium ou nomina confusa as seguintes especies de Madurella: M. ramiroi, M. oswaldoi, M. bovoi, M. tozeuri, M. mansonii, M. brumpti, M. reynieri, M. americana, M. lackawanna e M. ikedae, o mesmo ocorrendo com a chamada Rubromadurella mycetomi. As unicas especies validas sao Madurella mycetomatis McGinnis, 1980 (=Madurella mycetomi Brumpt, 1905) e Madurella grisea Mackinnon et al., 1949. Nos dois casos registrados o tratamento com itraconazol, por um periodo de 3 meses nao fez regredir as lesoes, havendo ligeira melhora clinica.

Disseminate Sporotrichosis - Report of a Clinical Case with Mucocutaneous, Osteo-Articular, and Ocular Lesions*

Summary: This paper reports a case of disseminate sporotrichosis with cutaneous, mucous, osseous, and ocular lesions, a fact rarely registered in the literature, mainly because it happened in Brazil where this mycosis is frequent. The cutaneous and mucous lesions were severe, causing irreversible sequelae. Of special gravity was the ocular lesion resulting in blindness of the affected eye. The study showed no altered delayed immunity.

Ultrastructure of black piedra

Summary. Black piedra or nodular tricho‐mycosis 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.

Feo-hifomicose subcutânea por Exophiala jeanselmei: registro de três casos em transplantados renais

We report three cases of subcutaneous phaeohy-phomycosis 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)27 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 immunosupressive 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. A review of the literature was carried out with the report mainly of cases published in Brazil.

Células fúngicas permanecem viáveis por até doze dias em lesões de cromomicose tratadas pela criocirurgia com nitrogênio líquido

FUNDAMENTOS: A criocirurgia com nitrogenio liquido (C-N2L) e um metodo terapeutico que vem sendo usado com frequencia crescente no tratamento da cromomicose. Acreditava-se anteriormente que as temperaturas baixas poderiam destruir o agente infectante, mas foi demonstrado que as culturas fungicas em temperaturas tao baixas como -196°C nao causaria a morte do mesmo. Apesar da comprovada eficacia, ainda nao se conhece o exato mecanismo de cura. OBJETIVO: Avaliar o periodo de persistencia de fungos viaveis em lesoes de cromomicose tratadas pela C-N2L. PACIENTES E METODOS: Cinco pacientes com cromomicose tiveram suas lesoes tratadas pela C-N2L. Foram colhidos, em diferentes intervalos de tempo apos a criocirurgia, fragmentos do tecido tratado. A coleta, realizada com punch de 4mm, foi feita em tres periodos diferentes: de 0 a 48h, de cinco a sete dias e de 10 a 14 dias apos a realizacao da criocirurgia. Os fragmentos obtidos foram inoculados em Agar Sabouraud para verificacao de crescimento de colonias fungicas. Cada paciente teve um total de tres amostras colhidas, uma em cada um dos tres periodos mencionados. RESULTADOS: O crescimento de colonias foi maior nas coletas mais precoces, enquanto nas amostras colhidas entre o pos-operatorio imediato e o quinto dia de pos-operatorio o indice de viabilidade foi de 7/8 (87,5%), e naquelas colhidas a partir do sexto dia de pos-operatorio foi de apenas 2/7 (28,5%). O maior periodo de pos-operatorio que demonstrou positividade foi de 12 dias. CONCLUSAO: Os resultados confirmam os achados anteriores, os quais demonstraram que as baixas temperaturas alcancadas pela C-N2L nao sao responsaveis pela destruicao dos fungos nas lesoes de cromomicose. Os autores acreditam que fenomenos biologicos tardios, como necrose ou imunoestimulacao sejam os verdadeiros responsaveis pela erradicacao dos fungos nas lesoes de cromomicose.

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.Four cases of Tinea favosa occurred in the same family are reported in a small city of Brazil (Itapecerica da Serra - State of Sao Paulo). Trichophyton schoenleinii was isolated from all four cases. Treatment consisted of oral griseofulvin (10 mg/kg/day) for at least three months.Os autores relatam 4 casos de tinha favosa por Trichophyton schoenleinii de ocorrencia familiar, identificados na cidade de Itapecerica da Serra, municipio da Grande Sao Paulo. Todos os casos foram tratados com griseofulvina por via oral na dose de 1.0 mg/kg/dia por no minimo 3 meses, tendo ocorrido cura clinica e laboratorial em 2 pacientes, e os dois restantes necessitaram de terapeutica mais prolongada.

First case of human infection by trichophyton vanbreuseghemii in Brazil.

This paper reports the first case of human infection caused by Ttrichophyton vanbreuseghemii in Brazil.