Danielle Patrícia Cerqueira Macêdo

Avaliação clínica e micológica de onicomicose em pacientes brasileiros com HIV/AIDS

INTRODUCAO: Onicomicoses sao comuns em pacientes imunocomprometidos embora especies emergentes tenham sido verificadas, modificado o perfil epidemiologico desta micose. Assim, o objetivo desta pesquisa e avaliar o perfil clinico e micologico da onicomicose em pacientes com infeccao pelo HIV/AIDS. METODOS: Amostras clinicas foram coletadas, processados para exame direto e a cultura mantida a temperatura de 30°C e 37oC durante 15 dias. RESULTADOS: Dos 100 pacientes, 32 apresentavam onicomicose. Os agentes isolados foram Candida albicans, C. parapsilosis, C. tropicalis, C. guilliermondii, Trichophyton rubrum, T. mentagrophytes, Fusarium solani, Scytalidium hialinum, S. japonicum, Aspergillus niger, Cylindrocarpon destructans e Phialophora reptans. CONCLUSOES: Onicomicoses em HIV/AIDS apresentam variadas manifestacoes clinicas e podem ser causadas por fungos emergentes. As peculiaridades apresentadas pelos diferentes agentes de origem fungica justificam a necessidade de identificacao ao nivel da especie, com a finalidade de orientar uma melhor abordagem terapeutica e minimizar a exposicao desses pacientes a condicoes de risco de uma infeccao disseminada.

A case of invasive rhinosinusitis by Fusarium verticillioides (Saccardo) Nirenberg in an apparently immunocompetent patient

A case of chronic invasive rhinosinusitis in an apparently healthy man, caused by Fusarium verticillioides, is described. The identity of the isolate as F. verticillioides was established by demonstrating characteristic morphological features and by amplification of rDNA using species-specific primers. Surgical debridement of the infected nasal tissue and therapy with amphotericin B resulted in a favorable outcome. To the best of our knowledge, F. verticillioides has not been described previously to cause this condition.

Pathogenic aspects of Epidermophyton floccosum langeron et milochevitch as possible aethiological agent of Tinea capits

The aim of this research was to verify the ability of 15 isolates of Epidermophyton floccosum to perforate hair in vitro and characterize them for pathogenicity factors such as growth at 37oC and proteinase and phospholipase production. Fourteen isolates perforated hair and from these twelve produced perforating organs. All isolates grew at 37oC and produced proteinase, but not phospholipase. These results suggest that E. floccosum may be a possible aethiological agent of tinea capitis.

Infecções oportunistas por leveduras e perfil enzimático dos agentes etiológicos

Yeast infections are common in immunocompromised patients, although emerging species have been changing the epidemiological profile. The ability to secrete proteinases has been associated with pathogenicity within the genus Candida. This study had the aims of diagnosing yeast infections in immunocompromised patients and evaluating the virulence of the etiological agents, based on a proteinase secretion assay using bovine serum albumin as a substrate. Out of a total of 104 patients studied, 19 presented episodes of yeast infection. The respiratory tract (63.2%), followed by the urinary tract (10.5%), were the most common sites of infection. Candida albicans, Candida parapsilosis, Candida tropicalis and emerging species such as Candida krusei and Candida guilliermondii were isolated. Five isolates of Candida parapsilosis and one of Candida albicans and Candida guilliermondii exhibited high enzymatic activity. We conclude that enzymatic characterization of Candida isolates may be a useful prognostic marker, especially among immunocompromised individuals, since yeast infections in such patients are generally serious.

Case report: disseminated dermatophytosis by microsporum gypseum in a systemic lupus erythematosus patient

Mycosis is a major contributor to morbidity and mortality in patients with systemic lupus erythematosus and frequent exposition to an infectious source could enhance the development of dermatophytic infections. A case of disseminated dermatophytosis by Microsporum gypseum is reported in a systemic lupus erythematosus (SLE) patient.

Cryptococcus laurentii fungaemia in a cervical cancer patient

Infections caused by emerging Cryptococcus non-neoformans species are being reported with increasingly frequency. Here, we present a case of fungaemia by Cryptococcus laurentii in a woman receiving aggressive immunosuppressive therapy for cervical neoplasia. Three venous blood samples were aseptically collected on consecutive days and C. laurentii was isolated and identified through phenotypic and molecular methods. After central venous catheter removal and appropriate antifungal therapy, the patient showed significant improvement and blood culture became negative. Thus, patients following immunosuppressive therapies and using invasive medical devices are at risk of C. laurentii blood infections.

Ciclopirox olamine: an antifungal alternative against cryptococcosis

Aims:  The in vitro activity of ciclopirox olamine was evaluated against Cryptococcus spp. obtained from the cerebrospinal fluid (CSF) of immunocompromised patients.

Candida Glabrata Esophagitis: new case reports and management

Candida esophagitis (CE) is a common opportunistic infection in the immunocompromised host. C. glabrata is rarely cited as agent of CE and has been underestimated due to lack of proper identification. In this study, two cases of C. glabrata esophagitis in AIDS and chagasic patients are reported. Diagnosis of Candida species should be considered an important key for the ideal choice of antifungal therapy against this mycosis.

Esophagitis caused by Candida guilliermondii in diabetes mellitus: first reported case

Diabetic patients are at risk of acquiring esophageal infections such as those caused by members of the genus Candida. Here we describe a case in which Candida guilliermondii was isolated from the esophageal mucosa of a patient with uncontrolled diabetes mellitus. Due to inappropriate and inaccurate identification, the emergence of non-C. albicans Candida species as potential pathogens has been underestimated. This should be a cause of concern since C. guilliermondii is a normal component of human microbiota. The identity of the isolate in our case was confirmed by its characteristic morphophysiological features and amplification of rDNA using species-specific primers. Fluconazole therapy produced no improvement of the esophageal symptoms, and resistance of the etiologic agent was confirmed through in vitro susceptibility tests. This is thought to be the first documented case of C. guilliermondii esophagitis in a patient with diabetes mellitus.

Engyodontium album fungaemia: the first reported case

Opportunistic mycoses have been increasingly observed among immunocompromised patients. We describe a case in which Engyodontium album was isolated and cultured from the blood of a patient with the Acquired Immunodeficiency Syndrome. E. album grew at 37oC and showed proteinase activity, both indicators of pathogenicity. This is the first time that this organism has been reported as agent of fungaemia.