Ligia Rangel B. Ruiz

Identificação de espécies de Candida e susceptibilidade antifúngica in vitro: estudo de 100 pacientes com candidíases superficiais

BACKGROUND: Yeasts of the genus Candida create colonization, superficial infections and systemic infections in immunodeficient individuals. The presentations of the disease lead to the necessity of using various diagnostic methods and treatments. OBJECTIVES: To differentiate among the Candida species, correlate them with the anatomical region involved and evaluate in vitro susceptibility to ketoconazole, fluconazole, itraconazole and amphotericin B. METHODS: An evaluation of 100 cases of immunocompetent patients with cutaneous or mucous candidiasis attended at the Santa Casa de Sao Paulo Hospital from May 1999 to July 2001. This study attempted to correlate the site of the involvement and the Candida species, isolated using the CHROMagar Candida® technique. The species were evaluated using the Etest® antifungal susceptibility to ketoconazole, fluconazole, itraconazole and amphotericin B. RESULTS: C. albicans was isolated in 76% of the material, C. krusei in 19% and C. tropicalis in 1%. It was not possible to establish a significant correlation between the involved area and the species isolated. Most of the samples proved to be susceptible to the antifungals tested. CONCLUSIONS: C. albicans was the most commonly observed species. The majority of samples presented susceptibility to the tested antifungals.

Cutaneous protothecosis: report of a third Brazilian case

The present report describes a case of cutaneous protothecosis caused by Prototheca wickerhamii in a nonimmunocompromised Brazilian female. Dermatological examination revealed a 15‐cm diffusely infiltrated eczema‐like plaque recovered with many pustule‐like lesions on the right forearm. We emphasize the mycological and pathological aspects of this infection that can lead to misdiagnosis. The patient was successfully treated with itraconazole.

Subcutaneous phaeohyphomycosis caused by Phoma cava: report of a case and review of the literature

We report a case of subcutaneous phaeohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by different Phoma species, is presented. The patient healed after therapy with amphotericin B. followed by itraconazole.

Dermatophytosis caused by Trichophyton raubitschekii. Report of the first case in São Paulo, Brazil

The authors report the first case of dermatophytosis caused by Trichophyton raubitschekii in a patient from the State of São Paulo with Tinea corporis lesions localized on the buttocks. Culture on Sabouraud-agar with cycloheximide permitted the isolation and identification of the fungus, and the diagnosis was confirmed by Dr. Lynne Sigler, University of Alberta, Canada. Systemic treatment with fluconazole, 150 mg/week for 4 weeks, in combination with topical treatment with isoconazole initially yielded favorable results, with recurrence of the lesions after the medication was discontinued. This is the fifth case of this dermatophytosis published in the Brazilian medical literature.

Onychoprotothecosis: Report of the first case in Brazil

The present report describes a case of onychoprotothecosis caused by Prototheca wickerhamii in a nonimmunocompromized female. Dermatological examination showed yellowish discoloration of the left and right forefinger nails, showing onicolysis and hyperkeratosis. The repeated isolation of the algae Prototheca (organisms morula‐like) as well as the repeated culture in media, Sabouraud agar, confirmed the diagnosis. The patient was successfully treated with tioconazol 1% topic solution. The aim of this paper was to present a rare condition.

Subcutaneous hyalohyphomycosis caused by Acremonium recifei: case report

We present a case of subcutaneous hyalohyphomycosis due to Acremonium recifei, a species whose habitat is probably the soil, first identified in 1934 by Arêa Leão and Lobo in a case of podal eumycetoma with white-yellowish grains and initially named Cephalosporium recifei. A white immunocompetent female patient from the state of Bahia, Brazil, with a history of traumatic injury to the right hand is reported. The lesions was painless, with edema, inflammation and the presence of fistulae. Seropurulent secretion with the absence of grains was present. Histopathological examination of material stained with hematoxylin-eosin showed hyaline septate hyphae. A culture was positive for Acremonium recifei. Treatment with itraconazole, 200 mg/day, for two months led to a favorable course and cure of the process. We report for the first time in the literature a case of subcutaneous hyalohyphomycosis due to Acremonium recifei in a immunocompetent woman. Treatment with itraconazole 200 mg/day, for two months, resulted in cure.

ESTUDO CLINICO COM O USO DO ITRACONAZOL EM TINHA CRURAL, TINHA DO CORPO E TINHA DO PE INTERDIGITAL

Os autores estudaram 31 pacientes portadores de tinhas crural, do corpo e do pe interdigital, tratados com 100 mg de itraconazol, administrados junto com o almoco, durante 15 dias. Foram realizadas 3 avaliacoes clinicas e micologicas: no pre-tratamento, no final do tratamento e 2 semanas apos o tratamento. O itraconazol mostrou-se eficaz para o tratamento das dermatofitoses estudadas, na dose empregada, com 100% de cura micologica. Em relacao a evolucao clinica, houve diminuicao estatistica significante (teste de Friedman - p < 0,001) dos sinais e sintomas avaliados. Nao foi observada ocorrencia de efeitos colaterais.The authors studied 31 patients with Tinea cruris, corporis or pedis interdigital. The patients were treated with 100 mg of itraconazole, once a day, during the lunch, for 15 days. Mycological and clinical evaluations were performed at the pre-treatment, by the end of treatment and 2 weeks after finishing the treatment. The results showed that itraconazole is effective for the treatment of dermatophytosis, at the studied posology. with 100% of mycological cure. Clinical evaluation showed a significant reduction (Friedman test - p < 0.001) of signs and symptoms. No side-effect was registered.

Clinical trial with itraconazole in the treatment of Tinea cruris, Tinea corporis and tinea pedis interdigital

Os autores estudaram 31 pacientes portadores de tinhas crural, do corpo e do pe interdigital, tratados com 100 mg de itraconazol, administrados junto com o almoco, durante 15 dias. Foram realizadas 3 avaliacoes clinicas e micologicas: no pre-tratamento, no final do tratamento e 2 semanas apos o tratamento. O itraconazol mostrou-se eficaz para o tratamento das dermatofitoses estudadas, na dose empregada, com 100% de cura micologica. Em relacao a evolucao clinica, houve diminuicao estatistica significante (teste de Friedman - p < 0,001) dos sinais e sintomas avaliados. Nao foi observada ocorrencia de efeitos colaterais.The authors studied 31 patients with Tinea cruris, corporis or pedis interdigital. The patients were treated with 100 mg of itraconazole, once a day, during the lunch, for 15 days. Mycological and clinical evaluations were performed at the pre-treatment, by the end of treatment and 2 weeks after finishing the treatment. The results showed that itraconazole is effective for the treatment of dermatophytosis, at the studied posology. with 100% of mycological cure. Clinical evaluation showed a significant reduction (Friedman test - p < 0.001) of signs and symptoms. No side-effect was registered.

Clinical study of the use of itraconazole in tinea cruris, tinea corporis and tinea pedis interdigitale.

Os autores estudaram 31 pacientes portadores de tinhas crural, do corpo e do pe interdigital, tratados com 100 mg de itraconazol, administrados junto com o almoco, durante 15 dias. Foram realizadas 3 avaliacoes clinicas e micologicas: no pre-tratamento, no final do tratamento e 2 semanas apos o tratamento. O itraconazol mostrou-se eficaz para o tratamento das dermatofitoses estudadas, na dose empregada, com 100% de cura micologica. Em relacao a evolucao clinica, houve diminuicao estatistica significante (teste de Friedman - p < 0,001) dos sinais e sintomas avaliados. Nao foi observada ocorrencia de efeitos colaterais.The authors studied 31 patients with Tinea cruris, corporis or pedis interdigital. The patients were treated with 100 mg of itraconazole, once a day, during the lunch, for 15 days. Mycological and clinical evaluations were performed at the pre-treatment, by the end of treatment and 2 weeks after finishing the treatment. The results showed that itraconazole is effective for the treatment of dermatophytosis, at the studied posology. with 100% of mycological cure. Clinical evaluation showed a significant reduction (Friedman test - p < 0.001) of signs and symptoms. No side-effect was registered.