Sporotrichosis is an endemic subcutaneous mycosis in Venezuela. There are no reports to this date of disseminated forms of the disease, even amongst patients with acquired immunodeficiency syndrome. Direct microscopic examination of wet mount slides with saline solution or distilled water in the search for asteroid bodies is paramount. Saturated sodium and potassium iodine solutions continue to be extremely efficacious and affordable to most of our patients, therefore our treatment of choice.
During a 2-year period 30 adults were selected out of a group of patients diagnosed with erysipelas, who, except for tinea pedis, were apparently otherwise healthy patients. Clinical and epidemiological studies were performed to establish how tinea pedis and erysipelas are related. Thirteen of 30 patients with a diagnosis of erysipelas were found to have tinea pedis due to Trichophyton mentagrophytes and Trichophyton rubrum. In seven of the patients (23%) tinea pedis was found to be the unique predisposing factor for erysipelas. Tinea pedis may be a risk factor for streptococcal infections such as erysipelas, mainly in tropical countries, where tinea pedis is a frequent disease.
Oropharyngeal candidiasis caused by various species of Candida is one of the most common infections in HIV seropositive or AIDS patients. Drug resistance among these yeasts is an increasing problem. We studied the frequency of resistance profile to fluconazole, itraconazole, ketoconazole, amphotericin B and terbinafine of 137 isolates of Candida sp. From HIV positive or AIDS patients with oropharyngeal candidiasis at Instituto de Inmunología, U.C.V. and the Hospital "Jose Ignacio Baldó", Caracas Venezuela, using the well diffusion susceptibility test (Magaldi et al.). We found that nearly 10% of C. albicans isolates were primarily fluconazole resistant, 45% of C. albicans isolates from patients with previous treatment were resistant to fluconazole, of which 93% showed cross-resistance to itraconazole, and even about 30% of C. tropicalis (n = 13) were resistant to fluconazole and/or itraconazole. To this respect, several recent reports have been described antifungal cross-resistance among azoles. Therefore, we consider that C. tropicalis should be added to the growing list of yeast in which antifungal drug resistance is common. This report could be useful for therapeutic aspect in AIDS patients with oral candidiasis.
Cerebral and cerebellar masses occurred in patients with paracoccidioidomycosis. Correct diagnosis was delayed due to overlooking the abnormal lung roentgenograms and the history of previous disease in a different localization. The fungus was identified through biopsy and direct examination of the samples. In two patients necropsy confirmed the diagnosis. None of the patients responded to amphotericin B or cotrimoxazole. A 10 year English and Latin American literature review on neuroparacoccidioidomycosis was performed through a MEDLINE and LILACS (Latin American Literature Search System) data base systems.
In pathogenicity studies of 31 Paracoccidioides brasiliensis isolates preserved using Castellani's method we intraperitoneally inoculated 104 young adult hamsters and found laminated concentric structures and calcified appearance that resembled Schaumann bodies, in 43 of them, especially in animals with apparently good condition. We characterized these structures histologically and histochemically using different stains (PAS, Grocott, haematoxylin-eosin, Von Kossa). The Von Kossa staining revealed calcium in these structures. Similar structures have been described in patients with sarcoidosis and also in hamsters inoculated with P. brasiliensis. We found no correlation between the presence of these calcifications and serum calcium levels.
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