Associação de cromoblastomicose e hanseníase: relato de dois casos

M, Silva Cde; Silva, AC; Sc, Marques; Ac, Saldanha; Jd, Nascimento; Mr, Branco; Rr, Silva; Jm, Costa

doi:10.1590/s0037-86821994000400007

Cited by 7 publications

(6 citation statements)

References 2 publications

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“…There are few reports of this coinfection, most of them from Brazil. 7 , 17 , 46 , 50 , 77 , 78 , 79 , 80 , 81 Two of the patients reported in this research were elderly (65 years or older), coinciding with two previous reports. 77 , 79 The explanation for the occurrence of chromoblastomycosis‐leprosy coinfection in the elderly can be very complex and could be related to immunosenescence.…”

Section: Discussionsupporting

confidence: 90%

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Molecular epidemiology and clinical‐laboratory aspects of chromoblastomycosis in Mato Grosso, Brazil

Guevara

Nery

Melhem

et al. 2022

Mycoses

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Introduction Chromoblastomycosis is a disease caused by melanized fungi, primarily belonging to the genera Fonsecaea and Cladophialophora, mainly affecting individuals who are occupationally exposed to soil and plant products. This research aimed to determine the clinical, epidemiological and laboratory characteristics of chromoblastomycosis in the state of Mato Grosso, Brazil. Materials and Methods Patients diagnosed with chromoblastomycosis treated at the Júlio Müller University Hospital, Cuiabá, Brazil, from January 2015 to December 2020, whose isolates were preserved in the Research Laboratory of the Faculty of Medicine of the Federal University of Mato Grosso. Isolates were identified by partly sequencing the Internal Transcribed Spacer (ITS) and β‐tubulin (BT2) loci. AFLP fingerprinting was used to explore the genetic diversity. Susceptibility to itraconazole, voriconazole, 5‐fluorocytosine, terbinafine and amphotericin B was determined by the broth microdilution technique. Results Ten patients were included, nine were male (mean age = 64.1 years). Mean disease duration was 8.6 years. Lesions were mainly observed in the lower limbs. Predominant clinical forms were verrucous and scarring. Systemic arterial hypertension and type II diabetes mellitus were the predominant comorbidities. Leprosy was the main concomitant infectious disease. Fonsecaea pedrosoi was the unique aetiological agent identified with moderate genetic diversity (H = 0.3934–0.4527; PIC = 0.3160–0.3502). Antifungal agents with the highest activity were terbinafine, voriconazole and itraconazole. Conclusion Chromoblastomycosis is affecting the poor population in rural and urban areas, mainly related to agricultural activities, with F. pedrosoi being the dominant aetiologic agent. All isolates had low MICs for itraconazole, voriconazole and terbinafine, confirming their importance as therapeutic alternatives for chromoblastomycosis.

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Section: Discussionsupporting

confidence: 90%

“…Three patients had chromoblastomycosis‐leprosy coinfection. There are few reports of this coinfection, most of them from Brazil 7,17,46,50,77–81 . Two of the patients reported in this research were elderly (65 years or older), coinciding with two previous reports 77,79 .…”

Section: Discussionsupporting

confidence: 89%

Molecular epidemiology and clinical‐laboratory aspects of chromoblastomycosis in Mato Grosso, Brazil

Guevara

Nery

Melhem

et al. 2022

Mycoses

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“…In the present casuistic we found only two cases of the disease in immunosuppressed hosts, including one case each of renal transplantation and systemic lupus. Other authors have also reported few cases of CBM in patients undergoing solid organ transplantation (kidney, heart and liver), pemphigus vulgaris, rheumatologic diseases (lupus erythematosus), solid tumors and chronic steroid users (type 2 leprosy reaction) [33,34].…”

Section: Discussionmentioning

confidence: 99%

Chromoblastomycosis in an Endemic Area of Brazil: A Clinical-Epidemiological Analysis and a Worldwide Haplotype Network

Santos

Vicente

Weiss

et al. 2020

JoF

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Chromoblastomycosis (CBM) is a neglected implantation mycosis prevalent in tropical climate zones, considered an occupational disease that affects impoverished rural populations. This retrospective study described clinical aspects of CBM in a hyperendemic area in Brazil and constructed a worldwide haplotype network of Fonsecaea spp. strains. The variables were collected from medical records using a standard report form, reporting 191 patients with CBM from Maranhão, Brazil. The mean age was 56.1 years, 168 (88%) patients were male and predominantly farmers (85.8%). The mean time of evolution of the disease until diagnosis was 9.4 years. Lower limbs (81.2%) and upper limbs (14.2%) were the main sites affected. Most patients exhibited verrucous (55%) and infiltrative plaque (48.2%). Fonsecaea spp. were identified in 136 cases and a haplotype network constructed with ITS sequences of 185 global strains revealed a total of 59 haplotypes exhibiting high haplotypic and low nucleotide diversities. No correlation was observed between the different haplotypes of Fonsecaea species and dermatological patterns, severity of disease or geographic distribution inside Maranhão. Data from this area contributed to better understanding the epidemiology of CBM. For the first time, a robust haplotype network with Fonsecaea strains reveals an evolutionary history with a recent population expansion.

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“…Facial lesions may produce eyelid retraction, leading to several grades of ectropion, xerophthalmia, and keratitis. Associations of CBM with several infectious diseases have been reported, including osteomyelitis, paracoccidioidomycosis, leishmaniasis, and leprosy (126,(250)(251)(252)(253)(254). These coinfections may increase the progression of both diseases, resulting in prolonged antifungal therapy and increased toxicity related to the respective therapies.…”

Section: Complications and Sequelaementioning

confidence: 99%

Chromoblastomycosis

et al. 2017

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SUMMARY Chromoblastomycosis (CBM), also known as chromomycosis, is one of the most prevalent implantation fungal infections, being the most common of the gamut of mycoses caused by melanized or brown-pigmented fungi. CBM is mainly a tropical or subtropical disease that may affect individuals with certain risk factors around the world. The following characteristics are associated with this disease: (i) traumatic inoculation by implantation from an environmental source, leading to an initial cutaneous lesion at the inoculation site; (ii) chronic and progressive cutaneous and subcutaneous tissular involvement associated with fibrotic and granulomatous reactions associated with microabscesses and often with tissue proliferation; (iii) a nonprotective T helper type 2 (Th2) immune response with ineffective humoral involvement; and (iv) the presence of muriform (sclerotic) cells embedded in the affected tissue. CBM lesions are clinically polymorphic and are commonly misdiagnosed as various other infectious and noninfectious diseases. In its more severe clinical forms, CBM may cause an incapacity for labor due to fibrotic sequelae and also due to a series of clinical complications, and if not recognized at an early stage, this disease can be refractory to antifungal therapy.

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Associação de cromoblastomicose e hanseníase: relato de dois casos

Cited by 7 publications

References 2 publications

Molecular epidemiology and clinical‐laboratory aspects of chromoblastomycosis in Mato Grosso, Brazil

Molecular epidemiology and clinical‐laboratory aspects of chromoblastomycosis in Mato Grosso, Brazil

Chromoblastomycosis in an Endemic Area of Brazil: A Clinical-Epidemiological Analysis and a Worldwide Haplotype Network

Chromoblastomycosis

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