O babaçu (Orbignya phalerata martins) como provável fator de risco de infecção humana pelo agente da cromoblastomicose no Estado do Maranhão, Brasil

Abstract

During a survey of 30 patients with chromoblastomycosis followed at the Hospital dos Servidores do Estado do Maranhão, the authors observed in 2 (6.6%) patients with lesions on the buttock. This is an uncommon site for the initial lesions of chromoblastomycosis. There is often a history of microtraumatism during the farming job hence the more frequent development of lesions in the lower limbs. Both patients had 10 years disease, with the presence of nodules and vegetant warty lesions in coalescent plaques on the right buttock. Etiologic diagnosis made through histopatologic and culture exams, with Fonsecaea pedrosoi isolated. The epidemiological exposure of the patients, was suggested by the fact that both worked as babaçu coconut cutters a common activity in Maranhão State. The relation between this kind of professional activity and the development of infection merits for the investigation.

Chromoblastomycosis

“…In nature, monoaromates are found in trace amounts in plant debris, thorns, and wood cortex, which provide microhabitats for these fungi (74). There is a strong correlation between the traumatic implantation of potential natural sources of infection and CBM lesions (74)(75)(76)(77)(78)(79)(80). This route of infection may be supported by clinical reports of patients exhibiting the presence of fragments of plant material at the site where they experienced a previous trauma.…”

“…During labor activities, individuals living in areas of endemicity are probably infected through diverse traumas related to environmental materials (80,(84)(85)(86)(87)(88) (Table 2). Remarkably, however, etiological agents of CBM are difficult to recover from their environment due to their saprobiotic lifestyle: direct isolation by the use of selective methods usually yields saprobic counterparts of the pathogens, while the pathogens are almost exclusively restricted to warm-blooded hosts.…”

“…Local dwellers collect the babassu nuts, which are rich in oil and are a well-known component used by industrial companies for the manufacture of international beauty products. Members of the Chaetothyriales are indeed enriched on babassu shell fragments, which are hypothetically considered a risk factor for the development of cutaneous lesions after labor trauma (78,80,84). The invasive potential of agents differs significantly between species and is as yet only fragmentarily understood.…”

Isolation of herpotrichiellacious fungi from the environment

“…The isolation of environmental strains is more difficult and the identification even harder due to their pleomorphic condition and slow growth. There are several papers reporting these agents in nature (6,7,8,11,12), and some discuss their ecological niche (1,11,15,16).…”

Eco-epidemiologic study of emerging fungi related to the work of babaçu coconut breakers in the State of Maranhão, Brazil

“…Babaçu coconut breakers are often affected by diseases, with a seemingly obvious relationship between the type of occupation and the development of fungal infection 6 . The exposure of babaçu coconut breakers to geophilic fungi and phytopathogens predisposes them to fungal infection and mycoses.…”