A case of chromoblastomycosis by <i>Fonsecaea nubica</i> indicating a possible insect route of transmission

Chen, Ying-Dan; Yin, Shutao; Li, Meirong; Chen, Rongzhang; Wei, Liwen; Ma, Han; Deng, Shuwen; Hoog, G. S. de; Wei, Lai; Li, Chun; Peng, Feng

doi:10.1111/myc.12523

Cited by 11 publications

(3 citation statements)

References 22 publications

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“…The combination therapy of ITZ and TBF is usually used in patients presenting refractory lesions 6 , 17 - 20 . In previous reports, ITZ and TBF showed good responses to treat CBM caused by F. nubica 17 , 21 . This is the first case report on CBM caused by F. nubica which was not responsive to ITZ and TBF.…”

Section: Discussionmentioning

confidence: 80%

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Synergistic effect of terbinafine and amphotericin B in killing Fonsecaea nubica in vitro and in vivo

Zhang

et al. 2019

Rev. Inst. Med. trop. S. Paulo

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Chromoblastomycosis is a chronic fungal infection. Itraconazole and terbinaﬁne are the most recommended antifungal drugs for chromoblastomycosis, while amphotericin B is not usually recommended. A patient with chromoblastomycosis in our hospital showed poor clinical responses to itraconazole and terbinaﬁne. The fungus isolated from the lesions of this patient was identified as Fonsecaea nubica and numbered zssy0803. In vitro antifungal susceptibilities of F. nubica zssy0803 to terbinaﬁne, amphotericin B, itraconazole, voriconazole and caspofungin were evaluated, as well as the combinations of terbinaﬁne with the other four antifungals. The combined effect of terbinaﬁne and amphotericin B on other 20 clinical F. nubica strains was also evaluated. The minimal inhibitory concentrations of terbinaﬁne, amphotericin B, itraconazole, voriconazole and caspofungin on F. nubica zssy0803 were 0.25 μg/mL, 2 μg/mL, 1 μg/mL, 4 μg/mL and 8 μg/mL, respectively. The combination of terbinaﬁne and amphotericin B showed the lowest fractional inhibitory concentration index of 0.28 to F. nubica zssy0803 in comparison with combinations of terbinaﬁne and the other four antifungal drugs. The combination of terbinaﬁne and amphotericin B was also synergistic for all the other 20 F. nubica strains. Then, the combination of oral terbinaﬁne (500 mg/day) and intralesional injections of amphotericin B (1 mg/mL) was used to treat this patient. After this combined therapy for 25 weeks and terbinaﬁne monotherapy for additional 12 weeks, the patient was cured. These findings indicate for the first time that terbinaﬁne and amphotericin B are synergistic in killing F. nubica both in vitro and in vivo .

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Section: Discussionmentioning

confidence: 80%

“…TBF also has been proved to be very effective 4 , 14 - 16 . The combination therapy of ITZ and TBF is usually used in patients presenting refractory lesions 6 , 17 - 20 . In previous reports, ITZ and TBF showed good responses to treat CBM caused by F. nubica 17 , 21 .…”

Section: Discussionmentioning

confidence: 99%

Synergistic effect of terbinafine and amphotericin B in killing Fonsecaea nubica in vitro and in vivo

Zhang

et al. 2019

Rev. Inst. Med. trop. S. Paulo

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“…The hyphae of the etiologic agents of CBM exist in the soil, plants, thorns, and even in the buccal apparatus and stings of invertebrates [147,148]. In a traumatic event with such elements, hyphae can be inoculated through the skin, initiating the infection.…”

Section: Clinical and Epidemiology Aspects Of Cbmmentioning

confidence: 99%

Reviewing the Etiologic Agents, Microbe-Host Relationship, Immune Response, Diagnosis, and Treatment in Chromoblastomycosis

Passero

Cavallone

Belda

2021

Journal of Immunology Research

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Chromoblastomycosis (CBM) is a neglected human disease, caused by different species of pigmented dematiaceous fungi that cause subcutaneous infections. This disease has been considered an occupational disease, occurring among people working in the field of agriculture, particularly in low-income countries. In 1914, the first case of CBM was described in Brazil, and although efforts have been made, few scientific and technological advances have been made in this area. In the field of fungi and host cell relationship, a very reduced number of antigens were characterized, but available data suggest that ectoantigens bind to the cell membrane of host cells and modulate the phagocytic, immunological, and microbicidal responses of immune cells. Furthermore, antigens cleave extracellular proteins in tissues, allowing fungi to spread. On the contrary, if phagocytic cells are able to present antigens in MHC molecules to T lymphocytes in the presence of costimulation and IL-12, a Th1 immune response will develop and a relative control of the disease will be observed. Despite knowledge of the resistance and susceptibility in CBM, up to now, no effective vaccines have been developed. In the field of chemotherapy, most patients are treated with conventional antifungal drugs, such as itraconazole and terbinafine, but these drugs exhibit limitations, considering that not all patients heal cutaneous lesions. Few advances in treatment have been made so far, but one of the most promising ones is based on the use of immunomodulators, such as imiquimod. Data about a standard treatment are missing in the medical literature; part of it is caused by the existence of a diversity of etiologic agents and clinical forms. The present review summarizes the advances made in the field of CBM related to the diversity of pathogenic species, fungi and host cell relationship, antigens, innate and acquired immunity, clinical forms of CBM, chemotherapy, and diagnosis.

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Fonsecaea and Chromoblastomycosis

Peng

Hoog

2017

Current Progress in Medical Mycology

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A case of chromoblastomycosis by Fonsecaea nubica indicating a possible insect route of transmission

Cited by 11 publications

References 22 publications

Synergistic effect of terbinafine and amphotericin B in killing Fonsecaea nubica in vitro and in vivo

Synergistic effect of terbinafine and amphotericin B in killing Fonsecaea nubica in vitro and in vivo

Reviewing the Etiologic Agents, Microbe-Host Relationship, Immune Response, Diagnosis, and Treatment in Chromoblastomycosis

Fonsecaea and Chromoblastomycosis

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