Case Report. A case of chromoblastomycosis effectively treated with terbinafine. Characteristics of chromoblastomycosis in the Kitasato region, Japan

Tanuma, Hiroyuki; Hiramatsu, Masahiro; Mukai, Hiroyuki; Abe, Michiko; Kume, Hikaru; Nishiyama, Shigeo; Katsuoka, Kensei

doi:10.1046/j.1439-0507.2000.00548.x

Cited by 47 publications

(18 citation statements)

References 5 publications

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“…However, the use of other heat sources, such as electric bed warmers, as monotherapy is insufficiently effective and should be used in combination with other physical therapeutic modalities (278). Local heat therapy for 2 h per day combined with the administration of posaconazole (PCZ) at 400 mg twice per day for an 8-month period led to a significant reduction of lesions, while the combination of heat therapy for 12 h/day and terbinafine (125 to 250 mg daily) led to negative direct examination and culture results within 2 weeks (278,279). Additional surgical therapy was necessary in recalcitrant cases.…”

Section: Heat Therapymentioning

confidence: 99%

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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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Section: Heat Therapymentioning

confidence: 99%

“…Terbinafine has cure rates that are similar to those with ITZ (278,293,299). It is an orally administered allylamine derivative with fungistatic and fungicidal effects through the inhibition of squalene-epoxidase, which interferes with ergosterol biosynthesis and fungal membrane function.…”

Section: First-line Therapymentioning

confidence: 99%

Chromoblastomycosis

et al. 2017

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“…The chronic subcutaneous fungal infection occurs most frequently in tropical and subtropical regions, especially South America and Japan (Fabra et al, 1994;Silva et al, 1999;Tanuma et al, 2000). The infection generally affects individuals who are engaged in farming , resulting from the traumatic implantation of fungal propagules.…”

Section: Introductionmentioning

confidence: 99%

Ectophosphatase activity in conidial forms of Fonsecaea pedrosoi is modulated by exogenous phosphate and influences fungal adhesion to mammalian cells

et al. 2004

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“…On the other hand terbinafine by virtue of its excellent in vitro and in vivo activity is under comparative evaluation for its therapeutic potential for a wide range of fungal infections (4,6,8,11,21,22).…”

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In Vitro Susceptibilities of Isolates of Sporothrix schenckii to Itraconazole and Terbinafine

et al. 2004

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Thirty isolates of the yeast form of Sporothrix schenckii were evaluated for in vitro susceptibility to itraconazole and terbinafine by the recommended NCCLS modified technique (M27-A2). The MICs of itraconazole obtained oscillated between 0.062 and 4.0 g/ml, and those of terbinafine oscillated between 0.007 and 0.50 g/ml; therefore, terbinafine showed greater in vitro activity.Sporotrichosis is a subacute or chronic infection affecting both animals and humans and is characterized by nodular cutaneous and subcutaneous lesions, which may involve the adjacent lymphatic system, which suppurates and drains (1,20).Itraconazole is currently considered the treatment of choice to treat the diverse clinical manifestations of sporotrichosis (13,14,17,18). On the other hand terbinafine by virtue of its excellent in vitro and in vivo activity is under comparative evaluation for its therapeutic potential for a wide range of fungal infections (4,6,8,11,21,22).Promising in vitro results with terbinafine for both the fixed and the lymphocutaneous forms of sporotrichosis due to the fungus Sporothrix schenckii (10,11,21) are being compared and confirmed clinically (4,8,10,19).In this study, our objective was to determine the in vitro efficacy of terbinafine against isolates of Sporothrix schenckii by the technique of macrodilution in a liquid medium (NCCLS M27-A2) (15) adapted for dimorphic fungi.Thirty strains of Sporothrix schenckii, including 2 reference isolates (ATCC 201679 and M527-88), 18 human clinical isolates, and 10 animal isolates (9 from cats and 1 from a horse) were included in this study. All the samples were isolated from clinical specimens, identified by micromorphological characteristics and demonstration of typical dimorphism. They were maintained in brain heart infusion (BHI) solid medium-0.5% glucose at a controlled temperature of 4°C, with replication onto new medium at 6-month intervals, and converted to the yeast form through successive passages in BHI solid medium and incubation at 35°C. Quality control (QC) strains Candida krusei (ATCC 6258) and Candida parapsilosis (ATCC 22019) were tested in parallel and were inhibited by MICs at the correct range for the antifungal tested (itraconazole) (15). The MIC range of terbinafine for the QC Candida strains has not yet been established by the NCCLS.Susceptibility tests were conducted using a technique of macrodilution in a liquid medium in accordance with the NCCLS protocol (M27-A2) (15), adapted for dimorphic fungi to include a 5-day incubation period to compensate for the sluggish growth of the yeast phase of Sporothrix schenckii, which requires 5 days to reach exponential growth (3, 7) and the addition of glucose to the medium (20 g/liter). The inoculum was prepared spectrophotometrically (520 nm, 60% of transmittance) to reach approximately 1 ϫ 10 6 to 5 ϫ 10 6 CFU/ml, at an incubation temperature of 35°C.The drugs itraconazole (Janssen Pharmaceutical, Beerse, Belgium) and terbinafine (Novartis Research Institute, Vienna, Austria) were obtained in their pur...

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Case Report. A case of chromoblastomycosis effectively treated with terbinafine. Characteristics of chromoblastomycosis in the Kitasato region, Japan

Cited by 47 publications

References 5 publications

Chromoblastomycosis

Chromoblastomycosis

Ectophosphatase activity in conidial forms of Fonsecaea pedrosoi is modulated by exogenous phosphate and influences fungal adhesion to mammalian cells

In Vitro Susceptibilities of Isolates of Sporothrix schenckii to Itraconazole and Terbinafine

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