Endemic Chromoblastomycosis Caused Predominantly by Fonsecaea nubica, Madagascar1

Abstract

We conducted a cross-sectional study as described (12). We recruited patients with clinically suspected chromoblastomycosis or another chronic dermatomycosis during March 2013-June 2017 at the Dermatology Department of the Joseph Raseta Befelatanana University Hospital in Antananarivo or during advanced consultation campaigns in districts (Figure 1, panel A). A clinical and demographic information form was completed for each participant. This study was approved by the Ethics Committee for Biomedical Research of the Ministry of Public Health of Madagascar (authorization no. 66-MSANP/CE). Case DefinitionWe provide clinical, mycological, histological, severity and prognostic criteria used for classifying cases in this study (Table 1). Cases were identified after a monthly consultation between the clinicians of the

The global burden of chromoblastomycosis

“…Although the route of acquisition of CBM agents is by traumatic inoculation, most of the series did not track the source of infection once clinical manifestations as several years usually elapse after trauma when the patients and the lesion(s) grows very slowly. We were not capable to analyze data related to trauma or characterization of rural jobs as this information were not available in most papers [ 1 , 3 , 6 , 18 , 19 , 27 , 35 , 56 , 70 , 116 , 165 , 238 , 239 ].…”

“…Although the different agents of CBM have certain ecological features, there is no apparent impact of the diversity of species on clinical manifestations or therapeutic management. Molecular characterization of different species has mostly been used to characterize this ecology and epidemiological aspects of the various etiological agents of CBM [ 1 , 11 – 13 , 238 , 239 ].…”

“…pugnacius , can cause disseminated CBM or phaeohyphomycosis with visceral impairment [ 165 , 245 , 246 ]. Finally, Fonsecaea nubica is also widely distributed in Asia, but current studies showed that Madagascar might be the country with the highest number of CBM caused by this species [ 239 ].…”

MALDI-TOF MS in a Medical Mycology Laboratory: On Stage and Backstage

“…This strategy was recently used in 2016 in our laboratory in the context of a large epidemiological study of sporotrichosis and chromoblastomycosis in Madagascar [42], which aimed at facilitating the diagnosis of these endemic dermo-invasive mycosis. For that purpose, and because reference spectra were extremely rare in the commercial databases at that time (2 MSPs in the Bruker database and 1 profile in the NIH database for Sporothrix sp., and none for the different agents of chromoblastomycosis), we generated 20 and 11 reference spectra from reference or previously sequenced strains for Sporothrix schenkii, and chromoblastomycosis causative agents (i.e., C. carrionii, F. nubica, F. pedrosoi, and F. monophora), respectively [43,44]. These homemade libraries now allow us to accurately and rapidly identify these agents, without the need for DNA sequencing.…”

Clinical aspects of previously treated chromoblastomycosis: A case series from Madagascar

“…In the late 1990s Madagascar was considered to be the most important focus of CBM in the world, with 1323 confirmed cases observed between 1955 and 1995 (Brygoo and Segretain, 1960;Esterre et al, 1996). The epidemiology and biology of CBM were recently updated, and showed the persistence of high endemicity of this infection in Madagascar (Rasamoelina et al, 2020). CBM lesions are recalcitrant and extremely difficult to eradicate.…”