Fungal diseases in children and adolescents in a referral centre in Bogota, Colombia

Abstract

A cross-sectional descriptive study was conducted at a dermatology referral centre in Bogotá, to estimate the frequencies and aetiologies of mycoses in the population under 18 years of age attending the medical mycology laboratory over a 13-year period (2000-2012). A total of 1337 samples from 1221 patients were evaluated, involving direct examination and culture for 1279 samples, direct examination alone for 50 and culture alone for 8. During the study period, dermatophytosis was diagnosed via culture in 537 cases (40.1%). The most common aetiological agents were Trichophyton rubrum (235 cases), Microsporum canis (177), Trichophyton mentagrophytes (74) and Microsporum gypseum (22). Pityriasis versicolor was found in 31 cases (5.1%), Candida spp. were found in 17 cases, and non-dermatophyte moulds were confirmed by a second sample in 6 cases (3 cases involving Fusarium spp., 2 Neoscytalidium dimidiatum and 1 Acremonium spp.). In addition, white piedra was diagnosed in 4 cases (0.7%), and tinea nigra in 2 cases (0.3%). Regarding subcutaneous mycoses, 14 cases of sporotrichosis were identified. The results from this study confirm the predominance of dermatophytosis in the paediatric population. T. rubrum and M. canis were the main aetiological agents. We found a few cases of onychomycosis by non-dermatophyte moulds. Sporotrichosis was the only subcutaneous mycosis diagnosed during the study period.

Species distribution of the main aetiologic agents causing skin dermatophytosis in Colombian patients: A 23‐year experience at a Mycological Reference Center

“…Of the total number of patients, 49.4% were diagnosed with dermatophytosis. These results are consistent with two studies carried out in Colombia where 40.1% and 53.6% of dermatophytosis cases were found in the studied populations 19,26 . Dermatophytosis occurred more frequently in males than females (50.3% vs 45.7%) patients in all cases, a fact that could be mainly related to occupational activities.…”

“…This agent was also the most frequent in all age groups, which corroborates that this anthropophilic fungus is currently the main causative agent of skin dermatophytosis worldwide, as reported in other studies 4,7,9,11,29,30 . Reports of studies carried out in Colombia describe T mentagrophytes complex and T rubrum as the main aetiologic agents of dermatophytosis 10,19,31‐33 …”

“…In the same way, it was observed that N gypsea complex presented a higher prevalence than M canis , differing again from what was observed in other works made in Colombia and around the world 12,16,19,26,30,34,35 . This may be due to the type of population assessed in the study and may be related to occupational activities such as gardeners or farmworkers 2 .…”

“…These can be classified, according to their habitat, as anthropophilic, geophilic and zoophilic. In studies conducted in Latin America, the five most frequent dermatophytes in the general population were Trichophyton rubrum (70%), Microsporum canis (13%), Trichophyton mentagrophytes complex (10%), Trichophyton tonsurans (3%) and Epidermophyton floccosum (1%) 6‐16 ; however, the distribution of these pathogenic species and the predominant anatomical sites of infection varies in response to the geographical location 4,13,16‐19 …”

Nondermatophyte mould onychomycosis

“…All but two of the included studies isolated NDM organisms from patients clinically suspected of onychomycosis, patients with nail abnormalities, or with a prediagnosis of onychomycosis visiting dermatology clinics or hospitals. [85][86][87][88][89][90][91][92][93][94][95][96][97][98][99][100] One study 101 sampled a general, healthy population in Spain and another study 102 sampled a high-risk group: residents of a male boarding school in Turkey. Thus, the data presented in this review may not be a true reflection of the prevalence of NDM onychomycosis in the general population.…”