Lobomicose

Abstract

A case of lobomycosis in a patient from the Brazilian Amazon region is presented. Lobomycosis is a subcutaneous mycosis caused by the yeast Lacazia loboi. It often affects adult males and has been reported in dolphins. Therapeutical options for localized lesions, such as the ones shown by the patient in this report, are eletrocoagulation, surgical exeresis, and cryotherapy. Disseminated lesions may be treated with Itraconazole or combination therapy with Clofazimine. There is still no curative therapy for disseminated lesions of lobomycosis. Keywords: Bacterial infections and mycoses; Fungi; Mycoses Resumo: Caso de lobomicose em paciente procedente da região amazônica brasileira. Essa micose subcutânea, causada pela levedura Lacazia loboi, acomete, frequentemente, homens adultos e foi também diagnosticada em golfinhos. O tratamento depende da apresentação clínica: eletrocoagulação, exérese cirúrgica e crioterapia são opções terapêuticas para as lesões localizadas, como a do paciente relatado, enquanto itraconazol e clofazimina, isolados ou em associação, podem ser empregados para lesões disseminadas. Até o presente, não há tratamento adequado para os casos com lesões disseminadas.

Lobomycosis: A case from Southeastern Europe and review of the literature

“…2,7,8 Although a common clinical presentation is a nodular, solid lesion with smooth surface, shiny and keloidal aspect, 7 lesions may occur also as papules, ulcers with a smooth brilliant aspect, sclerodermiform, verrucous and in plaques. 2,[5][6][7][8] Although a specific dermatologic pattern may dominate in any given case, lesions are rarely monomorphous. 2,14 Based on the lesion morphologic appearance, Silva and de Brito proposed a classification with five subtypes: infiltrative, keloidal, gummatous, ulcerative and verrucoid.…”

“…1,3,5 The human disease appears to be endemic in Central and Western Brazil, Bolivia, Colombia, Costa Rica, Ecuador, Guyana, Mexico, Panama, Peru, Suriname and Venezuela. [1][2][3][4][5][6]8,11,13,21 However, there have been isolated cases in the United States, 22 Canada, 16 Africa, 23 the Netherlands, 24 France 25 and Germany. 15 More than 550 human cases have been reported to date, especially in patients with a history of travel or residence in the areas of endemicity or in communities along rivers.…”

“…15 More than 550 human cases have been reported to date, especially in patients with a history of travel or residence in the areas of endemicity or in communities along rivers. [1][2][3][4][5][6]26,27 Our case represents the first documented case in Southeastern Europe (and Greece) and one of the rare cases in the Mediterranean countries. Our patient referred no history of travel to any of the above countries.…”

“…[1][2][3][4][5] The natural reservoir of L. loboi is unknown but it is believed to be aquatic, or associated with soil and vegetation. [1][2][3][4][6][7][8] Lobomycosis is described in dolphins and humans, particularly adult hunters, fishermen, miners and rural workers. 1,2,9 The lesions are pleomorphic and usually located on exposed and cooler areas of the body, particularly on limbs and ears.…”

Lobomicose

“…Em termos histológicos, observa-se reação inflamatória granulomatosa crônica que predomina na derme. 1,2 Relatos limitados de casos demonstraram que a lobomicose apresenta distribuição em áreas endêmicas na América Latina, tendo uma incidência maior na Amazónia brasileira. 2 Na realidade aqui ocorrem a maioria dos diagnósticos, 1,2 mas recentemente foram relatados 15 casos na Índia.…”