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

Abstract

Background: Lobomycosis, also known as Jorge Lobo's disease, represents a rare chronic subcutaneous mycosis caused by the fungus Lacazia loboi, an organism that is found within lesions but has not been cultured to date. The natural reservoir of L. loboi is unknown but it is believed to be aquatic, or associated with soil and vegetation. More than 550 human cases have been reported, especially in patients with a history of travel or residence in endemic areas (Central and South America, particularly Brazil) or in communities along rivers. Main observations:We describe a 64-year-old Greek female farmer living in a coastal region, who presented with an erythematous plaque on her left inner thigh resembling a keloid. The diagnosis was based on the triad: 1) absence of fungal growth in cultures, 2) positive direct microscopic examination of the lesion and 3) histopathology, all consistent with lobomycosis. Particularly, skin biopsy showed deep cutaneous fungal infection with granulomatous reaction. Fungal cells were found inside giant cells. The fungi were thick-walled with some budding, isolated or in short chains. Dermal fibrosis was present. Our patient had a medical history of common variable immunodeficiency but no history of travel to South or Central America. She probably acquired this rare infection by injury during her agricultural works. Conclusion:Our case represents probably the first documented case of human lobomycosis in Southeastern Europe. This case is unusual due to the rarity of lobomycosis in Mediterranean countries, particularly in Southeastern Europe. (J Dermatol Case Rep. 2012; 6(3): 65-69)

Two Cases of Lacaziosis in Bottlenose Dolphins (Tursiops truncatus) in Japan

“…Some cases have also been reported in the United States, but those patients thought to have been infected in Venezuela, Canada, The Netherlands, Surinam, France, South Africa [1-3, 8, 10], and Greece [11] bordering countries to the Atlantic Ocean. Interestingly, an unconfirmed case was reported from Bangladesh [12] which is not an endemic area.…”

Case Report: Molecular Confirmation of Lobomycosis in an Italian Traveler Acquired in the Amazon Region of Venezuela

“…3,4 The occurrence of lobomycosis outside Central and South America is exceedingly rare, although autochthonous cases have been reported in Africa and Greece. 5,6 Till date, only nine cases of imported lobomycosis in nonendemic countries have been described. 5,[7][8][9][10][11][12][13][14] In all cases, a long period elapsed between the exposure to endemic areas and the diagnosis.…”

Lacaziosis: Micosis cutánea profunda, reporte de un caso

“…5 Dentro de las complicaciones puede existir restricción de movimientos en lesiones yuxtaarticulares, compromiso estético, infección secundaria por piógenos y degeneración hacia carcinoma epidermoide. 5,6 El examen directo de las lesiones revela levaduras de pared gruesa, refringentes, de doble contorno, que miden aproximadamente 5 x 14 µm. Se reproduce por gemación simple.…”