Mucormycosis and chromoblastomycosis occurring in a patient with leprosy type 2 reaction under prolonged corticosteroid and thalidomide therapy

Basilio, F. M. A.; Hammerschmidt, Mariana; Mukai, Maira Mitsue; Werner, Betina; Pinheiro, Rosângela Lameira; Moritz, Sandra

doi:10.1590/s0365-05962012000500017

Cited by 12 publications

(8 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In another study, levels of IgG also correlated with the chronicity of disease, similar to antineutrophil antibody levels (134). In addition, the status of the host response against black yeasts may be dependent on many predisposing factors, such as gamma globulin levels (135). Notably, hypogammaglobulinemia occurs in one-to two-thirds of patients with lymphocytic immunosuppression (136), which is associated with low levels of antigen-specific antifungal IgG and IgA antibodies and corresponds with chronicity of fungal infections (137).…”

Section: Humoral Immunitymentioning

confidence: 99%

“…Notably, hypogammaglobulinemia occurs in one-to two-thirds of patients with lymphocytic immunosuppression (136), which is associated with low levels of antigen-specific antifungal IgG and IgA antibodies and corresponds with chronicity of fungal infections (137). Therefore, such factors may also be considered important prerequisites for susceptibility to infections caused by black yeasts (135). Therefore, one additional aspect that should be considered is the fact that patients with defects in humoral immunity, such as agammaglobulinemia or hypogammaglobulinemia, might have relatively normal resistance to black yeasts and their filamentous relatives.…”

Section: Humoral Immunitymentioning

confidence: 99%

See 1 more Smart Citation

Black Yeasts and Their Filamentous Relatives: Principles of Pathogenesis and Host Defense

et al. 2014

View full text Add to dashboard Cite

SUMMARY Among the melanized fungi, the so-called “black yeasts” and their filamentous relatives are particularly significant as agents of severe phaeohyphomycosis, chromoblastomycosis, and mycetoma in humans and animals. The pathogenicity and virulence of these fungi may differ significantly between closely related species. The factors which probably are of significance for pathogenicity include the presence of melanin and carotene, formation of thick cell walls and meristematic growth, presence of yeast-like phases, thermo- and perhaps also osmotolerance, adhesion, hydrophobicity, assimilation of aromatic hydrocarbons, and production of siderophores. Host defense has been shown to rely mainly on the ingestion and elimination of fungal cells by cells of the innate immune system, especially neutrophils and macrophages. However, there is increasing evidence supporting a role of T-cell-mediated immune responses, with increased interleukin-10 (IL-10) and low levels of gamma interferon (IFN-γ) being deleterious during the infection. There are no standardized therapies for treatment. It is therefore important to obtain in vitro susceptibilities of individual patients' fungal isolates in order to provide useful information for selection of appropriate treatment protocols. This article discusses the pathogenesis and host defense factors for these fungi and their severity, chronicity, and subsequent impact on treatment and prevention of diseases in human or animal hosts.

show abstract

Section: Humoral Immunitymentioning

confidence: 99%

Section: Humoral Immunitymentioning

confidence: 99%

Black Yeasts and Their Filamentous Relatives: Principles of Pathogenesis and Host Defense

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Systemic and topical glucocorticoids (GC) are widely used for treating inflammatory disorders, including a variety of kidney, respiratory, cardiovascular and skin diseases . While systemic or topical GC often demonstrate numerous short‐term benefits, significant side effects, including generalised infections, diabetes, Cushing's syndrome and osteoporosis, can limit their usage . Topical GC are among the most widely used form of anti‐inflammatory therapy in dermatology, but physicians also often are reluctant to deploy them due to their atrophogenic side effects, including skin hypopigmentation, telangiectasia, delayed wound healing and impaired cutaneous innate immunity .…”

Section: Introductionmentioning

confidence: 99%

Topical hesperidin prevents glucocorticoid‐induced abnormalities in epidermal barrier function in murine skin

Man

Mauro

Kim

et al. 2014

Experimental Dermatology

View full text Add to dashboard Cite

Systemic and topical glucocorticoids (GC) can cause significant adverse effects not only on the dermis, but also on epidermal structure and function. In epidermis, a striking GC-induced alteration in permeability barrier function occurs that can be attributed to an inhibition of epidermal mitogenesis, differentiation and lipid production. As prior studies in normal hairless mice demonstrated that topical applications of a flavonoid ingredient found in citrus, hesperidin, improve epidermal barrier function by stimulating epidermal proliferation and differentiation, we assessed here whether its topical applications could prevent GC-induced changes in epidermal function in murine skin and the basis for such effects. When hairless mice were co-treated topically with GC and 2% hesperidin twice-daily for 9 days, hesperidin co-applications prevented the expected GC-induced impairments of epidermal permeability barrier homoeostasis and stratum corneum (SC) acidification. These preventive effects could be attributed to a significant increase in filaggrin expression, enhanced epidermal β-glucocerebrosidase activity and accelerated lamellar bilayer maturation, the last two likely attributable to a hesperidin-induced reduction in stratum corneum pH. Furthermore, co-applications of hesperidin with GC largely prevented the expected GC-induced inhibition of epidermal proliferation. Finally, topical hesperidin increased epidermal glutathione reductase mRNA expression, which could counteract multiple functional negative effects of GC on epidermis. Together, these results show that topical hesperidin prevents GC-induced epidermal side effects by divergent mechanisms.

show abstract

“…Neutrophil functions in leprotic patients remain intact, making them not susceptible to infection with Mucorales fungi. Very rare reports in the literature reported the occurrence of mucormycosis with leprosy that is complicated with ENL [25]. However the coexistence of both diseases could be a result of the immunosuppressive treatment given to control lepra reactions, or the presence of immunosuppressive condition such as diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Ketoacidosis with Two Life Threatening Infections: Mucormycosis, and Bilateral Emphysematous Pyelonepritis, Preciptating Erythema Nodosum Leprosum as the Initial Presentation of Diabetes

Elbendary¹

2014

J Diabetes Metab

View full text Add to dashboard Cite

Emphysematous pyelonephritis is an acute necrotizing renal and perirenal infection, caused by gas forming organism. Mucormycosis is an opportunistic aggressive fungal infection causing tissue thrombosis and necrosis. Erythema nodosum leprosum reaction is an inflammatory reaction occurring in borderline and lepromatous leprosy before, during or after multidrug treatment, where immune complexes deposit in various organs resulting in considerable damage to the organs that were site of deposition. Both emphysematous pyelonephritis and mucormycosis are infections that occur principally in diabetics, especially with poor control of blood sugar. Herein we report a 27 year old woman presenting to the emergency department with diabetic ketoacidosis as a first presentation of diabetes, where array of investigations revealed emphysematous pyelonephritis, palatal mucormycosis, and erythema nodosum leprosum. The early aggressive management with the correction of blood glucose and ketoacidosis help to give a successful outcome to the patient. To the best of our knowledge, this case is the first in English literature to report coexisting bilateral emphysematous pyelonephritis and palatal mucormycosis in a diabetic patient, precipitating erythema nodosum leprosum, and highlights the possibility of occurrence of more than one serious condition in a diabetic at a time.

show abstract

Mucormycosis and chromoblastomycosis occurring in a patient with leprosy type 2 reaction under prolonged corticosteroid and thalidomide therapy

Cited by 12 publications

References 9 publications

Black Yeasts and Their Filamentous Relatives: Principles of Pathogenesis and Host Defense

Black Yeasts and Their Filamentous Relatives: Principles of Pathogenesis and Host Defense

Topical hesperidin prevents glucocorticoid‐induced abnormalities in epidermal barrier function in murine skin

Diabetic Ketoacidosis with Two Life Threatening Infections: Mucormycosis, and Bilateral Emphysematous Pyelonepritis, Preciptating Erythema Nodosum Leprosum as the Initial Presentation of Diabetes

Contact Info

Product

Resources

About