Partial suppression of cell mediated immunity in chromoblastomycosis

Fuchs, Jürgen; Pecher, Simão Arão

doi:10.1007/bf00443936

Cited by 18 publications

(9 citation statements)

References 8 publications

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“…In this context attention may be called to a recent clinical study of eight chromoblastomycosis patients [16]. It was pointed out that a partial suppression of cell-mediated immune response to fungal antigens occurred at some point during the patients' infections and might have played a predisposing role.…”

Section: Discussionmentioning

confidence: 99%

A rare case of chromoblastomycosis in a renal transplant recipient caused by a non-sporulating species ofRhytidhysteron

et al. 2008

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We report a rare case of chromoblastomycosis caused by a non-sporulating species of Rhytidhysteron (Order Patellariales, Ascomycota) which was identified by molecular methods. The patient was a post-renal transplant recipient male aged 50 years and a resident of Delhi. The diagnosis was made by direct microscopy, histopathology and isolation of multiple colonies of the dematiaceous mould in pure culture. The samples used to recover the organism were obtained from a biopsy of one of the lesions occurring on his left foot and extending to the shin and thigh. The lesions comprised necrotic granulation tissue with indurated and thickened margins. After 2 weeks of therapy with itraconazole, 100 mg twice daily, the lesions partially retracted. However, the patient developed complications of acute abdominal pain with respiratory distress, necessitating admission to a tertiary-care hospital where he died due to multiple organ failure within 48 h. All attempts to induce sporulation of the fungal isolate on various mycological culture media were unsuccessful. Thereafter, sequencing of the 18S rRNA gene of the isolate and its comparison with GenBank database revealed that the fungus belonged to the genus Rhytidhysteron. As far as we are aware, this is the first case of human infection caused by a fungus of the Order Patellariales. The case underlines the relevance of molecular techniques as valuable tools for identification of non-sporulating opportunistic pathogenic fungi.

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Section: Discussionmentioning

confidence: 99%

A rare case of chromoblastomycosis in a renal transplant recipient caused by a non-sporulating species ofRhytidhysteron

et al. 2008

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“…Stimulation of CD4 ϩ cells by macrophages responsible for the engulfment of F. pedrosoi is essential to prevent CBM development (228). Impairment of cell-mediated immunity in CBM patients led to an inefficient reaction to fungally derived antigens, resulting in the maintenance of CBM-related fungi in lesional skin (229). A delayed-type hypersensitivity (DTH) reaction in F. pedrosoi CBM indicates that inflammation may be mediated by T cells (227).…”

Section: Adaptive Immune Responsementioning

confidence: 99%

Chromoblastomycosis

et al. 2017

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SUMMARY Chromoblastomycosis (CBM), also known as chromomycosis, is one of the most prevalent implantation fungal infections, being the most common of the gamut of mycoses caused by melanized or brown-pigmented fungi. CBM is mainly a tropical or subtropical disease that may affect individuals with certain risk factors around the world. The following characteristics are associated with this disease: (i) traumatic inoculation by implantation from an environmental source, leading to an initial cutaneous lesion at the inoculation site; (ii) chronic and progressive cutaneous and subcutaneous tissular involvement associated with fibrotic and granulomatous reactions associated with microabscesses and often with tissue proliferation; (iii) a nonprotective T helper type 2 (Th2) immune response with ineffective humoral involvement; and (iv) the presence of muriform (sclerotic) cells embedded in the affected tissue. CBM lesions are clinically polymorphic and are commonly misdiagnosed as various other infectious and noninfectious diseases. In its more severe clinical forms, CBM may cause an incapacity for labor due to fibrotic sequelae and also due to a series of clinical complications, and if not recognized at an early stage, this disease can be refractory to antifungal therapy.

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“…It has been demonstrated that cell-mediated immunity in patients with a chronic form of black yeast infection is impaired and that patients are unable to develop an efficient immune reaction to fungal antigens, which corresponds to the chronicity and persistence of the fungus in tissue (113). In experimental infection models using athymic mice infected with black yeasts, it was shown that during the course of infection, granulomas became diffuse and confluent, with a random fungal distribution, suggesting a role for a T-cell-mediated immune response (114).…”

Section: Adaptive Immunitymentioning

confidence: 99%

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

et al. 2014

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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.

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Partial suppression of cell mediated immunity in chromoblastomycosis

Cited by 18 publications

References 8 publications

A rare case of chromoblastomycosis in a renal transplant recipient caused by a non-sporulating species ofRhytidhysteron

A rare case of chromoblastomycosis in a renal transplant recipient caused by a non-sporulating species ofRhytidhysteron

Chromoblastomycosis

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

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