Pythiosis in Equidae in Northeastern Brazil: 1985–2020

Souto, Erick Platiní Ferreira de; Maia, Lisanka Ângelo; Neto, E. G. Miranda; Kommers, Gláucia D.; Garino, Felício; Riet-Correa, Franklin; Galiza, Glauco José Nogueira de; Dantas, Antônio Flávio Medeiros

doi:10.1016/j.jevs.2021.103726

Cited by 10 publications

(6 citation statements)

References 29 publications

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“…Among all reported pythiosis cases, the frequently affected hosts included horses (n = 2312; 55.0%), followed by humans (n = 771; 18.3%), dogs (n = 664; 15.8%), cows (n = 292; 7.0%), sheep (n = 86; 2.1%), and cats (n = 41; 1.0%) (Table 3). The other affected vertebrates (i.e., donkeys, mules, camels, bears, birds, goat, tiger, and jaguar; n = 33) altogether accounted for 0.8% of all reported cases [78][79][80][81][82][83][84][85][86][87][88][89]. Pythiosis in animals has been mainly reported from the U.S.A. (n = 1876; 54.7% of all animal cases), Brazil (n = 842; 24.5%), Australia (n = 261; 7.6%), Colombia (n = 141; 4.1%), Egypt (n = 98; 2.9%), Venezuela (n = 79; 2.3%), and Costa Rica (n = 76; 2.2%), whereas the disease in humans has been primarily discovered in India (n = 434; 56.3% of all human cases) and Thailand (n = 293; 38.0%) (Table 1).…”

Section: Affected Animal Typesmentioning

confidence: 99%

Global Distribution and Clinical Features of Pythiosis in Humans and Animals

Yolanda

Krajaejun

2022

JoF

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Pythiosis is a difficult-to-treat infectious disease caused by Pythium insidiosum. The condition is unfamiliar among healthcare workers. Manifestation of pythiosis is similar to other fungal infections, leading to misdiagnosis and delayed treatment. The geographical extent of pythiosis at a global scale is unclear. This study aimed to analyze the clinical information recorded in the scientific literature to comprehensively project epidemiological characteristics, clinical features, and future trends of pythiosis. From 1980 to 2021, 4203 cases of pythiosis in humans (n = 771; 18.3%) and animals (primarily horse, dog, and cow; n = 3432; 81.7%), with an average of 103 cases/year, were recruited. Pythiosis case reports significantly increased in the last decade. Pythiosis spanned 23 tropical, subtropical, and temperate countries worldwide. Some patients acquired pythiosis from a trip to an endemic country. Strikingly, 94.3% of human cases were in India and Thailand, while 79.2% of affected animals were in the U.S.A. and Brazil. Clinical features of pythiosis varied. Vascular and ocular pythiosis were only observed in humans, whereas cutaneous/subcutaneous and gastrointestinal infections were predominant in animals. Mortality depended on host species and clinical forms: for example, none in patients with ocular pythiosis, 0.7% in cows with a cutaneous lesion, 26.8% in humans with vascular disease, 86.4% in dogs with gastrointestinal pathology, and 100% in several animals with disseminated infection. In summary, this study reports up-to-date epidemiological and clinical features of pythiosis in humans and animals. It increases awareness of this life-threatening disease, as the illness or outbreak can exist in any country, not limited to the endemic areas.

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Section: Affected Animal Typesmentioning

confidence: 99%

Global Distribution and Clinical Features of Pythiosis in Humans and Animals

Yolanda

Krajaejun

2022

JoF

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“…TA is an immunomodulator that could activate macrophages, increase an interleukin-10 level, and reduce eosinophils and immunoglobulin E antibodies [176,177]. Intramuscular injection of TA, as a monotherapy, cured several horses with cutaneous pythiosis [68,[79][80][81][82]. This study evaluated TA for its antimicrobial effect against P. insidiosum.…”

Section: Evaluation Of Alternative Chemicals For Anti-p Insidiosum Ac...mentioning

confidence: 99%

“…The management of such cases relies on antimicrobial agents and other treatment modalities to control the disease and prevent a recurrence. Some unconventional medications (i.e., potassium iodide (KI) [15,39,46,[67][68][69][70][71][72][73][74][75][76][77][78], triamcinolone acetonide (TA) [68,[79][80][81][82], dimethyl sulfoxide (DMSO) [83][84][85][86][87], and ethanol (EtOH) [88][89][90]) have been implemented for the management of several pythiosis patients and show satisfactory treatment outcomes. KI, TA, DMSO, and EtOH were not originally designed for use as antimicrobial agents.…”

Section: Introductionmentioning

confidence: 99%

“…Steroids (i.e., TA, prednisone, and dexamethasone) modulate the immune response, an important property used for controlling many medical conditions, such as allergies, autoimmune diseases, and inflammatory disorders [101][102][103]. Regarding pythiosis treatment, TA has been used as a monotherapy in some affected horses that fully recovered from the disease [68,[79][80][81]. When combined with surgery, immunotherapy, and other medications (i.e., terbinafine, itraconazole, and mefenoxam), prednisone successfully cured dogs with pythiosis [63,104].…”

Section: Introductionmentioning

confidence: 99%

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Selection of an Appropriate In Vitro Susceptibility Test for Assessing Anti-Pythium insidiosum Activity of Potassium Iodide, Triamcinolone Acetonide, Dimethyl Sulfoxide, and Ethanol

Yolanda

Lohnoo

Rujirawat

et al. 2022

JoF

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The orphan but highly virulent pathogen Pythium insidiosum causes pythiosis in humans and animals. Surgery is a primary treatment aiming to cure but trading off losing affected organs. Antimicrobial drugs show limited efficacy in treating pythiosis. Alternative drugs effective against the pathogen are needed. In-house drug susceptibility tests (i.e., broth dilution, disc diffusion, and radial growth assays) have been established, some of which adapted the standard protocols (i.e., CLSI M38-A2 and CLSI M51) designed for fungi. Hyphal plug, hyphal suspension, and zoospore are inocula commonly used in the drug susceptibility assessment for P. insidiosum. A side-by-side comparison demonstrated that each method had advantages and limitations. Minimum inhibitory and cidal concentrations of a drug varied depending on the selected method. Material availability, user experience, and organism and drug quantities determined which susceptibility assay should be used. We employed the hyphal plug and a combination of broth dilution and radial growth methods to screen and validate the anti-P. insidiosum activities of several previously reported chemicals, including potassium iodide, triamcinolone acetonide, dimethyl sulfoxide, and ethanol, in which data on their anti-P. insidiosum efficacy are limited. We tested each chemical against 29 genetically diverse isolates of P. insidiosum. These chemicals possessed direct antimicrobial effects on the growth of the pathogen in a dose- and time-dependent manner, suggesting their potential application in pythiosis treatment. Future attempts should focus on standardizing these drug susceptibility methods, such as determining susceptibility/resistant breakpoints, so healthcare workers can confidently interpret a result and select an effective drug against P. insidiosum.

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“…Las lesiones cutáneas son más frecuentes en las partes distales de las extremidades, el abdomen ventral y lateral, la región pectoral y la boca, quizá por el mayor contacto de estas áreas con aguas potencialmente contaminadas con zoosporas. Las lesiones son ulcerativas granulomatosas, con bordes irregulares, trayectos fistulosos o cavitaciones y con presencia de masas necróticas duras que se desprenden fácilmente (Atiba et al, 2020, Souto et al, 2021.…”

Section: Introductionunclassified

Inmunoterapia y manejo quirúrgico de Pythium insidiosum en un equino: reporte de caso

2021

Abanico Vet

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Pythiosis in Equidae in Northeastern Brazil: 1985–2020

Cited by 10 publications

References 29 publications

Global Distribution and Clinical Features of Pythiosis in Humans and Animals

Global Distribution and Clinical Features of Pythiosis in Humans and Animals

Selection of an Appropriate In Vitro Susceptibility Test for Assessing Anti-Pythium insidiosum Activity of Potassium Iodide, Triamcinolone Acetonide, Dimethyl Sulfoxide, and Ethanol

Inmunoterapia y manejo quirúrgico de Pythium insidiosum en un equino: reporte de caso

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