Chromoblastomycosis in the Amazon region, Brazil, caused by Fonsecaea pedrosoi, Fonsecaea nubica, and Rhinocladiella similis: Clinicopathology, susceptibility, and molecular identification
Autor: | Ana Maria Zimmer de Almeida, Maria Walderez Szeszs, Luís Marcelo Aranha Camargo, Elizabeth Harummyy Takagi, Walderez Gambale, Marcia S. C. Melhem, Juliana de Souza Almeida Aranha Camargo, Tânia Sueli de Andrade, Madson Albuquerque, Sergio de Almeida Basano |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male Fonsecaea Veterinary medicine Antifungal Agents Itraconazole FILOGENIA Microbial Sensitivity Tests Flucytosine 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Ascomycota Amphotericin B DNA Ribosomal Spacer medicine Humans DNA Fungal Phylogeny Aged Voriconazole 0303 health sciences Chromoblastomycosis biology 030306 microbiology Sequence Analysis DNA General Medicine Middle Aged medicine.disease biology.organism_classification Fonsecaea pedrosoi Infectious Diseases Terbinafine Female Mitosporic Fungi Brazil medicine.drug |
Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
ISSN: | 1460-2709 1369-3786 |
Popis: | Chromoblastomycosis is a chronic subcutaneous disease caused by human contact with melanized fungi occurring mainly in tropical and subtropical zones worldwide. This study assessed 12 patients with chromoblastomycosis from Rondônia, Brazil, Amazon region. In sum, 83.3% were men, 41.6% were from Monte Negro city, median age was 52.9 years, and median time to disease progression was 12.2 years. Lesions were located on the lower limbs (75%), and verruciform was prevalent form (66.6%). After 3 years of treatment with itraconazole, two patients were considered cured. The etiological agents were identified by the molecular sequence of the ribosomal internal transcribed spacer ITS1, 5.8S, and ITS2 region and β-tubulin genes. Eight strains were identified as Fonsecaea pedrosoi, two were F. nubica, and two were Rhinocladiella similis. The antifungal activity of five drugs was evaluated, and the most active drug was terbinafine (range minimal inhibitory concentration [MIC] 0.015–0.12 μg/ml), itraconazole (range MIC 0.03–0.5 μg/ml) and voriconazole (range MIC 0.06–0.5 μg/ml). The highest MIC was 5-fluorocytosine (range MIC 2–32 μg/ml), and amphotericin B (range MIC 0.25–2 μg/ml). In conclusion, the present study expanded the epidemiological disease database and described for the first time F. nubica and R. similis as chromoblastomycosis agents in the Brazilian Amazon region. Our results confirmed the importance of using molecular methods to identify the melanized fungi and stimulate the recognition of the disease in other places where no cases have been reported. |
Databáze: | OpenAIRE |
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