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Potenciano da Silva KL, Moraes D, Lechner B, Lindner H, Haas H, Almeida Soares CM, Silva-Bailão MG, Bailão AM. Fonsecaea pedrosoi produces ferricrocin and can utilize different host iron sources. Fungal Biol 2023; 127:1512-1523. [PMID: 38097325 DOI: 10.1016/j.funbio.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 12/18/2023]
Abstract
The survival of living organisms depends on iron, one of the most abundant metals in the Earth's crust. Nevertheless, this micronutrient is poorly available in our aerobic atmosphere as well as inside the mammalian host. This problem is circumvented by the expression of high affinity iron uptake machineries, including the production of siderophores, in pathogenic fungi. Here we demonstrated that F. pedrosoi, the causative agent of the neglected tropical disease chromoblastomycosis, presents gene clusters for siderophore production. In addition, ten putative siderophore transporters were identified. Those genes are upregulated under iron starvation, a condition that induces the secretion of hydroxamates, as revealed by chrome azurol S assays. RP-HPLC and mass spectrometry analysis allowed the identification of ferricrocin as an intra- and extracellular siderophore. F. pedrosoi can grow in different iron sources, including the bacterial ferrioxamine B and the host proteins ferritin, hemoglobin and holotransferrin. Of note, addition of hemoglobin, lactoferrin and holotransferrin to the growth medium of macrophages infected with F. pedrosoi enhanced significantly fungal survival. The ability to produce siderophores in iron limited conditions added to the versatility to utilize different sources of iron are strategies that certainly may contribute to fungal survival inside the host.
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Affiliation(s)
| | - Dayane Moraes
- Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.
| | - Beatrix Lechner
- Institute of Molecular Biology/ Biocenter, Medical University of Innsbruck, Innsbruck, Austria.
| | - Herbert Lindner
- Institute of Medical Biochemistry/Biocenter, Medical University of Innsbruck, Innsbruck, Austria.
| | - Hubertus Haas
- Institute of Molecular Biology/ Biocenter, Medical University of Innsbruck, Innsbruck, Austria.
| | | | | | - Alexandre Melo Bailão
- Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, Goiás, Brazil.
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Shenoy MM, Girisha BS, Krishna S. Chromoblastomycosis: A Case Series and Literature Review. Indian Dermatol Online J 2023; 14:665-669. [PMID: 37727562 PMCID: PMC10506812 DOI: 10.4103/idoj.idoj_292_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 09/21/2023] Open
Abstract
Chromoblastomycosis is a subcutaneous mycosis caused by a variety of dematiaceous fungi. Fonsecaea (F.) pedrosoi is the most common causative agent. Majority of cases have been reported from tropical and subtropical regions with rural and agricultural background. It is a chronic disease with low incidence of complications but is very refractory to therapies. This is a case series of 22 cases of chromoblastomycosis from two health-care facilities in India. Information regarding the history, clinical presentations, diagnostic methods, therapy, and outcome of treatment were retrieved. Preponderance was seen among the males and in the age group of 41-60 years. Manual and agricultural laborers were commonly affected. Lower extremities were the most common sites affected. Morphological patterns like verrucous plaque, psoriasiform plaque, and verrucous nodules were seen. Direct microscopy with potassium hydroxide (KOH) mount was positive in all the cases. Histopathology in all cases displayed suppurative granulomatous inflammation with pigmented fungal cells. Fungal culture was positive in 10 cases with F. pedrosoi being the commonest agent. Antifungal treatment alone was instituted in 10 cases, cryotherapy along with antifungal therapy was given in 9 cases, and surgical excision was done in 3 cases. Complete clinical cure was achieved in seven cases. Chromoblastomycosis is characterized by chronicity, diverse clinical presentations, and therapeutic recalcitrance. Direct KOH mount of the black dots forms an important bedside tool in the diagnosis. Long-term antifungal therapy along with adjuvant cryotherapy may be the best option for the management.
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Affiliation(s)
- Manjunath M. Shenoy
- Department of Dermatology, Yenepoya Medical College, Mangalore, Karnataka, India
| | - Banavasi S. Girisha
- Department of Dermatology, K. S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Sowmyashree Krishna
- Department of Dermatology, S. D. M. College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
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Favilla LD, Herman TS, Goersch CDS, de Andrade RV, Felipe MSS, Bocca AL, Fernandes L. Expanding the Toolbox for Functional Genomics in Fonsecaea pedrosoi: The Use of Split-Marker and Biolistic Transformation for Inactivation of Tryptophan Synthase ( trpB) Gene. J Fungi (Basel) 2023; 9:jof9020224. [PMID: 36836338 PMCID: PMC9963410 DOI: 10.3390/jof9020224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
Chromoblastomycosis (CBM) is a disease caused by several dematiaceous fungi from different genera, and Fonsecaea is the most common which has been clinically isolated. Genetic transformation methods have recently been described; however, molecular tools for the functional study of genes have been scarcely reported for those fungi. In this work, we demonstrated that gene deletion and generation of the null mutant by homologous recombination are achievable for Fonsecaea pedrosoi by the use of two approaches: use of double-joint PCR for cassette construction, followed by delivery of the split-marker by biolistic transformation. Through in silico analyses, we identified that F. pedrosoi presents the complete enzymatic apparatus required for tryptophan (trp) biosynthesis. The gene encoding a tryptophan synthase trpB -which converts chorismate to trp-was disrupted. The ΔtrpB auxotrophic mutant can grow with external trp supply, but germination, viability of conidia, and radial growth are defective compared to the wild-type and reconstituted strains. The use of 5-FAA for selection of trp- phenotypes and for counter-selection of strains carrying the trp gene was also demonstrated. The molecular tools for the functional study of genes, allied to the genetic information from genomic databases, significantly boost our understanding of the biology and pathogenicity of CBM causative agents.
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Affiliation(s)
- Luísa Dan Favilla
- Laboratory of Applied Immunology, Institute of Biology, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
- Graduate Program in Molecular Biology, Institute of Biology, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
| | - Tatiana Sobianski Herman
- Laboratory of Applied Immunology, Institute of Biology, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
- Graduate Program in Molecular Patology, Faculty of Medicine, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
| | - Camila da Silva Goersch
- Laboratory of Applied Immunology, Institute of Biology, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
- Graduate Program in Microbial Biology, Institute of Biology, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
| | - Rosangela Vieira de Andrade
- Graduate Program of Genomic Sciences and Biotechnology, Catholic University of Brasilia, Campus Asa Norte, Asa Norte, Federal District, Taguatinga 70790-160, Brazil
| | - Maria Sueli Soares Felipe
- Graduate Program of Genomic Sciences and Biotechnology, Catholic University of Brasilia, Campus Asa Norte, Asa Norte, Federal District, Taguatinga 70790-160, Brazil
| | - Anamélia Lorenzetti Bocca
- Laboratory of Applied Immunology, Institute of Biology, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
- Graduate Program in Molecular Biology, Institute of Biology, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
- Graduate Program in Molecular Patology, Faculty of Medicine, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
| | - Larissa Fernandes
- Laboratory of Applied Immunology, Institute of Biology, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
- Graduate Program in Microbial Biology, Institute of Biology, Campus Darcy Ribeiro, University of Brasília, Asa Norte, Federal District, Brasilia 70910-900, Brazil
- Centro Metropolitano, Faculty of Ceilândia, Campus UnB Ceilândia, University of Brasília, Ceilândia Sul, Federal District, Brasilia 72220-275, Brazil
- Correspondence:
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Guevara A, Nery AF, de Souza Carvalho Melhem M, Bonfietti L, Rodrigues AM, Hagen F, de Carvalho J, de Camargo ZP, de Souza Lima B, Vicente VA, Hahn RC. Molecular epidemiology and clinical-laboratory aspects of chromoblastomycosis in Mato Grosso, Brazil. Mycoses 2022; 65:1146-1158. [PMID: 35869803 PMCID: PMC9828117 DOI: 10.1111/myc.13505] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Chromoblastomycosis is a disease caused by melanized fungi, primarily belonging to the genera Fonsecaea and Cladophialophora, mainly affecting individuals who are occupationally exposed to soil and plant products. This research aimed to determine the clinical, epidemiological and laboratory characteristics of chromoblastomycosis in the state of Mato Grosso, Brazil. MATERIALS AND METHODS Patients diagnosed with chromoblastomycosis treated at the Júlio Müller University Hospital, Cuiabá, Brazil, from January 2015 to December 2020, whose isolates were preserved in the Research Laboratory of the Faculty of Medicine of the Federal University of Mato Grosso. Isolates were identified by partly sequencing the Internal Transcribed Spacer (ITS) and β-tubulin (BT2) loci. AFLP fingerprinting was used to explore the genetic diversity. Susceptibility to itraconazole, voriconazole, 5-fluorocytosine, terbinafine and amphotericin B was determined by the broth microdilution technique. RESULTS Ten patients were included, nine were male (mean age = 64.1 years). Mean disease duration was 8.6 years. Lesions were mainly observed in the lower limbs. Predominant clinical forms were verrucous and scarring. Systemic arterial hypertension and type II diabetes mellitus were the predominant comorbidities. Leprosy was the main concomitant infectious disease. Fonsecaea pedrosoi was the unique aetiological agent identified with moderate genetic diversity (H = 0.3934-0.4527; PIC = 0.3160-0.3502). Antifungal agents with the highest activity were terbinafine, voriconazole and itraconazole. CONCLUSION Chromoblastomycosis is affecting the poor population in rural and urban areas, mainly related to agricultural activities, with F. pedrosoi being the dominant aetiologic agent. All isolates had low MICs for itraconazole, voriconazole and terbinafine, confirming their importance as therapeutic alternatives for chromoblastomycosis.
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Affiliation(s)
- Armando Guevara
- Laboratory of Mycology/Research, Faculty of MedicineFederal University of Mato GrossoCuiabáMato GrossoBrazil
| | - Andréia Ferreira Nery
- Júlio Muller University HospitalFederal University of Mato GrossoCuiabáMato GrossoBrazil
| | - Márcia de Souza Carvalho Melhem
- Health DepartmentMycology Nucleus of Instituto Adolfo LutzSão PauloSPBrazil,School of MedicineFederal University of Mato Grosso do SulCampo Grande, MSBrazil
| | - Lucas Bonfietti
- Health DepartmentMycology Nucleus of Instituto Adolfo LutzSão PauloSPBrazil
| | - Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular BiologyFederal University of São Paulo (UNIFESP)São PauloBrazil,Department of Medicine, Discipline of Infectious DiseasesFederal University of São Paulo (UNIFESP)São PauloBrazil
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity InstituteUtrechtThe Netherlands,Institute for Biodiversity and Ecosystem Dynamics (IBED)University of AmsterdamThe Netherlands,Department of Medical MicrobiologyUtrecht University Medical CenterUtrechtThe Netherlands
| | - Jamile Ambrósio de Carvalho
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular BiologyFederal University of São Paulo (UNIFESP)São PauloBrazil,Department of Medicine, Discipline of Infectious DiseasesFederal University of São Paulo (UNIFESP)São PauloBrazil
| | - Zoilo Pires de Camargo
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular BiologyFederal University of São Paulo (UNIFESP)São PauloBrazil,Department of Medicine, Discipline of Infectious DiseasesFederal University of São Paulo (UNIFESP)São PauloBrazil
| | - Bruna Jacomel F. de Souza Lima
- Microbiology, Parasitology and Pathology Post‐Graduation Program, Department of PathologyFederal University of ParanáCuritibaParanáBrazil
| | | | - Rosane Christine Hahn
- Laboratory of Mycology/Research, Faculty of MedicineFederal University of Mato GrossoCuiabáMato GrossoBrazil,Júlio Muller University HospitalFederal University of Mato GrossoCuiabáMato GrossoBrazil
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Pagliari C, Kanashiro-Galo L, Sotto MN. Inflammasome and Inflammatory Programmed Cell Death in Chromoblastomycosis. Mycopathologia 2022; 188:63-70. [PMID: 36273348 DOI: 10.1007/s11046-022-00679-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/05/2022] [Indexed: 10/24/2022]
Abstract
Chromoblastomycosis (CBM) is a chronic, progressive fungal disease of the skin and subcutaneous tissue caused by a group of dematiaceous fungi. Verrucous lesions present parasite-rich granulomas and predominance of a Th2 patterns of cytokines. The inflammasome constitutes a macromolecular protein complex that play a role in the activation of caspase 1 that cleaves pro-IL1β and pro-IL18, essential mediators of inflammation, and also activates pyroptosis. We intended to explore the presence and a possible role of inflammasome elements in cutaneous human lesions in CBM, considering the expression of IL1β, IL18, caspase 1, NLRP1, and also RIPK3, a key downstream component of necroptosis signaling. 35 skin biopsies of cutaneous lesions of verrucous form of CBM and 10 biopsies from normal skin were selected. The diagnosis was based on histological and clinical analysis. An immunohistochemical protocol was performed. The histopathological analysis evidenced epidermis with hyperkeratosis, irregular acanthosis, and micro abscesses. The dermis presented suppurative granulomas and inflammatory infiltrate composed by giant cells, macrophages, epithelioid cells, lymphocytes, and some eosinophils. Positive cells were distributed in the inflammatory infiltrate, with an increased number of cells expressing caspase 1, IL1β and IL18. Cells expressing RIPK3 and NLRP1 were less frequent. The intense presence of caspase 1, IL1β and IL18, allied to NLRP1 expression, suggest that inflammasome and pyroptosis could play a role in the immune response against fungal agents of CBM. Our results, allied to data from literature, could suggest that inflammasome-mediated response and pyroptosis could be a target to be explored to decrease CBM lesions.
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Coelho RA, Alves GM, Figueiredo-Carvalho MHG, Almeida-Silva F, de Souza GR, Lourenço MCDS, Brito-Santos F, Amaral ACF, Almeida-Paes R. New possibilities for chromoblastomycosis and phaeohyphomycosis treatment: identification of two compounds from the MMV Pathogen Box® that present synergism with itraconazole. Mem Inst Oswaldo Cruz 2022; 117:e220089. [PMID: 36102413 PMCID: PMC9467274 DOI: 10.1590/0074-02760220089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/23/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Black fungi of the Herpotrichiellaceae family are agents of chromoblastomycosis and phaeohyphomycosis. There are few therapeutic options for these infections and it is common to associate antifungal drugs in their treatment. OBJECTIVES To investigate the Medicines for Malaria Venture (MMV) Pathogen Box® for possible compounds presenting synergism with antifungal drugs used to treat black fungal infections. METHODS An initial screening of the Pathogen Box® compounds was performed in combination with itraconazole or terbinafine at sub-inhibitory concentrations against Fonsecaea pedrosoi. Hits were further tested against eight Herpotrichiellaceae using the checkerboard method. FINDINGS No synergism was observed with terbinafine. MMV687273 (SQ109) and MMV688415 showed synergism with itraconazole against F. pedrosoi. Synergism of these compounds was confirmed with some black fungi by the checkerboard method. SQ109 and itraconazole presented synergism for Exophiala dermatitidis, F. pedrosoi, F. monophora and F. nubica, with fungicidal activity for F. pedrosoi and F. monophora. MMV688415 presented synergism with itraconazole only for F. pedrosoi, with fungicidal activity. The synergic compounds had high selectivity index values when combined with itraconazole. MAIN CONCLUSIONS These compounds in combination, particularly SQ109, are promising candidates to treat Fonsecaea spp. and E. dermatitidis infections, which account for most cases of chromoblastomycosis and phaeohyphomycosis.
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Affiliation(s)
- Rowena Alves Coelho
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brasil
| | - Gabriela Machado Alves
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brasil
| | | | - Fernando Almeida-Silva
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brasil
| | - Gabriela Rodrigues de Souza
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Plataforma de Bioensaios RPT 11B, Rio de Janeiro, RJ, Brasil
| | - Maria Cristina da Silva Lourenço
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Plataforma de Bioensaios RPT 11B, Rio de Janeiro, RJ, Brasil
| | | | - Ana Claudia Fernandes Amaral
- Fundação Oswaldo Cruz-Fiocruz, Farmanguinhos, Laboratório de Produtos Naturais e Derivados, Rio de Janeiro, RJ, Brasil
| | - Rodrigo Almeida-Paes
- Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Infectologia Evandro Chagas, Laboratório de Micologia, Rio de Janeiro, RJ, Brasil
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Guevara A, Vicente VA, de Souza Lima BJF, Nery AF, Hagen F, Hahn RC. Chromoblastomycosis-Leprosy Co-Infection in Central West Brazil. Presentation of Three Cases and Literature Review. Mycopathologia 2022; 187:363-374. [PMID: 35764905 PMCID: PMC9325793 DOI: 10.1007/s11046-022-00646-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/15/2022] [Indexed: 11/26/2022]
Abstract
Chromoblastomycosis and leprosy are chronic diseases with high prevalence in tropical and subtropical regions. Brazil is one of the countries with the highest incidence and prevalence for both diseases, however, reports of co-infections are scarce. The aim of this study was to describe three cases of chromoblastomycosis-leprosy co-infection in patients from Mato Grosso state, Brazil. A review of chromoblastomycosis-leprosy co-infection was performed of English, Portuguese and Spanish publications in LILACS, SciELO, PubMed and Web of Science databases using the descriptors (chromoblastomycosis OR cromoblastomicose OR cromoblastomicosis) AND (leprosy OR hanseníase OR lepra), without time period delimitation. Nineteen cases were included, 16 cases were published in 11 articles, plus the three cases reported in the current study. Most reported coninfection cases came from Brazil. Majority of the patients were male with a mean age of 52.2 years. Farmer was the main occupational activity reported. In 12 patients, the clinical signs and symptoms of leprosy started first. No contacts with patients affected by leprosy, armadillos or history of injuries at the anatomical site of chromoblastomycosis lesions were reported. Five leprosy patients who received steroid treatment for leprosy reactions or neuropathies, were diagnosed with chromoblastomycosis during immunosuppressive therapy. Four cases (21.1%) were reported among the elderly patients. Co-infections in patients with chromoblastomycosis or leprosy are uncommon, but the possibility should always be considered, especially if the patient is undergoing immunosuppressive treatment or is elder.
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Affiliation(s)
- Armando Guevara
- Laboratory of Mycology/Research, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Vânia Aparecida Vicente
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Bruna Jacomel F de Souza Lima
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Andréia Ferreira Nery
- Júlio Muller University Hospital - Ebserh, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Ferry Hagen
- Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584CT, Utrecht, The Netherlands.
- Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands.
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Rosane Christine Hahn
- Laboratory of Mycology/Research, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
- Júlio Muller University Hospital - Ebserh, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
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Liu H, Sun J, Li M, Cai W, Chen Y, Liu Y, Huang H, Xie Z, Zeng W, Xi L. Molecular Characteristics of Regional Chromoblastomycosis in Guangdong, China: Epidemiological, Clinical, Antifungal Susceptibility, and Serum Cytokine Profiles of 45 Cases. Front Cell Infect Microbiol 2022; 12:810604. [PMID: 35252030 PMCID: PMC8894709 DOI: 10.3389/fcimb.2022.810604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/24/2022] [Indexed: 11/20/2022] Open
Abstract
Chromoblastomycosis (CBM) is a chronic disease caused by several species of dematiaceous fungi. In this study, a regional collection of 45 CBM cases was conducted in Guangdong, China, a hyper-endemic area of CBM. Epidemiology findings indicated that the mean age of cases was 61.38 ± 11.20 years, long duration ranged from 3 months to 30 years, and the gender ratio of male to female was 4.6:1. Thirteen cases (29%) declared underlying diseases. Verrucous form was the most common clinical manifestation (n = 19, 42%). Forty-five corresponding clinical strains were isolated, and 28 of them (62%) were identified as F. monophora; the remaining 17 (38%) were identified as F. nubica through ITS rDNA sequence analysis. Antifungal susceptibility tests in vitro showed low MICs in azoles (PCZ 0.015–0.25 μg/ml, VCZ 0.015–0.5 μg/ml, and ITZ 0.03–0.5 μg/ml) and TRB (0.015–1 μg/ml). Itraconazole combined with terbinafine was the main therapeutic strategy used for 31 of 45 cases, and 68% (n = 21) of them improved or were cured. Cytokine profile assays indicated upregulation of IL-4, IL-7, IL-15, IL-11, and IL-17, while downregulation of IL-1RA, MIP-1β, IL-8, and IL-16 compared to healthy donors (p < 0.05). The abnormal cytokine profiles indicated impaired immune response to eliminate fungus in CBM cases, which probably contributed to the chronic duration of this disease. In conclusion, we investigated the molecular epidemiological, clinical, and laboratory characteristics of CBM in Guangdong, China, which may assist further clinical therapy, as well as fundamental pathogenesis studies of CBM.
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Affiliation(s)
- Hongfang Liu
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Guangdong Dermatology Hospital of Anhui Medical University, Guangzhou, China
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Minying Li
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Wenying Cai
- Sun Yat-sen Memorial Hospital of Zhongshan University, Guangzhou, China
| | - Yangxia Chen
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Yinghui Liu
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Huan Huang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zhenmou Xie
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Weiying Zeng
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Liyan Xi
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Sun Yat-sen Memorial Hospital of Zhongshan University, Guangzhou, China
- Department of Dermatology and Venerology, Guangzhou First People’s Hospital, Guangzhou, China
- *Correspondence: Liyan Xi,
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9
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Guevara A, Siqueira NP, Nery AF, Cavalcante LRDS, Hagen F, Hahn RC. Chromoblastomycosis in Latin America and the Caribbean: epidemiology over the past 50 years. Med Mycol 2021; 60:6391503. [PMID: 34637525 DOI: 10.1093/mmy/myab062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/30/2021] [Accepted: 10/09/2021] [Indexed: 01/19/2023] Open
Abstract
Chromoblastomycosis is a chronic disease caused by melanized fungi that mainly affect individuals performing soil-related labour. The objective of this study was to analyse the epidemiological and clinical characteristics of chromoblastomycosis in Latin America and the Caribbean by an extensive literature review. An integrative review was performed of English, French, Portuguese, and Spanish publications in LILACS, SciELO, PubMed, SCOPUS and Web of Science databases covering the period 1969-2019. A total of 1,211 articles were identified, of which 132 were included in the review, covering 2,081 patients, 80.3% were male, the mean age was 56.1 years. The mean duration of the disease was 10.8 years. The lesions were mainly described in the lower limbs (60%). The most frequent clinical forms were verrucous (46.4%) and tumorous (21.7%). Major disease symptoms and signs consisted of itching and pain. Bacterial infection and functional limitation were important complications. Immunosuppression post-kidney transplantation was the most frequent comorbidity while leprosy was the main concomitant infectious disease. Fonsecaea pedrosoi and Cladophialophora carrionii were the predominant etiological agents. Majority of the cured cases were treated with itraconazole as monotherapy or in combination with other antifungals, surgery or cryosurgery. Chromoblastomycosis affects hundreds of rural workers in Latin America and the Caribbean, causing disability and personal, family and economic losses. It is important to prioritize epidemiological surveillance and early diagnosis of this disease in order to reveal its real prevalence and direct resources to preventive actions, diagnosis and early treatment. LAY SUMMARY Chromoblastomycosis is a slowly progressing chronic disease caused by melanized fungi. We collected data from South America and the Caribbean covering 1969-2019, the 132 articles included 2 081 patients, mean disease duration was 10.8 years. Fonsecaea pedrosoi and Cladophialophora carrionii predominated.
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Affiliation(s)
- Armando Guevara
- Mycology/Research Laboratory, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Nathan Pereira Siqueira
- Mycology/Research Laboratory, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Andreia Ferreira Nery
- Department of Internal Medicine, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.,Júlio Muller University Hospital, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | | | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, Utrecht, The Netherlands.,Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Utrecht The Netherlands
| | - Rosane Christine Hahn
- Mycology/Research Laboratory, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.,Júlio Muller University Hospital, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
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Lima ACDC, Santos DWDCL, Hirata SH, Nishikaku AS, Enokihara MMSES, Ogawa MM. Therapeutic management of subcutaneous phaeohyphomycosis and chromoblastomycosis in kidney transplant recipients: a retrospective study of 82 cases in a single center. Int J Dermatol 2021; 61:346-351. [PMID: 34633082 DOI: 10.1111/ijd.15948] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 09/01/2021] [Accepted: 09/23/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Melanized fungi are a distinct group of pathogens that cause infections like chromoblastomycosis and phaeohyphomycosis, especially in a state of immunosuppression including solid organ transplant recipients. Guidelines for the treatment of these infections are lacking, and there is no available standard recommendation. OBJECTIVE To evaluate the therapeutic aspects of subcutaneous melanized fungal infections in kidney transplant recipients. METHODS A retrospective medical record was performed for kidney transplant recipients with melanized fungal infection evaluated in a single institution from January 1996 to December 2018. RESULTS Eighty-two episodes were noticed in our series. The treatment of subcutaneous phaeohyphomycosis was managed by surgical excision without antifungal therapy in 34 cases (34/68; 50%), and the association of both methods occurred in 18 cases (18/68; 26.5%). A complete surgical excision without antifungal therapy was observed in six (6/14; 42.9%) episodes of chromoblastomycosis, and combined treatment was possible in three (3/14; 21.4%) cases. Five episodes of chromoblastomycosis and 16 episodes of phaeohyphomycosis were managed only with antifungal therapy. CONCLUSION Management depends on the dermatologic lesion, immunosuppression condition, and anatomical cleavage plane. The sample size is still small in order to dictate a guideline, but it can be hard to execute a larger study given the rarity of this group of infections.
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Affiliation(s)
| | | | - Sérgio Henrique Hirata
- Department of Dermatology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | | | - Marilia Marufuji Ogawa
- Department of Dermatology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Santos DWCL, de Azevedo CDMPES, Vicente VA, Queiroz-Telles F, Rodrigues AM, de Hoog GS, Denning DW, Colombo AL. The global burden of chromoblastomycosis. PLoS Negl Trop Dis 2021; 15:e0009611. [PMID: 34383752 PMCID: PMC8360387 DOI: 10.1371/journal.pntd.0009611] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/30/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chromoblastomycosis (CBM), represents one of the primary implantation mycoses caused by melanized fungi widely found in nature. It is characterized as a Neglected Tropical Disease (NTD) and mainly affects populations living in poverty with significant morbidity, including stigma and discrimination. METHODS AND FINDINGS In order to estimate the global burden of CBM, we retrospectively reviewed the published literature from 1914 to 2020. Over the 106-year period, a total of 7,740 patients with CBM were identified on all continents except Antarctica. Most of the cases were reported from South America (2,619 cases), followed by Africa (1,875 cases), Central America and Mexico (1,628 cases), Asia (1,390 cases), Oceania (168 cases), Europe (35 cases), and USA and Canada (25 cases). We described 4,022 (81.7%) male and 896 (18.3%) female patients, with the median age of 52.5 years. The average time between the onset of the first lesion and CBM diagnosis was 9.2 years (range between 1 month to 50 years). The main sites involved were the lower limbs (56.7%), followed by the upper limbs (19.9%), head and neck (2.9%), and trunk (2.4%). Itching and pain were reported by 21.5% and 11%, respectively. Malignant transformation was described in 22 cases. A total of 3,817 fungal isolates were cultured, being 3,089 (80.9%) Fonsecaea spp., 552 (14.5%) Cladophialophora spp., and 56 Phialophora spp. (1.5%). CONCLUSIONS AND SIGNIFICANCE This review represents our current knowledge on the burden of CBM world-wide. The global incidence remains unclear and local epidemiological studies are required to improve these data, especially in Africa, Asia, and Latin America. The recognition of CBM as NTD emphasizes the need for public health efforts to promote support for all local governments interested in developing specific policies and actions for preventing, diagnosing and assisting patients.
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Affiliation(s)
- Daniel Wagner C. L. Santos
- Special Mycology Laboratory—LEMI, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, SP, Brazil
- Division of Infectious Diseases, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | - Vania Aparecida Vicente
- Microbiology, Parasitology, and Pathology Post Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, Brazil
| | - Flávio Queiroz-Telles
- Department of Public Health, Hospital de Clínicas, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - G. Sybren de Hoog
- Microbiology, Parasitology, and Pathology Post Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, Brazil
- Center of Expertise in Mycology, Radboud University Medical Center/CWZ, Nijmegen, The Netherlands
| | - David W. Denning
- Global Action Fund for Fungal Infections, Geneva, Switzerland
- Manchester Fungal Infection Group, Core Technology Facility, The University of Manchester, Manchester, United Kingdom
| | - Arnaldo Lopes Colombo
- Special Mycology Laboratory—LEMI, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, SP, Brazil
- Division of Infectious Diseases, Federal University of São Paulo, São Paulo, SP, Brazil
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Breda LCD, Menezes IG, Paulo LNM, de Almeida SR. Immune Sensing and Potential Immunotherapeutic Approaches to Control Chromoblastomycosis. J Fungi (Basel) 2020; 7:jof7010003. [PMID: 33375204 PMCID: PMC7822212 DOI: 10.3390/jof7010003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 12/30/2022] Open
Abstract
Chromoblastomycosis (CBM) is a neglected, chronic, and progressive subcutaneous mycosis caused by different species of fungi from the Herpotrichiellaceae family. CBM disease is usually associated with agricultural activities, and its infection is characterized by verrucous, erythematous papules, and atrophic lesions on the upper and lower limbs, leading to social stigma and impacts on patients' welfare. The economic aspect of disease treatment is another relevant issue. There is no specific treatment for CBM, and different anti-fungal drug associations are used to treat the patients. However, the long period of the disease and the high cost of the treatment lead to treatment interruption and, consequently, relapse of the disease. In previous years, great progress had been made in the comprehension of the CBM pathophysiology. In this review, we discuss the differences in the cell wall composition of conidia, hyphae, and muriform cells, with a particular focus on the activation of the host immune response. We also highlight the importance of studies about the host skin immunology in CBM. Finally, we explore different immunotherapeutic studies, highlighting the importance of these approaches for future treatment strategies for CBM.
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Abstract
The paper describes a case of chromoblastomycosis, a rare implantation mycosis in the Russian Federation. It gives data on the prevalence, etiology, and clinical presentations of the disease, and the diagnostic possibilities. Emphasis is laid on the leading role of a pathomorphological study in the diagnosis of chromoblastomycosis in non-endemic countries, including Russia. The clinical and pathomorphological presentations are described in detail. Histological examination detected 5-12-µm spherical or polygonal pigmented cells that are fungal elements, which allows chromoblastomycosis to be diagnosed in the cytoplasm of macrophages and extracellularly. A refusal to conduct a pathomorphological study leads to diagnostic errors and an irrational treatment policy.
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Affiliation(s)
- V A Molochkov
- M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
| | - A N Khlebnikova
- M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
| | - M S Petrova
- M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
| | - M A Bobrov
- M.F. Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, Russia
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Voidaleski MF, Gomes RR, Azevedo CMPES, Lima BJFS, Costa FF, Bombassaro A, Fornari G, Cristina Lopes da Silva I, Andrade LV, Lustosa BPR, Najafzadeh MJ, de Hoog GS, Vicente VA. Environmental Screening of Fonsecaea Agents of Chromoblastomycosis Using Rolling Circle Amplification. J Fungi (Basel) 2020; 6:E290. [PMID: 33212756 DOI: 10.3390/jof6040290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 12/15/2022] Open
Abstract
Chromoblastomycosis is a chronic, cutaneous or subcutaneous mycosis characterized by the presence of muriform cells in host tissue. Implantation disease is caused by melanized fungi related to black yeasts, which, in humid tropical climates, are mainly members of the genus Fonsecaea. In endemic areas of Brazil, F. pedrosoi and F. monophora are the prevalent species. The current hypothesis of infection is traumatic introduction via plant materials, especially by plant thorns. However, isolation studies have demonstrated a low frequency of the agents in environmental substrates. The present study aimed to detect F. pedrosoi and F. monophora in shells of babassu coconuts, soil, plant debris, and thorns from endemic areas of chromoblastomycosis in Maranhão state, northern Brazil, using Rolling Circle Amplification (RCA) with padlock probes as a new environmental screening tool for agents of chromoblastomycosis. In addition to molecular screening, the environmental samples were analyzed by fungal isolation using mineral oil flotation. The limit of detection of the RCA method was 2.88 × 107 copies of DNA per sample for the used padlock probes, indicating that this represents an efficient and sensitive molecular tool for the environmental screening of Fonsecaea agents. In contrast, with isolation from the same samples using several selective methods, no agents of chromoblastomycosis were recovered.
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Khandelwal S, Beniwal P, Malhotra V, Gupta V, Gaur N. Lower Limb Nodulo-ulcerative Lesion in Kidney Transplant Recipient - An Unusual Diagnosis. Indian J Nephrol 2020; 30:427-429. [PMID: 33840965 PMCID: PMC8023036 DOI: 10.4103/ijn.ijn_131_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 02/04/2020] [Accepted: 02/16/2020] [Indexed: 01/19/2023] Open
Abstract
A 56-year-old kidney transplant recipient presented with a progressive cauliflower-like growth on the plantar surface of the right foot and on workup found to have chromoblastomycosis, which was successfully treated by antifungal agent and surgical excision with no recurrence. Chromoblastomycosis belongs to the heterogeneous group of subcutaneous mycoses. It is caused by various pigmented (dematiaceous) fungi, which gain entry into the skin via traumatic implantation. The case is of interest because it has so far not been reported from the northwest arid zone of India in kidney transplant recipients.
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Affiliation(s)
- Shikha Khandelwal
- Department of Nephrology, S M S Medical College, Jaipur, Rajasthan, India
| | - Pankaj Beniwal
- Department of Nephrology, S M S Medical College, Jaipur, Rajasthan, India
| | - Vinay Malhotra
- Department of Nephrology, S M S Medical College, Jaipur, Rajasthan, India
| | - Vartul Gupta
- Department of Nephrology, S M S Medical College, Jaipur, Rajasthan, India
| | - Nisha Gaur
- Department of Nephrology, S M S Medical College, Jaipur, Rajasthan, India
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Breda LCD, Breda CNDS, de Almeida JRF, Paulo LNM, Jannuzzi GP, Menezes IDG, Albuquerque RC, Câmara NOS, Ferreira KS, de Almeida SR. Fonsecaeapedrosoi Conidia and Hyphae Activate Neutrophils Distinctly: Requirement of TLR-2 and TLR-4 in Neutrophil Effector Functions. Front Immunol 2020; 11:540064. [PMID: 33193308 PMCID: PMC7609859 DOI: 10.3389/fimmu.2020.540064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 08/31/2020] [Indexed: 12/16/2022] Open
Abstract
Chromoblastomycosis is a chronic and progressive subcutaneous mycosis caused mainly by the fungus Fonsecaea pedrosoi. The infection is characterized by erythematous papules and histological sections demonstrating an external layer of fibrous tissue and an internal layer of thick granulomatous inflammatory tissue containing mainly macrophages and neutrophils. Several groups are studying the roles of the innate and adaptive immune systems in F. pedrosoi infection; however, few studies have focused on the role of neutrophils in this infection. In the current study, we verify the importance of murine neutrophils in the killing of F. pedrosoi conidia and hyphae. We demonstrate that phagocytosis and reactive oxygen species during infection with conidia are TLR-2- and TLR-4-dependent and are essential for conidial killing. Meanwhile, hyphal killing occurs by NET formation in a TLR-2-, TLR-4-, and ROS-independent manner. In vivo experiments show that TLR-2 and TLR-4 are also important in chromoblastomycosis infection. TLR-2KO and TLR-4KO animals had lower levels of CCL3 and CXCL1 chemokines and impaired neutrophil migration to the infected site. These animals also had higher fungal loads during infection with F. pedrosoi conidia, confirming that TLR-2 and TLR-4 are essential receptors for F. pedrosoi recognition and immune system activation. Therefore, this study demonstrates for the first time that neutrophil activation during F. pedrosoi is conidial or hyphal-specific with TLR-2 and TLR-4 being essential during conidial infection but unnecessary for hyphal killing by neutrophils.
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Affiliation(s)
- Leandro Carvalho Dantas Breda
- Departamento de Imunologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | | | - José Roberto Fogaça de Almeida
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Larissa Neves Monteiro Paulo
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Grasielle Pereira Jannuzzi
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Isabela de Godoy Menezes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Renata Chaves Albuquerque
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Niels Olsen Saraiva Câmara
- Departamento de Imunologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Karen Spadari Ferreira
- Departamento de Ciências Farmacêuticas, Instituto de Ciências Naturais, Universidade Federal de São Paulo, Diadema, Brazil
| | - Sandro Rogério de Almeida
- Departamento de Imunologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
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Santos DWCL, Vicente VA, Weiss VA, de Hoog GS, Gomes RR, Batista EMM, Marques SG, de Queiroz-Telles F, Colombo AL, de Azevedo CDMPES. Chromoblastomycosis in an Endemic Area of Brazil: A Clinical-Epidemiological Analysis and a Worldwide Haplotype Network. J Fungi (Basel) 2020; 6:jof6040204. [PMID: 33022951 PMCID: PMC7711792 DOI: 10.3390/jof6040204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/27/2020] [Accepted: 10/01/2020] [Indexed: 12/14/2022] Open
Abstract
Chromoblastomycosis (CBM) is a neglected implantation mycosis prevalent in tropical climate zones, considered an occupational disease that affects impoverished rural populations. This retrospective study described clinical aspects of CBM in a hyperendemic area in Brazil and constructed a worldwide haplotype network of Fonsecaea spp. strains. The variables were collected from medical records using a standard report form, reporting 191 patients with CBM from Maranhão, Brazil. The mean age was 56.1 years, 168 (88%) patients were male and predominantly farmers (85.8%). The mean time of evolution of the disease until diagnosis was 9.4 years. Lower limbs (81.2%) and upper limbs (14.2%) were the main sites affected. Most patients exhibited verrucous (55%) and infiltrative plaque (48.2%). Fonsecaea spp. were identified in 136 cases and a haplotype network constructed with ITS sequences of 185 global strains revealed a total of 59 haplotypes exhibiting high haplotypic and low nucleotide diversities. No correlation was observed between the different haplotypes of Fonsecaea species and dermatological patterns, severity of disease or geographic distribution inside Maranhão. Data from this area contributed to better understanding the epidemiology of CBM. For the first time, a robust haplotype network with Fonsecaea strains reveals an evolutionary history with a recent population expansion.
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Affiliation(s)
- Daniel Wagner C. L. Santos
- Special Mycology Laboratory—LEMI, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, 04039-032 SP, Brazil; (D.W.C.L.S.); (A.L.C.)
- Division of Infectious Diseases, Federal University of São Paulo, São Paulo, 04024-002 SP, Brazil
| | - Vania Aparecida Vicente
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, 81531-980 PR, Brazil; (V.A.V.); (V.A.W.); (G.S.d.H.); (R.R.G.); (F.d.Q.-T.)
- Bioprocess Engineering and Biotechnology Graduate Program, Federal University of Paraná, Curitiba, 81531-980 PR, Brazil
| | - Vinicius Almir Weiss
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, 81531-980 PR, Brazil; (V.A.V.); (V.A.W.); (G.S.d.H.); (R.R.G.); (F.d.Q.-T.)
| | - G. Sybren de Hoog
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, 81531-980 PR, Brazil; (V.A.V.); (V.A.W.); (G.S.d.H.); (R.R.G.); (F.d.Q.-T.)
- Center of Expertise in Mycology, Radboud University Medical Center/CWZ, 6525 GA Nijmegen, The Netherlands
| | - Renata R. Gomes
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, 81531-980 PR, Brazil; (V.A.V.); (V.A.W.); (G.S.d.H.); (R.R.G.); (F.d.Q.-T.)
| | - Edith M. M. Batista
- Department of Medicine, Federal University of Maranhão, São Luís, 65080-040 MA, Brazil; (E.M.M.B.); (S.G.M.)
| | - Sirlei Garcia Marques
- Department of Medicine, Federal University of Maranhão, São Luís, 65080-040 MA, Brazil; (E.M.M.B.); (S.G.M.)
| | - Flávio de Queiroz-Telles
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, 81531-980 PR, Brazil; (V.A.V.); (V.A.W.); (G.S.d.H.); (R.R.G.); (F.d.Q.-T.)
| | - Arnaldo Lopes Colombo
- Special Mycology Laboratory—LEMI, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, 04039-032 SP, Brazil; (D.W.C.L.S.); (A.L.C.)
- Division of Infectious Diseases, Federal University of São Paulo, São Paulo, 04024-002 SP, Brazil
| | - Conceição de Maria Pedrozo e Silva de Azevedo
- Department of Medicine, Federal University of Maranhão, São Luís, 65080-040 MA, Brazil; (E.M.M.B.); (S.G.M.)
- Post-Graduation Program of Health Science, Federal University of Maranhão, São Luís, 65080-040 MA, Brazil
- Correspondence:
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de Andrade TS, de Almeida AMZ, Basano SDA, Takagi EH, Szeszs MW, Melhem MSC, Albuquerque M, Camargo JDSAA, Gambale W, Camargo LMA. Chromoblastomycosis in the Amazon region, Brazil, caused by Fonsecaea pedrosoi, Fonsecaea nubica, and Rhinocladiella similis: Clinicopathology, susceptibility, and molecular identification. Med Mycol 2020; 58:172-180. [PMID: 31329924 DOI: 10.1093/mmy/myz034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 02/28/2019] [Accepted: 04/10/2019] [Indexed: 02/02/2023] Open
Abstract
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.
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Affiliation(s)
- Tânia Sueli de Andrade
- Department of Culture Collection, Adolfo Lutz Institute, Secretary of Health, São Paulo, Brazil
| | | | - Sergio de Almeida Basano
- Department of Medicine, Faculty of São Lucas, Rondônia, Brazil.,Centre of Tropical Medicine of Rondônia, Brazil
| | | | | | - Marcia S C Melhem
- Mycology Unit, Adolfo Lutz Institute, Secretary of Health, São Paulo, Brazil
| | | | | | | | - Luís Marcelo Aranha Camargo
- Department of Medicine, Faculty of São Lucas, Rondônia, Brazil.,Institute of Biomedical Sciences 5, University of São Paulo, Monte Negro, Rondônia, Brazil.,Centre of Tropical Medicine Research, Secretary of Health of the State of Rondônia.,National Institute of Science and Research -Epidemiology of Amazônia, Brazilian Government
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Yang CS, Chen CB, Lee YY, Yang CH, Chang YC, Chung WH, Lee HE, Hui RCY, Chuang YH, Hong HS, Sun PL. Chromoblastomycosis in Taiwan: A report of 30 cases and a review of the literature. Med Mycol 2019; 56:395-405. [PMID: 29087525 DOI: 10.1093/mmy/myx075] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 08/21/2017] [Indexed: 01/19/2023] Open
Abstract
Chromoblastomycosis (CBM) is an implantation mycosis characterized by the presence of pigmented muriform cells in tissue. CBM is endemic in Taiwan, but only three formal cases have been reported to date because of underreporting. To describe and update its epidemiologic features, we report a series of 30 cases between 2003 and 2016 at a single medical center. Patients were predominately male (2.75:1). The mean age of onset was 65.9 years, and disease duration ranged from 2 months to 20 years. Diabetes was the most common comorbidity, and extremities were the most frequent sites of involvement. The lesions presented as papuloplaque, verrucous, cicatricial, targetoid, or mixed types. The dermoscopic features were variable, including red dots, white vague areas, black globules, and sand-like patterns. Among 10 Fonsecaea isolates further identified by sequencing the ITS regions of ribosomal DNA, nine were F. monophora and one was F. nubica. All but one patient received either systemic antifungal agents, surgical excision, or both. Surgical excision achieved a higher complete remission rate than the other forms of treatment did.
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Affiliation(s)
- Ching-Sheng Yang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taiwan
| | - Chun-Bing Chen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Collegeof Medicine,Chang Gung University, Taoyuan, Taiwan.,Departmentof Dermatology, Chang Gung Memorial Hospital, Keelung Branch, Taiwan
| | - Yung-Yi Lee
- Departmentof Dermatology, Chang Gung Memorial Hospital, Taipei Branch, Taiwan
| | - Chih-Hsun Yang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taiwan
| | - Ya-Ching Chang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taiwan
| | - Hua-En Lee
- Departmentof Dermatology, Chang Gung Memorial Hospital, Taipei Branch, Taiwan
| | | | - Ya-Hui Chuang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taiwan
| | - Hong-Shang Hong
- Departmentof Dermatology, Chang Gung Memorial Hospital, Keelung Branch, Taiwan
| | - Pei-Lun Sun
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Abstract
Background: Subcutaneous mycoses, although rare, are frequently reported from northeast India. Their spectrum varies with geographic region. Materials and Methods: We evaluated clinical records and histopathological features of subcutaneous mycoses cases seen during April 2013 to March 2017. Results: A total of 70 patients (44 males and 26 females) of subcutaneous mycoses were analyzed. Sixty-one percent of patients were 20–60 years old. Duration of the disease ranged from 3 months to 25 years. Most common site of involvement was the lower limb (32, 46%), followed by the upper limb (25, 36%). A history of trauma was obtained from 76% of patients. Eighty-seven percent of patients were from rural area. Ninety-two percent of patients were agricultural workers. There were 30 established cases of chromoblastomycosis and 16 cases of sporotrichosis. In 24 cases, subcutaneous mycosis was suspected clinically and showed some improvement to empirical itraconazole therapy. Multifocal lesions were seen in six patients. Complication of subcutaneous mycoses in the form of invasive squamous cell carcinoma was seen in one patient. On histopathological examination, verrucous hyperplasia was seen in 93% of cases. Granulomas with suppuration were seen in 77% of cases and granulomas without suppuration were seen in 14.3% of cases. Copper penny bodies were appreciated in 42.8% of cases. Fungal culture was positive only in 55.7% of cases. There was growth of Sporothrix schenckii in 16 patients, Fonsecaea sp. in 19, Cladosporium sp. in 3, and Curvularia sp. in 1. Conclusion: Chromoblastomycosis was the most common subcutaneous mycoses seen in northeast India followed by sporotrichosis. The diagnosis remained a challenge in a few cases as the culture positivity was very low. Suppurative granulomas in histopathology played a corroborative role. Therapeutic trial of itraconazole for 2 months was worth trying in such cases.
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Affiliation(s)
- Shikha Verma
- Department of Dermatology and STD, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Binod Kumar Thakur
- Department of Dermatology and STD, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Vandana Raphael
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
| | - Devinder Mohan Thappa
- Department of Dermatology and STD, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
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22
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Chaturvedi V, Bouchara JP, Hagen F, Alastruey-Izquierdo A, Badali H, Bocca AL, Cano-Lira JF, Cao C, Chaturvedi S, Chotirmall SH, van Diepeningen AD, Gangneux JP, Guinea J, de Hoog S, Ilkit M, Kano R, Liu W, Martinez-Rossi NM, de Souza Carvalho Melhem M, Ono MA, Ran Y, Ranque S, de Almeida Soares CM, Sugita T, Thomas PA, Vecchiarelli A, Wengenack NL, Woo PCY, Xu J, Zancope-Oliveira RM. Eighty Years of Mycopathologia: A Retrospective Analysis of Progress Made in Understanding Human and Animal Fungal Pathogens. Mycopathologia 2018; 183:859-877. [PMID: 30506286 DOI: 10.1007/s11046-018-0306-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 11/09/2018] [Indexed: 11/30/2022]
Abstract
Mycopathologia was founded in 1938 to 'diffuse the understanding of fungal diseases in man and animals among mycologists.' This was an important mission considering that pathogenic fungi for humans and animals represent a tiny minority of the estimated 1.5-5 million fungal inhabitants on Earth. These pathogens have diverged from the usual saprotrophic lifestyles of most fungi to colonize and infect humans and animals. Medical and veterinary mycology is the subdiscipline of microbiology that dwells into the mysteries of parasitic, fungal lifestyles. Among the oldest continuing scientific publications on the subject, Mycopathologia had its share of 'classic papers' since the first issue was published in 1938. An analysis of the eight decades of notable contributions reveals many facets of host-pathogen interactions among 183 volumes comprising about 6885 articles. We have analyzed the impact and relevance of this body of work using a combination of citation tools (Google Scholar and Scopus) since no single citation metric gives an inclusive perspective. Among the highly cited Mycopathologia publications, those on experimental mycology accounted for the major part of the articles (36%), followed by diagnostic mycology (16%), ecology and epidemiology (15%), clinical mycology (14%), taxonomy and classification (10%), and veterinary mycology (9%). The first classic publication, collecting nearly 200 citations, appeared in 1957, while two articles published in 2010 received nearly 150 citations each, which is notable for a journal covering a highly specialized field of study. An empirical analysis of the publication trends suggests continuing interests in novel diagnostics, fungal pathogenesis, review of clinical diseases especially with relevance to the laboratory scientists, taxonomy and classification of fungal pathogens, fungal infections and carriage in pets and wildlife, and changing ecology and epidemiology of fungal diseases around the globe. We anticipate that emerging and re-emerging fungal pathogens will continue to cause significant health burden in the coming decades. It remains vital that scientists and physicians continue to collaborate by learning each other's language for the study of fungal diseases, and Mycopathologia will strive to be their partner in this increasingly important endeavor to its 100th anniversary in 2038 and beyond.
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Affiliation(s)
- Vishnu Chaturvedi
- New York State Department of Health and University at Albany, Albany, NY, USA.
| | | | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | | | - Hamid Badali
- Mazandaran University of Medical Sciences, Sari, Iran
| | | | | | - Cunwei Cao
- Guangxi Medical University, Nanning, China
| | - Sudha Chaturvedi
- New York State Department of Health and University at Albany, Albany, NY, USA
| | | | | | | | | | - Sybren de Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | | | - Rui Kano
- Nihon University College of Bioresource Sciences, Fujisawa, Japan
| | - Weida Liu
- Peking Union Medical College, Nanjing, China
| | | | | | | | | | | | | | | | - Philip A Thomas
- Institute of Ophthalmology, Joseph Eye Hospital, Tiruchirappalli, India
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23
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Le TA, Nguyen KL, Pham MH, Vi TT, Do NA. Case Report: A Case of Chromoblastomycosis Caused by Fonsecaea pedrosoi in Vietnam. Mycopathologia 2018; 184:115-119. [PMID: 29974323 DOI: 10.1007/s11046-018-0284-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 06/27/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissues caused by different melanized fungi. The disease occurs worldwide, particularly in tropical and subtropical regions but not reported in Vietnam. A 47-year-old women was admitted to hospital 103, Hanoi, Vietnam, with a 10-year lasting lesion on backside of her right shank. Diagnosis of chromoblastomycosis was made after discovery of a muriform cell in histopathological examination. A black, slow-growth fungus was isolated and identified as Fonsecaea pedrosoi after molecular analysis. After 1-month treatment with itraconazole, the lesion has significant improvement. CONCLUSION This is the first case of chromoblastomycosis caused by Fonsecaea pedrosoi reported in Vietnam.
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Affiliation(s)
- Tran-Anh Le
- Department of Parasitology, Vietnam Military Medical University (VMMU), Phung Hung Street, Ha Dong Town, Hanoi, Vietnam.
| | - Khac-Luc Nguyen
- Department of Parasitology, Vietnam Military Medical University (VMMU), Phung Hung Street, Ha Dong Town, Hanoi, Vietnam
| | - My-Hang Pham
- Department of Dermatological Disease, Hospital 103, Vietnam Military Medical University (VMMU), Hanoi, Vietnam
| | - Thuat-Thang Vi
- Department of Pathology, Hospital 103, Vietnam Military Medical University (VMMU), Hanoi, Vietnam
| | - Ngoc-Anh Do
- Department of Parasitology, Vietnam Military Medical University (VMMU), Phung Hung Street, Ha Dong Town, Hanoi, Vietnam
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24
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de Brito AC, Bittencourt MDJS. Chromoblastomycosis: an etiological, epidemiological, clinical, diagnostic, and treatment update. An Bras Dermatol 2018; 93:495-506. [PMID: 30066754 PMCID: PMC6063100 DOI: 10.1590/abd1806-4841.20187321] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 09/24/2017] [Indexed: 01/19/2023] Open
Abstract
Chromoblastomycosis is a chronic, granulomatous, suppurative mycosis of the skin and subcutaneous tissue caused by traumatic inoculation of dematiaceous fungi of the family Herpotrichiellaceae. The species Fonsecaea pedrosoi and Cladophialophora carrionii are prevalent in regions where the disease is endemic. Chromoblastomycosis lesions are polymorphous: verrucous, nodular, tumoral, plaque-like, and atrophic. It is an occupational disease that predominates in tropical and subtropical regions, but there have been several reports of cases in temperate regions. The disease mainly affects current or former farm workers, mostly males, and often leaving disabling sequelae. This mycosis is still a therapeutic challenge due to frequent recurrence of lesions. Patients with extensive lesions require a combination of pharmacological and physical therapies. The article provides an update of epidemiological, clinical, diagnostic, and therapeutic features.
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Affiliation(s)
- Arival Cardoso de Brito
- Dermatology Course, Universidade Federal do Pará,
Belém (PA), Brazil
- Medical Residency in Dermatology, Universidade Federal do
Pará, Belém (PA), Brazil
- Dermatopathology Laboratory, Universidade Federal do Pará,
Belém (PA), Brazil
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25
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Florencio CS, Brandão FAS, Teixeira MDM, Bocca AL, Felipe MSS, Vicente VA, Fernandes L. Genetic manipulation of Fonsecaea pedrosoi using particles bombardment and Agrobacterium mediated transformation. Microbiol Res 2018; 207:269-279. [PMID: 29458863 DOI: 10.1016/j.micres.2018.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/04/2017] [Accepted: 01/01/2018] [Indexed: 11/24/2022]
Abstract
Fonsecaea pedrosoi, a melanized fungal pathogen that causes Chromoblastomycosis, a human disease with a worldwide distribution. Biolistic is a widely used technique for direct delivery of genetic material into intact cells by particles bombardment. Another well-established transformation method is Agrobacterium-mediated transformation (ATMT), which involves the transfer of a T-DNA from the bacterium to the target cells. In F. pedrosoi there are no reports of established protocols for genetic transformation, which require optimization of physical and biological parameters. In this work, intact conidia of F. pedrosoi were particle bombarded and subjected to ATMT. In addition, we proposed hygromycin B, nourseothricin and neomycin as dominant selective markers for F. pedrosoi and vectors were constructed. We tested two parameters for biolistic: the distance of the particles to the target cells and time of cells recovery in nonselective medium. The biolistic efficiency was 37 transformants/μg of pFpHYG, and 45 transformants/μg of pAN7.1. Transformants expressing GFP were successfully obtained by biolistic. A co-culture ratio of 10: 1 (bacterium: conidia) and co-incubation time of 72 h yielded the largest number of transformants after ATMT. Southern blot analysis showed the number of foreign DNA insertion into the genome is dependent upon the plasmid used to generate the mutants. This work describes for the first time two efficient methods for genetic modification of Fonsecaea and these results open new avenues to better understand the biology and pathogenicity of the main causal agent of this neglected disease.
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Affiliation(s)
- Camille Silva Florencio
- Programa de Pós-graduação em Ciências e Tecnologias em Saúde, Faculdade de Ceilândia, Universidade de Brasília, Brasília, DF, Brazil; Laboratório de Imunologia Aplicada, Instituto de Biologia, Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF, Brazil.
| | - Fabiana Alves Silva Brandão
- Laboratório de Imunologia Aplicada, Instituto de Biologia, Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF, Brazil.
| | | | - Anamélia Lorenzetti Bocca
- Laboratório de Imunologia Aplicada, Instituto de Biologia, Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF, Brazil.
| | | | - Vânia Aparecida Vicente
- Programa de Pós-graduação em Engenharia de Bioprocessos e Biotecnologia, Setor de Ciências Biológicas, Departamento de Patologia Básica, Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | - Larissa Fernandes
- Programa de Pós-graduação em Ciências e Tecnologias em Saúde, Faculdade de Ceilândia, Universidade de Brasília, Brasília, DF, Brazil; Laboratório de Imunologia Aplicada, Instituto de Biologia, Departamento de Biologia Celular, Universidade de Brasília, Brasília, DF, Brazil; Programa de Pós-graduação em Engenharia de Bioprocessos e Biotecnologia, Setor de Ciências Biológicas, Departamento de Patologia Básica, Universidade Federal do Paraná, Curitiba, PR, Brazil.
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26
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Label M, Karayan LC, De Hoog S, Afeltra J, Bustamante T, Vitale RG. Differential distribution patterns of Fonsecaea agents of chromoblastomycosis, exemplified by the first case due to F. monophora from Argentina. Med Mycol Case Rep 2017; 20:35-38. [PMID: 29552459 PMCID: PMC5852295 DOI: 10.1016/j.mmcr.2017.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/04/2017] [Accepted: 11/24/2017] [Indexed: 11/17/2022] Open
Abstract
Chromoblastomycosis is a mutilating infection of the skin and subcutaneous tissues caused by melanized fungi belonging to the order Chaetothyriales. Proven cases of the main agent, Fonsecaea pedrosoi are mainly limited to (sub)tropical, humid climates of Latin and Central America and the Caribbean. Fonsecaea monophora has a global distribution along the equator. Cases outside the (sub)tropics have thus far mostly been considered to have been imported, but here we report the first endemic case by F. monophora from Argentina. Patient was a 82-year-old rural female worker from Corrientes, a province with a dry continental climate.
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Affiliation(s)
- Marcelo Label
- Dermatology Division, Ramos Mejia Hospital, Buenos Aires C1221ADC, Argentina
| | - Luciana C Karayan
- Ramos Mejia Hospital, Parasitology Unit, Mycology Branch, Buenos Aires C1221ADC, Argentina
| | - Sybren De Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | - Javier Afeltra
- Ramos Mejia Hospital, Parasitology Unit, Mycology Branch, Buenos Aires C1221ADC, Argentina
| | - Togo Bustamante
- Dermatology Division, Ramos Mejia Hospital, Buenos Aires C1221ADC, Argentina
| | - Roxana G Vitale
- Ramos Mejia Hospital, Parasitology Unit, Mycology Branch, Buenos Aires C1221ADC, Argentina.,Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.,The National Council of Scientific and Technological Research (CONICET), Buenos Aires, Argentina
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27
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Purim KSM, Peretti MC, Fillus J, Olandoski M. Chromoblastomycosis: tissue modifications during itraconazole treatment. An Bras Dermatol 2017; 92:478-483. [PMID: 28954095 PMCID: PMC5595593 DOI: 10.1590/abd1806-4841.20175466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/28/2016] [Indexed: 11/24/2022] Open
Abstract
Background Histological and mycological changes during itraconazole use have not been
totally established in chromoblastomycosis. Objectives To evaluate tissue modifications in chromoblastomycosis carriers under
itraconazole treatment. Methods A histological retrospective study of 20 cases of chromoblastomycosis seen at
the university hospital at the south of Brazil, during itraconazole 400 mg
daily treatment. Patients were classified into two groups: plaque or tumor
lesions, and underwent periodic evaluations every four months during three
years. Hematoxylin-eosin stain was used to analyze epidermal modifications,
inflammatory infiltrate and fibrosis, and Fontana-Masson stain for parasite
evaluation. Results Fontana-Masson stain was superior to hematoxylin-eosin stain in fungal count
in the epidermis (mean difference=0.14; p<0.05). The most distinct
mycosis tissue responses were registered in the dermis. Epidermal thinning,
granulomatous infiltrate decrease or disappearance, fibrosis increase and
quantitative/morphological changes occurred during treatment. Study limitations Patients could not be located to have their current skin condition
examined. Conclusion Parasitic and tissue changes verified in this study can reflect the
parasite-host dynamics under itraconazole action.
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Affiliation(s)
- Kátia Sheylla Malta Purim
- Discipline of Dermatology of the Medical School - Universidade Positivo (UP) - Curitiba (PR), Brazil
| | - Murilo Calvo Peretti
- Dermatology Service of theHospital das Clínicas - Universidade Federal do Paraná (HC-UFPR) - Curitiba (PR), Brazil
| | - José Fillus
- Dermatology Service of the Hospital Evangélico de Curitiba - Universidade Evangélica do Paraná - Curitiba (PR), Brazil
| | - Marcia Olandoski
- Discipline of Biostatistics of the Medical School - Pontifícia Universidade Católica do Paraná (PUC-PR) - Curitiba (PR), Brazil
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28
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Queiroz-Telles F, de Hoog S, Santos DW, Salgado CG, Vicente VA, Bonifaz A, Roilides E, Xi L, Azevedo CM, da Silva MB, Pana ZD, Colombo AL, Walsh TJ. Chromoblastomycosis. Clin Microbiol Rev 2017; 30:233-76. [PMID: 27856522 DOI: 10.1128/CMR.00032-16] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
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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Rasamoelina T, Raharolahy O, Rakotozandrindrainy N, Ranaivo I, Andrianarison M, Rakotonirina B, Maubon D, Rakotomalala F, Rakoto Andrianarivelo M, Andriantsimahavandy A, Rapelanoro Rabenja F, Ramarozatovo L, Cornet M. Chromoblastomycosis and sporotrichosis, two endemic but neglected fungal infections in Madagascar. J Mycol Med 2017; 27:312-324. [DOI: 10.1016/j.mycmed.2017.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/08/2017] [Accepted: 08/08/2017] [Indexed: 01/19/2023]
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30
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Abstract
Chromoblastomycosis (CBM) is a chronic, progressive, cutaneous and subcutaneous fungal infection following the traumatic implantation of certain dematiaceous fungi. The disease has worldwide prevalence with predominant cases reported from humid tropical and subtropical regions of America, Asia, and Africa. Diagnosis is often delayed or misdirected either due to poor degree of clinical suspicions or clinical simulation of dermatological conditions. The infection is not uncommon in India and several case reports from the sub-Himalayan belt and western and eastern coasts of India have been published; however, very few have reviewed the cases. We reviewed 169 cases published in English literature from India during 1957 through May 2016, including 2 recent cases from our institute. A tremendous increase in the number of reported cases was noticed since 2012, since which, more than 50% of the cases had been published. A majority of the patients (74.1%) were involved in various agricultural activities directly or indirectly. The mean age at presentation was 43.3 years ± 16.0, with male to female ratio of 4.2:1. The duration of disease at the time of presentation varied from 20 days to 35 years. Any history of trauma was recalled only in 33.8% of the studied cases. The lower extremity was the most common site afflicted, followed by the upper extremity. The culture was positive in 80.3% of the cases with Fonsecaea pedrosoi, isolated as the most common fungal pathogen, followed by Cladophialophora carrionii. Although all the commercially available antifungals were prescribed in these cases, itraconazole and terbinafine were the most commonly used, either alone or in combination with other drugs/physical methods, with variable degrees of outcome. Combinations of different treatment modalities (chemotherapy and physical methods) yielded a cure rate of 86.3%. CBM is refractory to treatment and no single antifungal agent or regimen has demonstrated satisfactory results. Increased awareness with early clinical suspicion of the disease and adequate therapy are necessary to improve the outcome. However, depending upon the causative agent, disease severity, and the choice of antifungals, variable outcomes can be observed.
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31
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Queiroz-Telles F, Fahal AH, Falci DR, Caceres DH, Chiller T, Pasqualotto AC. Neglected endemic mycoses. Lancet Infect Dis 2017; 17:e367-e377. [PMID: 28774696 DOI: 10.1016/s1473-3099(17)30306-7] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/19/2016] [Accepted: 03/23/2017] [Indexed: 01/18/2023]
Abstract
Fungi often infect mammalian hosts via the respiratory route, but traumatic transcutaneous implantation is also an important source of infections. Environmental exposure to spores of pathogenic fungi can result in subclinical and unrecognised syndromes, allergic manifestations, and even overt disease. After traumatic cutaneous inoculation, several fungi can cause neglected mycoses such as sporotrichosis, chromoblastomycosis, mycetoma, entomophthoramycosis, and lacaziosis. Most of these diseases have a subacute to chronic course and they can become recalcitrant to therapy and lead to physical disabilities, including inability to work, physical deformities, and amputations. For many years, paracoccidioidomycosis was considered the most prevalent endemic systemic mycosis in the Americas, but this situation might be changing with recognition of the worldwide presence of Histoplasma capsulatum. Both paracoccidioidomycosis and histoplasmosis can mimic several infectious and non-infectious medical conditions and lead to death if not recognised early and treated. Cutaneous implantation and systemic mycoses are neglected diseases that affect millions of individuals worldwide, especially in low-income countries where their management is suboptimum because challenges in diagnosis and therapeutic options are substantial issues.
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Affiliation(s)
| | | | - Diego R Falci
- Infectious Diseases Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Centro Universitário La Salle, Canoas, Brazil
| | - Diego H Caceres
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alessandro C Pasqualotto
- Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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32
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Gomes RR, Vicente VA, de Azevedo CMPS, Salgado CG, da Silva MB, Queiroz-Telles F, Marques SG, Santos DWCL, de Andrade TS, Takagi EH, Cruz KS, Fornari G, Hahn RC, Scroferneker ML, Caligine RB, Ramirez-Castrillon M, de Araújo DP, Heidrich D, Colombo AL, de Hoog GS. Molecular Epidemiology of Agents of Human Chromoblastomycosis in Brazil with the Description of Two Novel Species. PLoS Negl Trop Dis 2016; 10:e0005102. [PMID: 27893750 PMCID: PMC5125572 DOI: 10.1371/journal.pntd.0005102] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 10/11/2016] [Indexed: 12/13/2022] Open
Abstract
The human mutilating disease chromoblastomycosis is caused by melanized members of the order Chaetothyriales. To assess population diversity among 123 clinical strains of agents of the disease in Brazil we applied sequencing of the rDNA internal transcribed spacer region, and partial cell division cycle and β-tubulin genes. Strains studied were limited to three clusters divided over the single family Herpotrichiellaceae known to comprise agents of the disease. A Fonsecaea cluster contained the most important agents, among which F. pedrosoi was prevalent with 80% of the total set of strains, followed by 13% for F. monophora, 3% for F. nubica, and a single isolate of F. pugnacius. Additional agents, among which two novel species, were located among members of the genus Rhinocladiella and Cyphellophora, with frequencies of 3% and 1%, respectively. Chromoblastomycosis, a skin disease found among rural populations in tropical and subtropical regions, is caused by melanized fungi related to the black yeasts. The present study evaluates the species distribution among 123 clinical strains from endemic areas in Brazil based on multilocus sequence data, and describes two new agents of the disease which proved to be affiliated to Rhinocladiella and Cyphellophora.
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Affiliation(s)
- Renata R. Gomes
- Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil
- Department of Biological Science, State University of Parana/ Campus Paranaguá, Paranaguá, PR, Brazil
| | - Vania A. Vicente
- Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil
- * E-mail: (VAV); (GSdH)
| | | | - Claudio G. Salgado
- Dermato-Immunology Laboratory, Institute of Biological Sciences, Federal University of Para. Marituba, PA, Brazil
| | - Moises B. da Silva
- Dermato-Immunology Laboratory, Institute of Biological Sciences, Federal University of Para. Marituba, PA, Brazil
| | - Flávio Queiroz-Telles
- Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil
- Clinical Hospital of the Federal University of Paraná, Curitiba, PR, Brazil
| | - Sirlei G. Marques
- University Hospital of Federal University of Maranhão, Sao Luis, MA, Brazil
- Cedro Laboratories Maranhão, Sao Luis, MA, Brazil
| | | | - Tania S. de Andrade
- Department of Culture Collection, Adolfo Lutz Institute, São Paulo, SP, Brazil
| | - Elizabeth H. Takagi
- Department of Culture Collection, Adolfo Lutz Institute, São Paulo, SP, Brazil
| | - Katia S. Cruz
- National Institute of Amazonian Research, Manaus, Brazil
| | - Gheniffer Fornari
- Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil
| | - Rosane C. Hahn
- Veterinary Laboratory of Molecular Biology, Faculty of Agronomy and Veterinary Medicine, Federal University of Mato Grosso, Cuiabá, MT, Brazil
| | - Maria L. Scroferneker
- Department of Microbiology, ICBS, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rachel B. Caligine
- Postgraduate Program in Medicine and Biomedicine, Santa Casa de Belo Horizonte Hospital, MG, Brazil
| | - Mauricio Ramirez-Castrillon
- Postgraduate Program in Cellular and Molecular Biology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Daniella P. de Araújo
- Dermato-Immunology Laboratory, Institute of Biological Sciences, Federal University of Para. Marituba, PA, Brazil
| | - Daiane Heidrich
- Postgraduate Program in Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Arnaldo L. Colombo
- Division of Infectious Diseases, Federal University of São Paulo, SP, Brazil
| | - G. S. de Hoog
- Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil
- Centraalbureau voor Schimmelcultures KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
- * E-mail: (VAV); (GSdH)
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Roy P, Prasanna S, Laxmikant DV, Chaudhari CN. Chromoblastomycosis caused by Cladophialophora carrionii in a skin graft recipient. Med J Armed Forces India 2016; 72:389-392. [PMID: 27843190 DOI: 10.1016/j.mjafi.2015.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 08/16/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Partha Roy
- Professor, Department of Microbiology, Armed Forces Medical College, Pune 411040, India
| | - S Prasanna
- Resident, Department of Microbiology, Armed Forces Medical College, Pune 411040, India
| | | | - C N Chaudhari
- Professor, Department of Microbiology, INHS Asvini, Colaba, Mumbai 400005, India
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Ogawa MM, Peternelli MP, Enokihara MMSS, Nishikaku AS, Gonçalves SS, Tomimori J. Spectral Manifestation of Melanized Fungal Infections in Kidney Transplant Recipients: Report of Six Cases. Mycopathologia 2016; 181:379-85. [PMID: 27025729 DOI: 10.1007/s11046-016-0005-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/19/2016] [Indexed: 11/29/2022]
Abstract
Chromoblastomycosis and phaeohyphomycosis are melanized fungal infections, which affect skin and subcutaneous tissues in immunocompetent and immunosuppressed patients, as solid-organ transplant recipients, respectively. In this present study, we report six cases of melanized fungal infection in kidney transplant recipients. In five cases, culture of tissue specimens identified two cases of Exophiala spp. and three cases of Fonsecaea spp. Molecular identification was performed in three cases based on sequencing of rDNA (ITS region) that revealed the following agents: Exophiala xenobiotica, Exophiala bergeri and Fonsecaea monophora. Clinically, they presented verrucous lesion, erythematous-squamous plaque, nodules and lymphangitic distribution. Histopathological aspect was tuberculous granuloma, with concomitant presence of muriform bodies and hyphae. Some patients presented fungal transepithelial elimination. One patient received only terbinafine. Three patients underwent surgery, and two of them received itraconazole. In these four cases, the infection did not relapse. The other two patients were treated only with itraconazole, one of them is still under treatment and the other one was lost to follow-up. These patients presented clinical and histopathological characteristics ranging from resistant to nonresistant forms.
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Affiliation(s)
- Marilia M Ogawa
- Department of Dermatology, Federal University of São Paulo (UNIFESP), Rua Borges Lagoa, 508, São Paulo, SP, CEP 04038-001, Brazil.
| | - Marcella P Peternelli
- Department of Dermatology, Federal University of São Paulo (UNIFESP), Rua Borges Lagoa, 508, São Paulo, SP, CEP 04038-001, Brazil
| | - Milvia M S S Enokihara
- Department of Pathology, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Angela S Nishikaku
- Special Laboratory of Mycology, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | - Jane Tomimori
- Department of Dermatology, Federal University of São Paulo (UNIFESP), Rua Borges Lagoa, 508, São Paulo, SP, CEP 04038-001, Brazil
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Abstract
Chromoblastomycosis (CMB) is a chronic fungal infection of the skin and the
subcutaneous tissue caused by a transcutaneous traumatic inoculation of a specific
group of dematiaceous fungi occurring mainly in tropical and subtropical zones
worldwide. If not diagnosed at early stages, patients with CBM require long term
therapy with systemic antifungals, sometimes associated with physical methods. Unlike
other neglected endemic mycoses, comparative clinical trials have not been performed
for this disease. Nowadays, therapy is based on a few open trials and on expert
opinion. Itraconazole either as monotherapy or associated with other drugs, or with
physical methods, is widely used. Recently, photodynamic therapy has been
successfully employed in combination with antifungals in patients presenting with
CBM. In the present revision the most used therapeutic options against CBM are
reviewed as well as the several factors that may have impact on the patient's
outcome.
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Affiliation(s)
- Flavio Queiroz-Telles
- Departamento de Saúde Pública, Universidade Federal do Paraná, Curitiba, PR, Brasil,
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Li XQ, Guo BL, Cai WY, Zhang JM, Huang HQ, Zhan P, Xi LY, Vicente VA, Stielow B, Sun JF, de Hoog GS. The role of melanin pathways in extremotolerance and virulence of Fonsecaea revealed by de novo assembly transcriptomics using illumina paired-end sequencing. Stud Mycol 2016; 83:1-18. [PMID: 27504027 PMCID: PMC4969264 DOI: 10.1016/j.simyco.2016.02.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Melanisation has been considered to be an important virulence factor of Fonsecaea monophora. However, the biosynthetic mechanisms of melanisation remain unknown. We therefore used next generation sequencing technology to investigate the transcriptome and digital gene expression data, which are valuable resources to better understand the molecular and biological mechanisms regulating melanisation in F. monophora. We performed de novo transcriptome assembly and digital gene expression (DGE) profiling analyses of parent (CBS 122845) and albino (CBS 125194) strains using the Illumina RNA-seq system. A total of 17 352 annotated unigenes were found by BLAST search of NR, Swiss-Prot, Gene Ontology, Clusters of Orthologous Groups and Kyoto Encyclopedia of Genes and Genomes (KEGG) (E-value <1e‒5). A total of 2 283 unigenes were judged to be the differentially expressed between the two genotypes. We identified most of the genes coding for key enzymes involved in melanin biosynthesis pathways, including polyketide synthase (pks), multicopper oxidase (mco), laccase, tyrosinase and homogentisate 1,2-dioxygenase (hmgA). DEG analysis showed extensive down-regulation of key genes in the DHN pathway, while up-regulation was noted in the DOPA pathway of the albino mutant. The transcript levels of partial genes were confirmed by real time RT-PCR, while the crucial role of key enzymes was confirmed by either inhibitor or substrate tests in vitro. Meanwhile, numbers of genes involved in light sensing, cell wall synthesis, morphology and environmental stress were identified in the transcriptome of F. monophora. In addition, 3 353 SSRs (Simple Sequence Repeats) markers were identified from 21 600 consensus sequences. Blocking of the DNH pathway is the most likely reason of melanin deficiency in the albino strain, while the production of pheomelanin and pyomelanin were probably regulated by unknown transcription factors on upstream of both pathways. Most of genes involved in environmental tolerance to oxidants, irradiation and extreme temperatures were also assembled and annotated in transcriptomes of F. monophora. In addition, thousands of identified cSSR (combined SSR) markers will favour further genetic linkage studies. In conclusion, these data will contribute to understanding the regulation of melanin biosynthesis and help to improve the studies of pathogenicity of F. monophora.
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Affiliation(s)
- X Q Li
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - B L Guo
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - W Y Cai
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - J M Zhang
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - H Q Huang
- Department of Dermatology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - P Zhan
- Dermatology Hospital of Jiangxi Province, Nanchang, China; CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
| | - L Y Xi
- Department of Dermatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - V A Vicente
- Basic Pathology Department, Federal University of Paraná State, Curitiba, Paraná, Brazil
| | - B Stielow
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - J F Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - G S de Hoog
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands; Basic Pathology Department, Federal University of Paraná State, Curitiba, Paraná, Brazil; Biological Sciences Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Dermatology, First Hospital of Peking University, Beijing, China
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Deng S, Tsui CKM, Gerrits van den Ende AHG, Yang L, Najafzadeh MJ, Badali H, Li R, Hagen F, Meis JF, Sun J, Dolatabadi S, Papierok B, Pan W, de Hoog GS, Liao W. Global Spread of Human Chromoblastomycosis Is Driven by Recombinant Cladophialophora carrionii and Predominantly Clonal Fonsecaea Species. PLoS Negl Trop Dis 2015; 9:e0004004. [PMID: 26496430 PMCID: PMC4619687 DOI: 10.1371/journal.pntd.0004004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/22/2015] [Indexed: 12/20/2022] Open
Abstract
Global distribution patterns of Cladophialophora carrionii, agent of human chromoblastomycosis in arid climates of Africa, Asia, Australia, Central-and South-America, were compared with similar data of the vicarious Fonsecaea spp., agents of the disease in tropical rain forests. Population diversities among 73 C. carrionii strains and 60 strains of three Fonsecaea species were analyzed for rDNA ITS, partial β-tubulin, and amplified fragment-length polymorphism (AFLP) fingerprints. Populations differed significantly between continents. Lowest haplotype diversity was found in South American populations, while African strains were the most diverse. Gene flow was noted between the African population and all other continents. The general pattern of Fonsecaea agents of chromoblastomycosis differed significantly from that of C. carrionii and revealed deeper divergence among three differentiated species with smaller numbers of haplotypes, indicating a longer evolutionary history.
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Affiliation(s)
- Shuwen Deng
- Shanghai Institute of Medical Mycology, Changzheng Hospital, Shanghai, China
- First Hospital of Xinjiang Medical University, Xinjiang, China
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - Clement K. M. Tsui
- British Columbia Public Health Microbiology & Reference Laboratory at BCCDC site, Provincial Health Services Authority, Vancouver, Canada
| | | | - Liyue Yang
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - Mohammad Javad Najafzadeh
- Department of Parasitology and Mycology & Cancer Molecular Pathology Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Badali
- Department of Medical Mycology and Parasitology / Invasive Fungi Research Center (IFRC), School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ruoyu Li
- Research Center for Medical Mycology, Beijing Medical University, Beijing, China
| | - Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Jacques F. Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Somayeh Dolatabadi
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Weihua Pan
- Shanghai Institute of Medical Mycology, Changzheng Hospital, Shanghai, China
| | - G. S. de Hoog
- Shanghai Institute of Medical Mycology, Changzheng Hospital, Shanghai, China
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
- Research Center for Medical Mycology, Beijing Medical University, Beijing, China
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
- King Abdulaziz University, Jeddah, Saudi Arabia
- * E-mail: (GSdH); (WL)
| | - Wanqing Liao
- Shanghai Institute of Medical Mycology, Changzheng Hospital, Shanghai, China
- * E-mail: (GSdH); (WL)
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Bhat RM, Monteiro RC, Bala N, Dandakeri S, Martis J, Kamath GH, Kambil SM, Asha Vadakayil R. Subcutaneous mycoses in coastal Karnataka in south India. Int J Dermatol 2015; 55:70-8. [PMID: 26267755 DOI: 10.1111/ijd.12943] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 10/27/2014] [Accepted: 12/03/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Subcutaneous mycoses are chronic, localized infections of the skin and subcutaneous tissue which occur following traumatic implantation of the etiological agent. The causative organisms are soil saprophytes of regional epidemiology with varying ability to adapt to the tissue environment and elicit disease. OBJECTIVES This study was conducted to evaluate the various types of subcutaneous mycoses, including actinomycotic mycetomas, in south coastal Karnataka, India. METHODS Between January 2005 and January 2013, a total of 25 patients were diagnosed with subcutaneous mycoses based on a detailed clinical history and presentation, histopathology, and culture of organisms. RESULTS Chromoblastomycosis was the infection most commonly seen (n = 16 patients, 64%), followed by mycetoma (n = 4, 16%), sporotrichosis (n = 4, 16%), and rhinoentomophthoromycosis (n = 1, 4%). The extremities were the most common site of involvement, with the lower limb being most affected (64%). Males were more commonly afflicted (64%) than females (36%). Most patients were agricultural workers, although preceding trauma was noted in only three patients. The majority of patients responded well to therapy and were disease-free on follow-up. CONCLUSIONS Subcutaneous mycoses are a rare group of disorders. Chromoblastomycosis is the most frequent subcutaneous fungal infection in south India. Morphologically, chromomoblastomycoses present as verrucous, ulcerative, nodular, or eczematous lesions. Clinical diagnosis is important as culture is often negative. The incidence of infection is higher among rubber tappers. It is important to clinically differentiate chromoblastomycosis from tuberculosis verrucosa cutis. Most of the subcutaneous mycoses respond well to treatment, with the exception of rhinoentomophthoromycosis, which is a rare form of deep mycosis with associated mutilation. Eumycetomas are not observed in this part of India.
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Affiliation(s)
- Ramesh M Bhat
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Rochelle C Monteiro
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Nandakishore Bala
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Sukumar Dandakeri
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Jacintha Martis
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Ganesh H Kamath
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Srinath M Kambil
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Ramay Asha Vadakayil
- Department of Dermatology, Venereology and Leprosy, Father Muller Medical College, Mangalore, Karnataka, India
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de Azevedo CM, Gomes RR, Vicente VA, Santos DW, Marques SG, do Nascimento MM, Andrade CE, Silva RR, Queiroz-Telles F, de Hoog GS. Fonsecaea pugnacius, a Novel Agent of Disseminated Chromoblastomycosis. J Clin Microbiol 2015; 53:2674-85. [PMID: 26085610 DOI: 10.1128/JCM.00637-15] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/03/2015] [Indexed: 11/20/2022] Open
Abstract
We report a fatal case of a chromoblastomycosis-like infection caused by a novel species of Fonsecaea in a 52-year-old immunocompetent Caucasian male from an area of chromoblastomycosis endemicity in Brazil. The patient had a 30-year history of slowly evolving, verrucous lesions on the right upper arm which gradually affected the entire arm, the left hemifacial area, and the nose. Subsequent dissemination to the brain was observed, which led to death of the patient. The internal transcribed spacer (ITS) and partial large subunit (LSU), BT2, and CDC42 genes of the isolates recovered from skin and brain were sequenced, confirming the novelty of the species. The species is clinically unique in causing brain abscesses secondary to chromoblastomycosis lesions despite the apparent intact immunity of the patient. Histopathologic appearances were very different, showing muriform cells in skin and hyphae in brain.
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Carolina Rojas O, León-Cachón RBR, Pérez-Maya AA, Aguirre-Garza M, Moreno-Treviño MG, González GM. Phenotypic and molecular identification ofFonsecaea pedrosoistrains isolated from chromoblastomycosis patients in Mexico and Venezuela. Mycoses 2015; 58:267-72. [DOI: 10.1111/myc.12308] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 01/20/2015] [Accepted: 02/05/2015] [Indexed: 11/29/2022]
Affiliation(s)
- O. Carolina Rojas
- División Ciencias de la Salud; Departamento de Ciencias Básicas; Universidad de Monterrey; San Pedro Garza García Nuevo León México
- Departamento de Microbiología; Facultad de Medicina; Universidad Autónoma de Nuevo León; Monterrey Nuevo León México
| | - Rafael B. R. León-Cachón
- División Ciencias de la Salud; Departamento de Ciencias Básicas; Universidad de Monterrey; San Pedro Garza García Nuevo León México
| | - Antonio Alí Pérez-Maya
- Departamento de Bioquímica y Medicina Molecular; Facultad de Medicina; Universidad Autónoma de Nuevo León; Monterrey Nuevo León México
| | - Marcelino Aguirre-Garza
- División Ciencias de la Salud; Departamento de Ciencias Básicas; Universidad de Monterrey; San Pedro Garza García Nuevo León México
| | - María G. Moreno-Treviño
- División Ciencias de la Salud; Departamento de Ciencias Básicas; Universidad de Monterrey; San Pedro Garza García Nuevo León México
| | - Gloria M. González
- Departamento de Microbiología; Facultad de Medicina; Universidad Autónoma de Nuevo León; Monterrey Nuevo León México
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41
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Abstract
Chromoblastomycosis belongs to the heterogeneous group of subcutaneous mycoses. It is caused by various pigmented (dematiaceous) fungi, which gain entry into the skin via traumatic implantation. We would like to share a case report of chromoblastomycosis in a 32-year-old male, who presented to us with 3 years history of slowly progressive, itchy, verrucous, crusted lesions over right forearm and arm. He is being treated with itraconazole 100 mg twice daily. The case is of interest because it has so far not been reported from our region- the northwest arid zone of India. The patient showed favorable response to itraconazole.
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Affiliation(s)
- Asit Mittal
- Department of Dermatology, RNT Medical College, Udaipur, Rajashtan, India
| | - Nidheesh Agarwal
- Department of Dermatology, RNT Medical College, Udaipur, Rajashtan, India
| | - Lalit Kuamr Gupta
- Department of Dermatology, RNT Medical College, Udaipur, Rajashtan, India
| | - Ashok Kumar Khare
- Department of Dermatology, RNT Medical College, Udaipur, Rajashtan, India
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42
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Krzyściak PM, Pindycka-Piaszczyńska M, Piaszczyński M. Chromoblastomycosis. Postepy Dermatol Alergol 2014; 31:310-21. [PMID: 25395928 DOI: 10.5114/pdia.2014.40949] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/12/2013] [Accepted: 01/19/2014] [Indexed: 12/05/2022] Open
Abstract
Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue. The infection usually results from a traumatic injury and inoculation of microorganism from a specific group of dematiaceous fungi (usually Fonsecaea pedrosoi, Phialophora verrucosa, Cladophialophora carrionii). In the tissues fungi produce characteristic sclerotic cells or muriform cells. Dermal lesions can range from small nodules to large papillary-like eruptions. The disease has been described worldwide but the prevalence is higher in rural populations in countries with a tropical or subtropical climate, such as Madagascar in Africa and Brazil in South America. Diagnostic techniques are based on direct examination, culture and histopathology. Despite a variety of treatment modalities, which include long courses of antifungals, surgical excision and destructive physical therapies, the disease remains one of the most difficult deep mycotic infections to eradicate.
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43
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Silva AA, Criado PR, Nunes RS, da Silva WL, Kanashiro-Galo L, Duarte MI, Sotto MN, Pagliari C. In situ immune response in human chromoblastomycosis--a possible role for regulatory and Th17 T cells. PLoS Negl Trop Dis 2014; 8:e3162. [PMID: 25233082 DOI: 10.1371/journal.pntd.0003162] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 08/04/2014] [Indexed: 11/26/2022] Open
Abstract
Background Chromoblastomycosis is a chronic fungal infection that affects skin and subcutaneous tissue. Lesions can be classified in tumorous, verrucous, cicatricial and plaque type. The cellular immune response in the severe form of the disease seems to correlate with a Th2 pattern of cytokines. The humoral immune response also seems to play a role. We intended to explore the populations of regulatory T cells and the Th17 pattern. Methodology Twenty-three biopsies of verrucous form were obtained from patients with clinical, culture and histopathological diagnostic of chromoblastomycosis, without treatment. It was performed an immunohistochemistry method to detect Foxp3, CD25, TGF-β, IL-6, IL-17 and IL-23. Principal findings IL-17 was the only cytokine with high expression in CBM when compared to normal skin. The expression of Treg cells, TGF- β, IL-6 and IL-23 were similar to normal skin. Conclusions/Significance The constitution of a local immune response with high expression of IL-17 and low expression of other cytokines could be at least in part, an attempt to help the immune system against fungal infection. On the other hand, high levels of local immune response mediated by Th17 profile could overcome the role of Treg cells. The inefficient immunomodulation as a consequence of the unbalance by Treg/Th17 cells seems to corroborate with the less effective immune response against fungi. Chromoblastomycosis (CBM) is a chronic infection that affects skin and subcutaneous tissue, caused by some fungi which have a brownish color due to the presence of melanin pigments. The most frequent lesions are of verrucous type. Here we describe the participation of regulatory T cells and cells with the Th17 pattern of cytokines. High levels of Th17 cells participate in chronic inflammatory conditions, once at least in part they could improve the immune response and act in concomitance to the Th1 and Th2 patterns. Our results indicate a predominance of the Th17 pattern over Treg cells in verrucous lesions. We speculate that the local immune imbalance in CBM lesions characterized by exacerbated Th17 response, probably by suppressing the Treg response, is not effective for total fungal elimination. Even after long-period treatments, most patients has no absolute cure and often there is recurrence of the lesions. We believe that our study could contribute to the understanding of the immunopathogenesis of CBM and in such a way, presents some aspects to new possible therapies.
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Verma GK, Verma S, Singh G, Shanker V, Tegta GR, Minhas S, Sharma V, Thakur J. A case of extensive chromoblastomycosis from North India. Braz J Microbiol 2014; 45:275-7. [PMID: 24948945 PMCID: PMC4059311 DOI: 10.1590/s1517-83822014005000025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Accepted: 04/04/2013] [Indexed: 01/19/2023] Open
Abstract
A case of extensive chromoblastomycosis of the right leg and thigh with verruciform to nodular lesions evolving rapidly over five years duration is reported. The diagnosis was confirmed by visualizing pathognomonic pigmented muriform bodies with unique septate hyphae and mycological culture yielding Fonsecaea pedrosoi.
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Affiliation(s)
| | - Santwana Verma
- Departament of Microbiology Indira Gandhi Medical College Shimla India
| | - Gagandeep Singh
- Departament of Medical Microbiology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Vinay Shanker
- Departament of Dermatology Indira Gandhi Medical College Shimla India
| | - Geeta Ram Tegta
- Departament of Dermatology Indira Gandhi Medical College Shimla India
| | - Smridhi Minhas
- Departament of Dermatology Indira Gandhi Medical College Shimla India
| | - Vineeta Sharma
- Departament of Microbiology Indira Gandhi Medical College Shimla India
| | - Jatin Thakur
- Departament of Dermatology Indira Gandhi Medical College Shimla India
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González GM, Rojas OC, González JG, Kang Y, de Hoog GS. Chromoblastomycosis caused by Rhinocladiella aquaspersa. Med Mycol Case Rep 2013; 2:148-51. [PMID: 24432242 DOI: 10.1016/j.mmcr.2013.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 08/15/2013] [Accepted: 08/21/2013] [Indexed: 11/28/2022] Open
Abstract
A case of chromoblastomycosis of the hand caused by Rhinocladiella aquaspersa is described. The case was acquired locally in tropical Venezuela and was successfully treated with oral itraconazole.
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Vicente VA, Najafzadeh MJ, Sun J, Gomes RR, Robl D, Marques SG, Azevedo CMPS, de Hoog GS. Environmental siblings of black agents of human chromoblastomycosis. FUNGAL DIVERS 2014; 65:47-63. [DOI: 10.1007/s13225-013-0246-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Deng S, de Hoog GS, Badali H, Yang L, Najafzadeh MJ, Pan B, Curfs-Breuker I, Meis JF, Liao W. In vitro antifungal susceptibility of Cladophialophora carrionii, an agent of human chromoblastomycosis. Antimicrob Agents Chemother 2013; 57:1974-7. [PMID: 23380718 DOI: 10.1128/AAC.02114-12] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A global collection of Cladophialophora carrionii strains (n = 81) was tested against nine antifungal drugs. MIC90s of all strains were as follows in increasing order: itraconazole and posaconazole, 0.063 μg/ml; terbinafine, 0.125 μg/ml; isavuconazole and voriconazole, 0.25 μg/ml; caspofungin, 2 μg/ml; micafungin, 4 μg/ml; amphotericin B, 8 μg/ml; and fluconazole, 64 μg/ml.
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Abstract
Subcutaneous mycoses are common in tropical and subtropical regions of the world. These infections have multiple features in common, including similar epidemiology, mode of transmission, indolent chronic presentation with low potential for dissemination in immunocompetent hosts, and pyogranulomatous lesions on histopathology. Herein, we provide up-to-date epidemiologic, clinical, diagnostic, and therapeutic data for three important subcutaneous mycoses: chromoblastomycosis, mycetoma, and sporotrichosis.
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Affiliation(s)
- Ricardo M La Hoz
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, Tinsley Harrison Tower 229, Birmingham, AL, 35294-0006, USA
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Rangel LP, Moreira OC, Livramento GN, Britto C, Alviano DS, Alviano CS, Ferreira-Pereira A. Putative role of an ABC transporter in Fonsecaea pedrosoi multidrug resistance. Int J Antimicrob Agents 2012; 40:409-15. [PMID: 22999764 DOI: 10.1016/j.ijantimicag.2012.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 07/10/2012] [Accepted: 07/16/2012] [Indexed: 10/27/2022]
Abstract
Fonsecaea pedrosoi, a dematiaceous fungus, is the main agent responsible for chromoblastomycosis, a chronic and progressive mycosis of the skin and subcutaneous tissues. This disease can cause different types of lesions depending on the immune status of the host. Its treatment is complicated by the toxicity of available antifungal agents as well as drug resistance. In this work, an ATP-binding cassette (ABC) transporter in this fungus was characterised, with the degree of expression related to the drug resistance of two strains (a patient isolated strain and a laboratory strain). A 150 kDa protein was detected by western blotting. The ATPase activity of membrane preparations was also evaluated. The F. pedrosoi transporter appears to behave like Pdr5p, a well-studied multidrug resistance transporter in Saccharomyces cerevisiae with the ability to hydrolyse different triphosphate nucleotides, as well as its response to classical inhibitors tested. Finally, a reverse transcription polymerase chain reaction (RT-PCR) approach was used and a 400 bp product was detected, corresponding to the highly conserved ATP-binding domain of ABC transporters. We suggest that an ABC transporter must be involved in F. pedrosoi multidrug resistance, and a complete understanding of this protein could bring an important contribution to antifungal treatment of this disease.
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Affiliation(s)
- Luciana P Rangel
- Departamento de Microbiologia Geral, Laboratório de Bioquímica Microbiana/IMPPG, CCS, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho 373, Cidade Universitária, CEP 21941902, Rio de Janeiro, Brazil
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