RESUMEN
Human pythiosis is a rarely encountered yet potentially harmful infectious disease. It is mostly caused by Pythium insidiosum, an aquatic fungal-like organism, and primarily manifests in tropical locales such as India and Thailand. Cutaneous/subcutaneous pythiosis accounts for a small proportion of all clinical forms. The relationship between cutaneous pythiosis and hemoglobinopathy remains uncertain, unlike the vascular form. The histopathology of the disease demonstrates eosinophilic granulomatous inflammation and dense eosinophilic material enveloping the organism, known as the Splendore-Hoeppli phenomenon. These histopathologic characteristics resemble those observed in entomophthoromycosis. Until now, the histopathology of human cutaneous pythiosis has been scarcely delineated in the literature. Herein, we report a case of cutaneous pythiosis in an adult thalassemic agricultural worker who presented with a 2-month history of a progressive, painful, erythematous infiltrative plaque on the left leg. The definitive diagnosis was ascertained through histopathologic examination and the identification of anti-P. insidiosum antibodies in the serum utilizing enzyme-linked immunosorbent assay. This report demonstrates the exquisite histopathologic findings of a rare case of human cutaneous pythiosis.
RESUMEN
Pythiosis is a fatal disease which has high incidence in tropical regions. In contrast with vascular pythiosis, cutaneous and subcutaneous pythiosis are both uncommon. Here, we report a case of subcutaneous pythiosis in a pregnant farmer manifested with a progressively larger and more painful mass at right deltoid. The tissue culture and molecular test were negative for fungi. The diagnosis was supported by the positivity of serum immunochromatographic test (ICT) for pythiosis. Patients responded well to the combination therapy of itraconazole, terbinafine and azithromycin.
RESUMEN
Pythiosis is reported for the first time in a goat. The affected goat had daily access to an aquatic environment and had developed an ulcerative lesion on the skin of the left hindlimb. Microscopically, there were dermal pyogranulomas with 'negatively stained' hyphae, which were identified immunohistochemically as Pythium insidiosum.
Asunto(s)
Enfermedades de las Cabras/patología , Pitiosis/patología , Pitiosis/parasitología , Enfermedades de la Piel/parasitología , Enfermedades de la Piel/veterinaria , Animales , CabrasRESUMEN
El objetivo de este estudio fue evaluar y caracterizar los aspectos clínicos e histopatológicos de la pitiosis cutánea en burros (Equus asinus) en el departamento de Córdoba, Colombia. Se realizó un estudio de tipo descriptivo, no probabilístico en animales de conveniencia. Fueron analizados nueve burros con pitiosis cutánea diagnosticados clínica e histopatológicamente. Al describir los casos se observó una grave ulceración granulomatosa en forma de cráter, con tejido necrótico, apariencia tumoral, abundante exudación filante fibrino-sanguinolenta y salida de material caseificado de color blanco amarillento denominado kunkers. Las lesiones se ubicaron en miembros, abdomen ventral y pecho de los animales. Histopatológicamente, con la coloración de hematoxilina-eosina, se observó dermatitis piogranulomatosa severa, con abundante infiltrado inflamatorio de tipo eosinofílico y neutrofílico; con la coloración de Grocott se evidenciaron hifas con tabiques y parcialmente ramificadas en ángulo recto, de color café. El diagnóstico definitivo de la enfermedad se fundamentó en las características clínicas, el diagnóstico diferencial y en los hallazgos histopatológicos. Fue concluyente el diagnóstico de la pitiosis cutánea. El presente estudio se convierte en el primer reporte de esta enfermedad en burros (Equus asinus) en el departamento de Córdoba y en Colombia.
The purpose of this study was to evaluate and characterize the clinical and histopathological aspects of cutaneous pythiosis in donkeys (Equus asinus) in the Department of Cordoba, Colombia. A descriptive, non-probability study was conducted on domesticated animals. Nine donkeys clinically and histopathologically diagnosed with cutaneous pythiosis were analyzed. After describing the cases, a serious, crater-shaped granulomatous ulcer was observed, with necrotic tissue, a tumor appearance, abundant fibrinous-bloody exudation and yellowish-white caseous material known as kunkers. The lesions were found in the members, ventral abdomen and chest of the animals. Histopathologically, with the hematoxylin-eosin staining, severe pyogranulomatous dermatitis was observed, with abundant eosinophilic and neutrophilic inflammatory infiltrate; with the Grocott staining, hyphae with septa were found, partially branching into a right angle and brown in color. The definitive diagnosis of the disease was based on the clinical features, the differential diagnosis and the histopathological findings. The diagnosis of cutaneous pythiosis was conclusive. This study becomes the first report of this disease in donkeys (Equus asinus) in the department of Córdoba and in Colombia.
O objetivo deste estudo foi avaliar e caracterizar os aspectos clínicos e histopatológicos da pitiose cutânea em burros (Equus asinus) no Estado de Córdoba, Colômbia. Realizou-se um estudo de tipo descritivo, não probabilístico em animais de conveniência. Foram analisados nove burros com pitiose cutânea, diagnosticados clínica e histopatologicamente. Ao descrever os casos se observou uma grave ulceração granulomatose em forma de cratera com tecido necrótico, aparência tumoral, abundante exsudação pegajosa fibrinosa sanguinolenta e saída de material caseoso de cor branca amarelada denominada kunkers. As lesões se localizaram em membros, abdômen ventral e peito dos animais. Histopatologicamente, com a coloração de hematoxilina-eosina, se observou dermatite pio granulomatosa severa, com abundante infiltrado inflamatório de tipo eosinofílico e neutrofílico; com a coloração de Grocott se evidenciaram hifas com tabiques e parcialmente ramificadas em ângulo reto, de cor marrom. O diagnóstico definitivo da doença se fundamentou nas características clínicas, o diagnóstico diferencial e nos achados histopatológicos. Foi concluinte o diagnóstico da pitiose cutânea. O presente estudo se converte no primeiro relatório desta doença em burros (Equus asinus) no Estado de Córdoba na Colômbia.