RESUMEN
UNLABELLED: Fungal infections are common in tropical countries and can have an important impact on public health. Lobomycosis is a common fungal infection in the tropical rain forest of South America, and paracoccidioidomycosis (South American blastomycosis) is a widespread and sometimes severe illness. Penicilliosis marneffei is an opportunistic infection of AIDS patients in southeast Asia. Chromoblastomycosis and mycetomas are causes of morbidity around the world. Sporotrichosis is a worldwide subcutaneous mycosis with a high incidence in tropical countries and is an important illness in immunocompromised patients. Rhinosporidiosis was classed as a fungal infection but is now considered a protistan parasite that belongs to the class Mesomycetozoea. It is included in this review because of its historical classification. In the past, most of these mycoses were restricted to specific geographic areas and natural reservoirs. There are, however, situations in which people from other regions come in contact with the pathogen. A common situation involves an accidental contamination of a traveler or worker who has contact with a tropical mycosis. Even minor trauma to the skin surface or inhalation of the fungal conidia can infect the patient. Thus recognition of the clinical symptoms and the dermatologic findings of the diseases, as well as the geographic distribution of the pathogens, can be critical in diagnosis of the tropical mycoses. This review discusses some of the more common tropical subcutaneous and systemic mycoses, as well as their signs, symptoms, methods of diagnosis, and therapies. LEARNING OBJECTIVE: At the completion of this learning activity, participants should be able to recognize the clinical and histologic presentations of tropical fungal diseases with cutaneous manifestations and be familiar with the appropriate therapies.
Asunto(s)
Dermatomicosis , Animales , Blastomicosis/diagnóstico , Blastomicosis/microbiología , Blastomicosis/terapia , Cromoblastomicosis/diagnóstico , Cromoblastomicosis/microbiología , Cromoblastomicosis/terapia , Dermatomicosis/diagnóstico , Dermatomicosis/microbiología , Dermatomicosis/terapia , Humanos , Micetoma/diagnóstico , Micetoma/microbiología , Micetoma/terapia , Paracoccidioidomicosis/diagnóstico , Paracoccidioidomicosis/microbiología , Paracoccidioidomicosis/terapia , Penicillium , Rinosporidiosis/diagnóstico , Rinosporidiosis/microbiología , Rinosporidiosis/terapia , Esporotricosis/diagnóstico , Esporotricosis/microbiología , Esporotricosis/terapia , Medicina TropicalRESUMEN
A patient with blastomycosis complained of pain in his lower back after the administration of amphotericin B and parenteral alimentation via a femoral venous catheter. A bone scan that was performed to exclude bony involvement with blastomycosis showed abnormal tracer accumulation in the right paravertebral region. Computed tomography revealed the venous catheter to lie in the right ascending lumbar vein. There was calcification of a portion of the right psoas muscle. In addition, the epidural venous plexus was calcified from L2 to L4. It was this dystrophic calcification that caused the heterotopic accumulation of bone tracer.
Asunto(s)
Blastomicosis/terapia , Calcinosis/metabolismo , Cateterismo Periférico/efectos adversos , Flebitis/metabolismo , Medronato de Tecnecio Tc 99m/farmacocinética , Adolescente , Calcinosis/etiología , Humanos , Masculino , Flebitis/etiologíaRESUMEN
De 11 casos estudiados entre los años 1976 y 1986 en el Consultorio Externo del Instituto de Medicina Tropical, se presentan 7 con diagnóstico etiológico y con el objetivo de ahondar en el conocimiento y detección de la Blastomicosis Sudamericana de importante incidencia en nuestro país. Se señalan las variantes epidemiológicas y clínicas, los medios de diagnóstico utilizados y el tratamiento que tentativamente se ha aplicado
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Paracoccidioidomicosis/epidemiología , Blastomicosis/terapia , Paracoccidioidomicosis/epidemiología , Perú , Sulfameter/uso terapéutico , Gastroenteritis/diagnóstico , Cetoconazol/uso terapéutico , Enfermedades Pulmonares Fúngicas/etiologíaRESUMEN
Fluconazole, anew oral triazole antifungal agent, was againts Blastomyces dermatitidis in vitro and in a murine model (pulmonary challenge) and compared with ketoconazole, an oral imidazole known to be effective against this agent in mice and in humans. Although fluconazole appeared less active than ketoconazole in vitro, in experiments involving 3 weeks of treatment and 2 months of observation, fluconazole was >10 times as potent (mg/kg) in vivo against blastomycosis (prolongation of life). In the model neither drug was curative at the doses and regimens used. A possible explanation for the efficacy of fluconazole in vivo is its favorable pharmacokinetic profile (i.e., prolonged serum concentrations that exceeded the MIC for the pathogen after oral administration. Dosages of 100 mg/(kg.d) were tolerated for 3 weeks without evidence toxicity
Asunto(s)
Blastomicosis/fisiopatología , Blastomicosis/terapia , Blastomicosis/tratamiento farmacológico , Cetoconazol/análisis , Cetoconazol/síntesis química , Cetoconazol/uso terapéutico , Fluconazol/análisis , Fluconazol/síntesis química , Fluconazol/uso terapéuticoRESUMEN
A Blastomicose Sul-Americana é uma doença rara em mulheres. Alguns autores admitem que isto ocorre provavelmente devivo ao fato delas estarem menos expostas do que os homens aos agentes da natureza. Outros afirmam que se deve à participaçåo de fatores hormonais. Esta raridade aumenta quando a doença incide primária ou secundariamente na regiåo vulvar. É registrado o caso de uma paciente de 22 anos, com blastomicose pulmonar, tegumentar e vulvar