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1.
Transpl Infect Dis ; 7(3-4): 162-5, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16390408

RESUMO

Trichosporon asahii is a yeast that may cause systemic infection, especially in neutropenic patients. To our knowledge, only two cases of invasive infection with Trichosporon were previously described in liver transplant recipients. We describe an additional case of T. asahii infection after orthotopic liver transplantation in a non-neutropenic patient who had no known risk factor for invasive fungal infection, and died in spite of amphotericin B therapy.


Assuntos
Transplante de Fígado/efeitos adversos , Micoses/microbiologia , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico , Micoses/tratamento farmacológico , Neutropenia , Trichosporon/isolamento & purificação
2.
Rev. bras. pesqui. méd. biol ; Braz. j. med. biol. res;36(5): 613-616, May 2003. tab, graf
Artigo em Inglês | LILACS | ID: lil-331458

RESUMO

Many studies have attempted to evaluate the importance of airborne fungi in the development of invasive fungal infection, especially for immunocompromised hosts. Several kinds of instruments are available to quantitate fungal propagule levels in air. We compared the performance of the most frequently used air sampler, the Andersen sampler with six stages, with a portable one, the Reuter centrifugal sampler (RCS). A total of 84 samples were analyzed, 42 with each sampler. Twenty-eight different fungal genera were identified in samples analyzed with the Andersen instrument. In samples obtained with the RCS only seven different fungal genera were identified. The three most frequently isolated genera in samples analyzed with both devices were Penicillium, Aspergillus and Cladophialophora. In areas supplied with a high efficiency particulate air filter, fungal spore levels were usually lower when compared to areas without these filters. There was a significant correlation between total fungal propagule measurements taken with both devices on each sampling occasion (Pearson coefficient = 0.50). However, the Andersen device recovered a broader spectrum of fungi. We conclude that the RCS can be used for quantitative estimates of airborne microbiological concentrations. For qualitative studies, however, this device cannot be recommended


Assuntos
Humanos , Microbiologia do Ar , Poluição do Ar em Ambientes Fechados , Monitoramento Ambiental , Fungos , Hospitais , Centrifugação , Monitoramento Ambiental , Filtração , Fungos
3.
Braz J Med Biol Res ; 36(5): 613-6, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12715080

RESUMO

Many studies have attempted to evaluate the importance of airborne fungi in the development of invasive fungal infection, especially for immunocompromised hosts. Several kinds of instruments are available to quantitate fungal propagule levels in air. We compared the performance of the most frequently used air sampler, the Andersen sampler with six stages, with a portable one, the Reuter centrifugal sampler (RCS). A total of 84 samples were analyzed, 42 with each sampler. Twenty-eight different fungal genera were identified in samples analyzed with the Andersen instrument. In samples obtained with the RCS only seven different fungal genera were identified. The three most frequently isolated genera in samples analyzed with both devices were Penicillium, Aspergillus and Cladophialophora. In areas supplied with a high efficiency particulate air filter, fungal spore levels were usually lower when compared to areas without these filters. There was a significant correlation between total fungal propagule measurements taken with both devices on each sampling occasion (Pearson coefficient = 0.50). However, the Andersen device recovered a broader spectrum of fungi. We conclude that the RCS can be used for quantitative estimates of airborne microbiological concentrations. For qualitative studies, however, this device cannot be recommended.


Assuntos
Microbiologia do Ar , Poluição do Ar em Ambientes Fechados/análise , Monitoramento Ambiental/instrumentação , Fungos/isolamento & purificação , Hospitais , Centrifugação/instrumentação , Monitoramento Ambiental/métodos , Filtração/instrumentação , Fungos/classificação , Humanos
4.
Rev Inst Med Trop Sao Paulo ; 43(3): 163-6, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11452326

RESUMO

We report a case of cutaneous infection caused by Phialemonium curvatum GAMS et COOKE, 1983, after bone marrow transplantation. The genus Phialemonium was created by GAMS & MCGINNIS in 1983 including three new species: Ph. obovatum, Ph. curvatum and Ph. dimorphosporum, and represents an intermediate genus between Acremonium and Phialophora. Nowadays, the genus Phialemonium is considered to be a pheoid fungus which may cause the eventual lesions observed in pheo- and hyalohyphomycosis. Species of this genus have been described as opportunistic agents in humans and animals, mainly as a result of immunosuppression. In the present case, the patient had multiple myeloma and received an allogenic bone marrow transplant from his HLA-compatible brother. Two months after transplantation, he developed purplish and painful nodular lesions on the right ankle. Some of these lesions drained spontaneously and apparently hyaline mycelial filaments were observed, whose culture was initially identified as Acremonium sp. Subsequent studies showed that the fungus was Phialemonium curvatum. The infection was treated with amphotericin B, followed by ketoconazole. The patient was submitted to surgical debridement followed by two skin grafts to repair the bloody area. The duration of the treatment was 4 months and secondary prophylaxis with ketoconazole alone was maintained for one additional month. No recurrence was observed after discontinuation of treatment. The authors comment on the pathogenicity of the genus Phialemonium.


Assuntos
Transplante de Medula Óssea/efeitos adversos , Dermatomicoses/microbiologia , Fungos Mitospóricos/isolamento & purificação , Infecções Oportunistas/complicações , Adulto , Dermatomicoses/tratamento farmacológico , Humanos , Hospedeiro Imunocomprometido , Masculino
5.
J Clin Microbiol ; 39(6): 2321-4, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11376082

RESUMO

A case of phaeohyphomycosis is reported in a male renal transplant recipient with a nodular lesion in the right leg who was treated with immunosuppressing drugs. The lesion consisted of a purulent cyst with thick walls. The cyst was excised surgically, and the patient did not receive any antifungal therapy. One year later he remains well. Histological study of the lesion showed a granulomatous reaction of epithelioid and multinucleate giant cells, with a central area of necrosis and pus. Fontana-Masson staining demonstrated the presence of pigmented hyphal elements. The fungus Colletotrichum crassipes was grown in different cultures from the cyst. The in vitro inhibitory activities of eight antifungal drugs against the isolate were tested. Clotrimazole and UR-9825 were the most active drugs. This case represents the first known reported infection caused by this rare species.


Assuntos
Colletotrichum/isolamento & purificação , Cistos/diagnóstico , Dermatomicoses/diagnóstico , Adulto , Colletotrichum/classificação , Colletotrichum/crescimento & desenvolvimento , Meios de Cultura , Cistos/microbiologia , Cistos/cirurgia , Dermatomicoses/microbiologia , Dermatomicoses/cirurgia , Humanos , Transplante de Rim , Masculino
6.
Rev Inst Med Trop Sao Paulo ; 41(5): 313-7, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10602546

RESUMO

The authors report the first case of dermatophytosis caused by Trichophyton raubitschekii in a patient from the State of São Paulo with Tinea corporis lesions localized on the buttocks. Culture on Sabouraud-agar with cycloheximide permitted the isolation and identification of the fungus, and the diagnosis was confirmed by Dr. Lynne Sigler, University of Alberta, Canada. Systemic treatment with fluconazole, 150 mg/week for 4 weeks, in combination with topical treatment with isoconazole initially yielded favorable results, with recurrence of the lesions after the medication was discontinued. This is the fifth case of this dermatophytosis published in the Brazilian medical literature.


Assuntos
Tinha/microbiologia , Trichophyton/isolamento & purificação , Antifúngicos/uso terapêutico , Brasil/epidemiologia , Feminino , Fluconazol/uso terapêutico , Humanos , Miconazol/análogos & derivados , Miconazol/uso terapêutico , Tinha/tratamento farmacológico , Tinha/epidemiologia , Trichophyton/classificação , Trichophyton/citologia
7.
Rev Inst Med Trop Sao Paulo ; 41(5): 319-23, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10602547

RESUMO

The authors report two cases of onychomycosis in the dystrophic form, one of them involving an HIV-positive patient, provoked by Scytalidium dimidiatum, previously called Scytalidium lignicola. The subject is reviewed from the taxonomic viewpoint, considering the anamorph Hendersonula toruloidea as a synonym of Nattrassia mangiferae, and having Scytalidium dimidiatum as the major synanamorph. According to many mycologists, Scytalidium hyalinum may be a separate species or a hyaline mutant of Scytalidium dimidiatum. Scytalidium lignicola Pesante 1957 was considered to be the type-species of the genus by ELLIS (1971)13 and later to be a "conidial state" of Hendersonula toruloidea by the same author, today known as Nattrassia mangiferae. The microorganism lives only on the roots of certain plants (mainly Platanus and Pinus). It produces pycnidia and is not considered to be a pathogen, although it is considered as a possible emerging agent capable of provoking opportunistic fungal lesions. The importance of this topic as one of the most outstanding in fungal taxonomy, so likely to be modified over time, as well as its interest in the field of dermatologic mycology, are emphasized.


Assuntos
Fungos Mitospóricos/classificação , Onicomicose/microbiologia , Adulto , Antifúngicos/uso terapêutico , Feminino , Dermatoses do Pé/tratamento farmacológico , Dermatoses do Pé/microbiologia , Dermatoses da Mão/tratamento farmacológico , Dermatoses da Mão/microbiologia , Humanos , Itraconazol/uso terapêutico , Cetoconazol/uso terapêutico , Masculino , Fungos Mitospóricos/isolamento & purificação , Onicomicose/tratamento farmacológico
8.
Rev Inst Med Trop Sao Paulo ; 41(2): 79-86, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10413954

RESUMO

The authors conducted a mycologic, immunochemical and molecular biology study on two strains of Paracoccidioides brasiliensis, one of them, called IBIA, isolated from soil in the municipality of IBIA (Minas Gerais) by Silva-Vergara et al. (1996, 1998), and the other, BAT, cultivated from a human case of paracoccidioidomycosis in Ribeirão Preto (São Paulo/Brazil) by Freitas Da Silva (1996). Both strains showed cotton-like (M) and yeast-like (Y) forms and were pathogenic for testicularly inoculated guinea pigs, producing granulomatous and/or suppurative orchitis. Immunochemically was demonstrated the presence of gp43 by double immunodiffusion, immunoelectrophoresis and immunoblotting.


Assuntos
Paracoccidioides/classificação , Paracoccidioides/imunologia , Animais , Cobaias , Humanos , Imunoquímica/métodos , Técnicas de Tipagem Micológica , Paracoccidioides/isolamento & purificação
9.
Rev Hosp Clin Fac Med Sao Paulo ; 54(5): 169-71, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10788840

RESUMO

Although opportunistic fungal infections occur commonly in immunocompromised hosts, mycetoma has never been reported in association with HIV infection. The authors present a case that to their knowledge is the first reported case of mycetoma associated with HIV infection. Diagnosis was confirmed by direct examination of grains and histologic examination. Precise identification of the agent, an actinomycete, was not possible. The unusual site of infection may probably be related to the use of contaminated needless and syringes for HIV drug injection.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Micetoma/microbiologia , Adulto , Humanos , Masculino , Micetoma/patologia
10.
Rev Inst Med Trop Sao Paulo ; 40(5): 321-3, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-10030078

RESUMO

A forty-year-old man underwent an allogeneic BMT from his HLA identical sister. GvHD prophylaxis was done with cyclosporine (CyA), methotrexate and prednisone (PDN). On day +90 extensive GvHD was noted and higher doses of immunosuppressive drugs alternating CyA with PDN were initiated. Patient's follow-up was complicated by intermittent episodes of leukopenia and monthly episodes of sinusitis or pneumonia. One year after BMT, the patient developed hoarseness and nasal voice. No etiologic agent could be identified on a biopsy sample of the vocal chord. Upon tapering the doses of immunosuppressive drugs, the patient had worsening of chronic GvHD and was reintroduced on high doses of cyclosporine alternating with prednisone on day +550. Three months later, GvHD remained out of control and the patient was started on azathioprine. On day +700, hoarseness and nasal voice recurred. Another biopsy of the left vocal chord failed to demonstrate infection. Episodes of sinusitis became more frequent and azathioprine was withheld 3 months after it was started. One month later, the patient had bloody nasal discharge and surgical drainage of maxillary sinuses was performed. Histopathology showed hyphae and cultures grew Scedosporium apiospermum. Itraconazole 800 mg/day was initiated. The patient developed progressive respiratory failure and died 15 days later.


Assuntos
Transplante de Medula Óssea , Dermatomicoses/diagnóstico , Pseudallescheria , Sinusite/microbiologia , Adulto , Evolução Fatal , Doença Enxerto-Hospedeiro/complicações , Humanos , Masculino , Complicações Pós-Operatórias
11.
J Am Soc Nephrol ; 8(9): 1415-22, 1997 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9294833

RESUMO

Nephrotoxicity is the major adverse effect of conventional amphotericin B (AMB/D), often limiting administration of full dosage. The new liposomal amphotericin B seems to be less toxic. The new liposomal amphotericin B seems to be less toxic. In this study, it is proposed that solubilizing the standard AMB/D preparation with 10% lipid emulsion will attenuate nephrotoxicity. Rats were injected with either AMB/D (Fungizone), AMB, AMB/D plus lipid emulsion (AMB/D/LE), or sodium deoxycholate (D). Renal function studies were performed on day 5. To assess a direct tubular toxic effect, isolated rat proximal tubule suspensions and inner medullary collecting duct cells in culture were exposed to AMB/D, AMB, AMB/D/LE, liposomal amphotericin B, and D for 60 min in normoxia. Lactate dehydrogenase (LDH) release was assessed as an index of cell injury. Creatinine clearance (ml/min per 100 g) averaged 0.79 +/- 0.04 in control rats, 0.29 +/- 0.09 in AMB rats (P < 0.001 versus control), 0.38 +/- 0.04 in AMB/D rats, 0.46 +/- 0.05 in D rats, and 0.78 +/- 0.03 in AMB/LE rats. Renal blood flow (ml/min per 100 g) was 3.45 +/- 0.31 in control, 1.29 +/- 0.28 in AMB, 1.42 +/- 0.23 in AMB/D, 3.03 +/- 0.39 in D, and 2.71 +/- 0.21 in AMB/D/LE rats. The fractional excretion of potassium (%) was 27.3 +/- 1.18 in control rats, 61.6 +/- 7.00 in AMB/D rats, 58.4 +/- 15.32 in AMB rats, and 37.9 +/- 2.06 in AMB/D/LE rats. LDH release (%) in proximal tubules incubated with AMB/D and D was 43.6 +/- 3.39 and 58.6 +/- 4.20, respectively. Addition of lipid emulsion decreased LDH release: 21.6 +/- 1.22 for AMB/D/LE and 26.4 +/- 3.03 for deoxycholate plus lipid emulsion. AMB did not demonstrate any toxic effect in proximal tubule suspensions. D was not toxic to inner medullary collecting duct cells at 0.16 mg/ml, whereas D at a higher dose and AMB induced a significant LDH release. Addition of lipid emulsion did not affect the antifungal activity as assessed by the Etest method. In conclusion, an alternative way of administering standard AMB with reduced nephrotoxicity is proposed.


Assuntos
Anfotericina B/intoxicação , Antibacterianos/intoxicação , Rim/efeitos dos fármacos , Lipídeos/farmacologia , Animais , Células Cultivadas , Emulsões , Rim/microbiologia , Rim/fisiopatologia , Medula Renal , Túbulos Renais Coletores/metabolismo , Túbulos Renais Coletores/patologia , Túbulos Renais Proximais/metabolismo , L-Lactato Desidrogenase/metabolismo , Masculino , Ratos , Ratos Wistar , Solubilidade
12.
Rev Inst Med Trop Sao Paulo ; 39(3): 141-4, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9460253

RESUMO

The present study concern on mycologic and immunochemical data obtained from two samples of a fungus considered as belonging to the species Paracoccidioides cerebriformis described by Moore in 1935, and maintained since then on Sabouraud's agar in the mycology collection of the Instituto de Medicina Tropical de São Paulo. After 60 years, the samples exhibited the same characteristics described by MOORE (1935). However, experimental lesions did not resulted in guinea-pigs inoculated intratesticularly. The dominant antigen in Paracoccidioides brasiliensis, 43 kDa glicoprotein (gp43), could not be demonstrated by SDS PAGE and Western blotting. Immunoelectrophoresis did not demonstrated the E arch of cathodic migration using a policlonal anti gp43 serum. According to these findings, it is concluded that the fungus described by MOORE (1935) as P. cerebriformis does not belong to the genus Paracoccidioides. Paracoccidioidomycosis should therefore be considered as resulting from infection by a single species, Paracoccidioides brasiliensis (Splendore, 1912) as asserted by ALMEIDA (1930). Further studies, through molecular biology methods, could identify the mentioned fungus.


Assuntos
Paracoccidioides/classificação , Paracoccidioides/imunologia , Animais , Cobaias , Humanos , Imuno-Histoquímica
13.
Rev Inst Med Trop Sao Paulo ; 39(1): 43-8, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9394536

RESUMO

We report a case of subcutaneous phaeohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by different Phoma species, is presented. The patient healed after therapy with amphotericin B. followed by itraconazole.


Assuntos
Fungos Mitospóricos , Micoses , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Humanos , Itraconazol/uso terapêutico , Masculino , Pessoa de Meia-Idade , Fungos Mitospóricos/isolamento & purificação , Micoses/tratamento farmacológico , Micoses/microbiologia
14.
Rev Inst Med Trop Sao Paulo ; 39(5): 299-304, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9661310

RESUMO

UNLABELLED: Coccidioidomycosis is an endemic infection with a relatively limited geographic distribution: Mexico, Guatemala, Honduras, Colombia, Venezuela, Bolivia, Paraguay, Argentina and the southwest of the United States. In these countries, the endemic area is restricted to the semiarid desert like regions which are similar to the northeast of Brazil. CASE REPORT: The patient is a 32 year-old male, born in the state of Bahia (Northeast of Brazil) and has been living in São Paulo (Southeast) for 6 years. He was admitted at Hospital das Clínicas, at the Department of Pneumology in October 1996, with a 6 month history of progressive and productive cough, fever, malaise, chills, loss of weight, weakness and arthralgia in the small joints. Chest x-rays and computerized tomography disclosed an interstitial reticulonodular infiltrate with a cavity in the right upper lobe. The standard potassium hydroxide preparation of sputum and broncoalveolar lavage demonstrated the characteristic thickened wall spherules in various stages of development. Sabouraud dextrose agar, at 25 degrees C and 30 degrees C showed growth of white and cottony aerial miceleium. The microscopic morphology disclosed branched hyphae characterized by thick walled, barrel shaped arthroconidia alternated with empty cells. The sorological studies with positive double immunodiffusion test, and also positive complement fixation test in 1/128 dilution confirmed the diagnosis. The patient has been treated with ketoconazole and presents a favorable clinical and radiological evolution.


Assuntos
Coccidioidomicose/diagnóstico , Pneumopatias Fúngicas/diagnóstico , Adulto , Brasil , Humanos , Masculino
15.
Rev Inst Med Trop Sao Paulo ; 38(5): 379-90, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-9293082

RESUMO

The basidiomycosis, fungal infections provoked by basidiomycetes or agaric fungi have been recorded at growing frequencies in the medical literature, especially after the advent of AIDS in 1991. The basidiospores of these fungi, scattered in the atmosphere and transported by winds or air currents, reach the maxillary sinuses through the nasal route, most of the times causing signs and symptoms of chronic sinusitis. Basidiomycetes have also been isolated from sputum, especially Schizophyllum commune. Lesions of the buccal mucosa, brain abscesses, onychomycosis and endocarditis have been described, with a growing interest in this type of deep mycosis on the part of mycologists and infectologists. The present paper reports descriptions of mycetism as well as infectious processes caused by basidiomycetes, such as Schizophyllum commune, Ustilago maydis (= Ustilago zeae) and Coprinus cinereus.


Assuntos
Basidiomycota/classificação , Micoses , Humanos , Micoses/diagnóstico , Micoses/microbiologia
16.
Rev Inst Med Trop Sao Paulo ; 37(3): 267-70, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-8525275

RESUMO

We present a case of subcutaneous hyalohyphomycosis due to Acremonium recifei, a species whose habitat is probably the soil, first identified in 1934 by Arêa Leão and Lobo in a case of podal eumycetoma with white-yellowish grains and initially named Cephalosporium recifei. A white immunocompetent female patient from the state of Bahia, Brazil, with a history of traumatic injury to the right hand is reported. The lesions was painless, with edema, inflammation and the presence of fistulae. Seropurulent secretion with the absence of grains was present. Histopathological examination of material stained with hematoxylin-eosin showed hyaline septate hyphae. A culture was positive for Acremonium recifei. Treatment with itraconazole, 200 mg/day, for two months led to a favorable course and cure of the process. We report for the first time in the literature a case of subcutaneous hyalohyphomycosis due to Acremonium recifei in a immunocompetent woman. Treatment with itraconazole 200 mg/day, for two months, resulted in cure.


Assuntos
Acremonium/isolamento & purificação , Micetoma/diagnóstico , Idoso , Brasil , Feminino , Humanos , Itraconazol/uso terapêutico , Micetoma/tratamento farmacológico , Micetoma/patologia , Microbiologia do Solo
17.
Rev Inst Med Trop Sao Paulo ; 37(1): 43-9, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7569639

RESUMO

A sample of P. brasiliensis isolated from the spleen and the liver of an armadillo (Dasipus novencinctus) has been analysed under a mycological and immunochemical viewpoint. The armadillo was captured in an area of Tucuruí (State of Pará, Brazil), the animal being already established as an enzootic reservoir of P. brasiliensis at that region of the country. This sample maintained in the fungal collection of the Tropical Medicine Institute of São Paulo (Brazil) numbered 135, has got all the characteristics of P. brasiliensis, with a strong antigenic power and low virulence for guinea-pigs and Wistar rats. The specific exoantigen of P. brasiliensis--the glycoprotein with a molecular weight of 43 kDa--was easily demonstrated with double immunodiffusion, immunoelectrophoresis, SDS-PAGE and immunobloting techniques.


Assuntos
Tatus/microbiologia , Paracoccidioides/isolamento & purificação , Animais , Antígenos de Fungos/isolamento & purificação , Cricetinae , Reservatórios de Doenças , Cobaias , Imunoquímica , Imunoglobulina G , Masculino , Paracoccidioides/imunologia , Ratos , Ratos Wistar
18.
Rev Inst Med Trop Sao Paulo ; 36(5): 465-9, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7569615

RESUMO

Two cases of Aspergillosis in immunocompromised children are reported. Both were caused by Aspergillus flavus. Early diagnosis and treatment led to the remission of the process. One patient had acute myeloid leukemia; the fungus was isolated from the blood. The other patient with bone marrow aplasia, presented an invasive aspergillosis of the paranasal sinuses with dissemination of fungal infection; the diagnosis was obtained by histology and culture of biopsied tissue from a palatal ulceration.


Assuntos
Aspergilose/complicações , Doenças da Medula Óssea/complicações , Leucemia Mieloide Aguda/complicações , Adolescente , Anfotericina B/uso terapêutico , Aspergilose/diagnóstico , Aspergilose/tratamento farmacológico , Aspergilose/imunologia , Aspergillus flavus/isolamento & purificação , Doenças da Medula Óssea/imunologia , Criança , Feminino , Humanos , Hospedeiro Imunocomprometido , Itraconazol/uso terapêutico , Leucemia Mieloide Aguda/imunologia
19.
Rev Inst Med Trop Sao Paulo ; 36(2): 175-83, 1994.
Artigo em Português | MEDLINE | ID: mdl-7997796

RESUMO

We report three cases of subcutaneous phaeohyphomycosis due to Exophiala jeanselmei (Langeron) McGinnis et Padhye 1977, in kidney transplant patients. Exophiala jeanselmei is a dematious fungus having also ability to rarely procedure eumycetoma (black grains). According to KWON-CHUNG & BENNETT (1992) such fungus is antigenically very heterogeneous, since so far three serotypes have been identified; each serotype including subgroups. Subcutaneous phaeohyphomycosis is becoming more and more frequent in kidney transplant patients submitted to an immunosuppressive treatment. As Exophiala jeanselmei has already been isolated from the environment it becomes difficult to explain the pathogenicity of these cases by a reactivation of quiescent processes. The authors suggest an occasional fungistatic action of cyclosporine A upon Exophiala jeanselmei.


Assuntos
Dermatomicoses/microbiologia , Exophiala/isolamento & purificação , Transplante de Rim/efeitos adversos , Infecções Oportunistas/microbiologia , Adulto , Ciclosporina/uso terapêutico , Dermatomicoses/patologia , Dermatomicoses/terapia , Exophiala/patogenicidade , Feminino , Humanos , Terapia de Imunossupressão/efeitos adversos , Masculino , Pessoa de Meia-Idade
20.
Rev Inst Med Trop Sao Paulo ; 35(5): 469-78, 1993.
Artigo em Português | MEDLINE | ID: mdl-8115818

RESUMO

The purpose of this work was to collect the main information from the literature about the biotyping of Cryptococcus neoformans. The more up-to date research concerning the epidemiology of cryptococcosis comprising quite a few articles, mainly after the advent of AIDS, was also reviewed. The Cryptococcus neoformans varieties neoformans and gattii are well defined biochemically nowadays chiefly through the C.G.B. medium, according to Kwon-Chung et al. (1982). The isolation of C. neoformans var. gattii from flowers and leaves of Eucalyptus camaldulensis and Eucalyptus tereticornis, specially in Australia, through the works of Ellis & Pfeiffer (1990) and Pfeiffer & Ellis (1992) permitted very interesting epidemiological investigations on C. neoformans, a capsulated yeast by which Sanfelice, in Italy (1894; 1895) attracted attention of medical class. Busse, in 1894, described the first human case of cryptococcosis under the presentation of a bone lesion simulating sarcoma. In this paper, the Brazilian researchers focused on this subject were pointed out, followed by the Author's experience with the C.G.B. medium (L-canavanine, glycine and bromothymol blue) proposed by Kwon-Chung et al. (1982) with very good results. It was possible with such medium the study of 50 C.N.S. liquor samples, being 39 from AIDS patients (78%) and 11 from non-AIDS ones (22%). Thirty-seven out of the 39 HIV-positive patients (74%) were identified as C. neoformans var. gattii. From the negative HIV, 8 (16%) were classified as C. neoformans var. neoformans and 3 (6%) as C. neoformans var. gattii. We could not perform the serotyping of the above referred samples. It is evident anyway that in Brazil there exist both varieties gattii and neoformans, agents of neurocryptococcosis, including AIDS patients. The importance of neurocryptococcosis, mainly among AIDS patients, is stressed here, showing once more the value of C.G.B. medium in the typing of C. neoformans in its two varieties. Also, it is of relevant importance the demonstration that some species of eucalyptus may act as "host-trees" of C. neoformans var. gattii.


Assuntos
Criptococose/epidemiologia , Cryptococcus neoformans/classificação , Animais , Azul de Bromotimol , Canavanina , Criptococose/fisiopatologia , Cryptococcus neoformans/isolamento & purificação , Meios de Cultura , Glicina , Sorotipagem
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