Chromoblastomycosis can also cause severe but usually superficial lesions on the legs.Like other deep mycosis, this chronic and disabling condition is seen in many tropical regions,including Argentina,where this man w...Chromoblastomycosis can also cause severe but usually superficial lesions on the legs.Like other deep mycosis, this chronic and disabling condition is seen in many tropical regions,including Argentina,where this man was infected.We describe the spatial epidemiology and identify risk factors for disease.展开更多
Chromoblastomycosis(CBM)is a fungal disease,distributed in tropical and subtropical regions,affecting mainly rural workers.It is characterized by chronic skin lesions that may vary from nodular,tumorous,verrucous or p...Chromoblastomycosis(CBM)is a fungal disease,distributed in tropical and subtropical regions,affecting mainly rural workers.It is characterized by chronic skin lesions that may vary from nodular,tumorous,verrucous or plaque type.Associated constitutional symptoms are rarely found.The histological presentation may yield a pathognomonic feature,the Medlar(sclerotic)bodies,in which a typical brown to black pigment is depicted,explaining“copper pennies”as its alias.In this article,the case of a 56-year-old woman in the countryside of Brazil is reported,whose main complaint was a chronic leg ulcer for the past 8 years.The left leg had a large,partially ulcerated plaque lesion was found.Microbiological cultures were positive for the pathogen.Histological analysis demonstrated pseudoepitheliomatous hyperplasia,lymphohistiocytic infiltrate and sclerotic bodies(“copper pennies”).CBM’s epidemiological panorama,once established uniquely by geographical distribution,is transitioning to a global health issue,influenced by immunosuppressive conditions,global warming and migration.This scenario demands CBM to be widely considered as a differential diagnosis and may represent a clinical challenge in regions whose professionals have little expertise in infectious tropical diseases.展开更多
Agents of human chromoblastomycosis,a skin disease almost exclusively caused by members of the order Chaetothyriales,are assumed to be traumatically inoculated into the skin with sharp environmental materials such as ...Agents of human chromoblastomycosis,a skin disease almost exclusively caused by members of the order Chaetothyriales,are assumed to be traumatically inoculated into the skin with sharp environmental materials such as plant thorns or wooden splinters carrying the respective opportunist.In the supposition that such fungi should have their main habitat in the environment,we investigated the occurrence of black fungi in living areas of patients with chromoblastomycosis.In South America Fonsecaea agents are prevalent as agents of the disease,while also related Cladophialophora species,known from other types of skin infections,are known from the continent.Ninety environmental isolates were preliminarily selected as possible agents of chromoblastomycosis,based on morphology.Judging from ITS sequence data isolates were attributed to the genera Cladophialophora,Cyphellophora,Exophiala,Fonsecaea,Phialophora,and Veronaea.A total of 45 fungi morphologically identified as Fonsecaea or Cladophialophora isolated from debris and thorns of living prickly plants in Brazil were processed for taxonomic studies.Phylogenetic analysis revealed that the isolates indeed belonged to the Chaetothyriales,but only rarely an agent of chromoblastomycosis was concerned;only two strains of F.pedrosoi and one F.monophora were isolated from debris plants.The remaining isolates belonged to hitherto unknown molecular siblings of Fonsecaea.Two novel taxa are introduced.展开更多
Introduction:Chromoblastomycosis is a chronic subcutaneous fungal infection caused by the inoculation of pigmented(dematiaceous)fungi.Disseminated chromoblastomycosis is a very rare form that spreads to the bones,lymp...Introduction:Chromoblastomycosis is a chronic subcutaneous fungal infection caused by the inoculation of pigmented(dematiaceous)fungi.Disseminated chromoblastomycosis is a very rare form that spreads to the bones,lymph nodes,or respiratory tract and has a poor prognosis.Herein,we report a case of chromoblastomycosis with suspected dissemination to the spine.Case presentation:A 67-year-old man presented with a chief complaint of hard,scaly,pruritic lumps on the lumbar region,gluteal region,and left lower limb that had become thicker and emitted a foul odor for 4 weeks.A dermoscopic examination of a plaque on the left lower limb showed scattered reddish-black dots.A histopathologic examination of skin biopsy and 10.0% potassium hydroxide of skin scraping revealed muriform cells(Medlar bodies).The morphology of fungal plate culture colonies was in accordance with Phialophora verrucosa Medlar.Molecular diagnostic tests for Mycobacterium tuberculosis in sputum and cutaneous tissue were negative.Magnetic resonance imaging showed tuberculous spondylitis,which was difficult to distinguish from spinal dissemination of fungal infection.Discussion:The initial lesion in this case was reported in the form of small verrucous plaque on the upper left anterior femoral region and spread slowly for 48 years to affect the entire left lower limb and nearby areas,with suspected dissemination to spine.The patient complained of lower back pain and walking difficulty and was diagnosed with paraparesis by the neurology department,and referred to a dermatology clinic for the extensive skin lesion.The clinical manifestation suggested a differential diagnosis of chromoblastomycosis,cutaneous tuberculosis,and skin malignancy.The diagnosis of chromoblastomycosis was confirmed by histopathological examinations,and the patient was given oral antifungal,but extensive lesions yielded inadequate treatment.Conclusion:Disseminated chromoblastomycosis carries high morbidity and mortality rates.The diagnosis and treatments are complicated,especially for spine involvement,requiring multidisciplinary combination for a long period.展开更多
Fungi in the order Chaetothyriales are renowned for their ability to cause human infections.Nevertheless,they are not regarded as primary pathogens,but rather as opportunists with a natural habitat in the environment....Fungi in the order Chaetothyriales are renowned for their ability to cause human infections.Nevertheless,they are not regarded as primary pathogens,but rather as opportunists with a natural habitat in the environment.Extremotolerance is a major trend in the order,but quite different from black yeasts in Capnodiales which focus on endurance,an important additional parameter is advancing toxin management.In the ancestral ecology of rock colonization,the association with metabolite-producing lichens is significant.Ant-association,dealing with pheromones and repellents,is another mainstay in the order.The phylogenetically derived family,Herpotrichiellaceae,shows dual ecology in monoaromatic hydrocarbon assimilation and the ability to cause disease in humans and cold-blooded vertebrates.In this study,data on ecology,phylog-eny,and genomics were collected and analyzed in order to support this hypothesis on the evolutionary route of the species of Chaetothyriales.Comparing the ribosomal tree with that of enzymes involved in toluene degradation,a significant expansion of cytochromes is observed and the toluene catabolism is found to be complete in some of the Herpotrichiellaceae.This might enhance human systemic infection.However,since most species have to be traumatically inoculated in order to cause disease,their invasive potential is categorized as opportunism.Only in chromoblastomycosis,true pathogenicity might be surmised.The criterion would be the possible escape of agents of vertebrate disease from the host,enabling dispersal of adapted genotypes to subsequent generations.展开更多
文摘Chromoblastomycosis can also cause severe but usually superficial lesions on the legs.Like other deep mycosis, this chronic and disabling condition is seen in many tropical regions,including Argentina,where this man was infected.We describe the spatial epidemiology and identify risk factors for disease.
文摘Chromoblastomycosis(CBM)is a fungal disease,distributed in tropical and subtropical regions,affecting mainly rural workers.It is characterized by chronic skin lesions that may vary from nodular,tumorous,verrucous or plaque type.Associated constitutional symptoms are rarely found.The histological presentation may yield a pathognomonic feature,the Medlar(sclerotic)bodies,in which a typical brown to black pigment is depicted,explaining“copper pennies”as its alias.In this article,the case of a 56-year-old woman in the countryside of Brazil is reported,whose main complaint was a chronic leg ulcer for the past 8 years.The left leg had a large,partially ulcerated plaque lesion was found.Microbiological cultures were positive for the pathogen.Histological analysis demonstrated pseudoepitheliomatous hyperplasia,lymphohistiocytic infiltrate and sclerotic bodies(“copper pennies”).CBM’s epidemiological panorama,once established uniquely by geographical distribution,is transitioning to a global health issue,influenced by immunosuppressive conditions,global warming and migration.This scenario demands CBM to be widely considered as a differential diagnosis and may represent a clinical challenge in regions whose professionals have little expertise in infectious tropical diseases.
基金The work of Vania A.Vicente was supported by a Brazilian Government fellowshipby financial support from the Brazilian Federal Agency for Support and Evaluation of Graduate Education-CAPES and Conselho Nacional de Pesquisa(CNPq).The work of Mohammad Javad Najafzadeh was supported by the Faculty of Medicine,Mashhad University of Medical Sciences,Mashhad,Iran.
文摘Agents of human chromoblastomycosis,a skin disease almost exclusively caused by members of the order Chaetothyriales,are assumed to be traumatically inoculated into the skin with sharp environmental materials such as plant thorns or wooden splinters carrying the respective opportunist.In the supposition that such fungi should have their main habitat in the environment,we investigated the occurrence of black fungi in living areas of patients with chromoblastomycosis.In South America Fonsecaea agents are prevalent as agents of the disease,while also related Cladophialophora species,known from other types of skin infections,are known from the continent.Ninety environmental isolates were preliminarily selected as possible agents of chromoblastomycosis,based on morphology.Judging from ITS sequence data isolates were attributed to the genera Cladophialophora,Cyphellophora,Exophiala,Fonsecaea,Phialophora,and Veronaea.A total of 45 fungi morphologically identified as Fonsecaea or Cladophialophora isolated from debris and thorns of living prickly plants in Brazil were processed for taxonomic studies.Phylogenetic analysis revealed that the isolates indeed belonged to the Chaetothyriales,but only rarely an agent of chromoblastomycosis was concerned;only two strains of F.pedrosoi and one F.monophora were isolated from debris plants.The remaining isolates belonged to hitherto unknown molecular siblings of Fonsecaea.Two novel taxa are introduced.
文摘Introduction:Chromoblastomycosis is a chronic subcutaneous fungal infection caused by the inoculation of pigmented(dematiaceous)fungi.Disseminated chromoblastomycosis is a very rare form that spreads to the bones,lymph nodes,or respiratory tract and has a poor prognosis.Herein,we report a case of chromoblastomycosis with suspected dissemination to the spine.Case presentation:A 67-year-old man presented with a chief complaint of hard,scaly,pruritic lumps on the lumbar region,gluteal region,and left lower limb that had become thicker and emitted a foul odor for 4 weeks.A dermoscopic examination of a plaque on the left lower limb showed scattered reddish-black dots.A histopathologic examination of skin biopsy and 10.0% potassium hydroxide of skin scraping revealed muriform cells(Medlar bodies).The morphology of fungal plate culture colonies was in accordance with Phialophora verrucosa Medlar.Molecular diagnostic tests for Mycobacterium tuberculosis in sputum and cutaneous tissue were negative.Magnetic resonance imaging showed tuberculous spondylitis,which was difficult to distinguish from spinal dissemination of fungal infection.Discussion:The initial lesion in this case was reported in the form of small verrucous plaque on the upper left anterior femoral region and spread slowly for 48 years to affect the entire left lower limb and nearby areas,with suspected dissemination to spine.The patient complained of lower back pain and walking difficulty and was diagnosed with paraparesis by the neurology department,and referred to a dermatology clinic for the extensive skin lesion.The clinical manifestation suggested a differential diagnosis of chromoblastomycosis,cutaneous tuberculosis,and skin malignancy.The diagnosis of chromoblastomycosis was confirmed by histopathological examinations,and the patient was given oral antifungal,but extensive lesions yielded inadequate treatment.Conclusion:Disseminated chromoblastomycosis carries high morbidity and mortality rates.The diagnosis and treatments are complicated,especially for spine involvement,requiring multidisciplinary combination for a long period.
基金supported by International Joint Projects of National Natural Science Foundation of China(81720108026,Project 111 D20009,81720108026,32060034)China-Ukraine Intergovernmental Exchange Project(8),Foreign Expert Project Talent Category(G2021038009L)+6 种基金International Science and Technology Cooperation Base of Guizhou Province[(2020)4101]Guizhou Scientific Plan Project[(2020)4Y220]and[(2019)2873]Talent Base Project of Guizhou Province,China[FCJD2018-22]Guizhou Provincial Academician Workstation of Microbiology and Health[(2020)4004]High-Level Innovation Talent Project of Guizhou Province[GCC(2022)036-1]Major Science and Technology Projects of China Tobacco[No.110202101048(LS-08)]Funding by the Austrian Science Fund FWF Grant P 31990-B to VM is gratefully acknowledged.
文摘Fungi in the order Chaetothyriales are renowned for their ability to cause human infections.Nevertheless,they are not regarded as primary pathogens,but rather as opportunists with a natural habitat in the environment.Extremotolerance is a major trend in the order,but quite different from black yeasts in Capnodiales which focus on endurance,an important additional parameter is advancing toxin management.In the ancestral ecology of rock colonization,the association with metabolite-producing lichens is significant.Ant-association,dealing with pheromones and repellents,is another mainstay in the order.The phylogenetically derived family,Herpotrichiellaceae,shows dual ecology in monoaromatic hydrocarbon assimilation and the ability to cause disease in humans and cold-blooded vertebrates.In this study,data on ecology,phylog-eny,and genomics were collected and analyzed in order to support this hypothesis on the evolutionary route of the species of Chaetothyriales.Comparing the ribosomal tree with that of enzymes involved in toluene degradation,a significant expansion of cytochromes is observed and the toluene catabolism is found to be complete in some of the Herpotrichiellaceae.This might enhance human systemic infection.However,since most species have to be traumatically inoculated in order to cause disease,their invasive potential is categorized as opportunism.Only in chromoblastomycosis,true pathogenicity might be surmised.The criterion would be the possible escape of agents of vertebrate disease from the host,enabling dispersal of adapted genotypes to subsequent generations.
