Accidental Jorge Lobo's disease in a worker dealing with Lacazia loboi infected mice: a case report

<p>Abstract</p> <p>Introduction</p> <p>Jorge Lobo's disease (Lacaziosis) is a subcutaneous infection of humans living in the Amazon region of Latin America, and in dolphins inhabiting the east coastal areas of the United States. The disease mainly affects people from rural areas living or working in close contact with vegetation and aquatic environments. Most patients refer having developed lesions after accidental trauma with plant thorns or insect bites. Inter-human transmission has never been confirmed suggesting that <it>Lacazia loboi </it>is acquired from environmental propagules.</p> <p>Case presentation</p> <p>We report the case of a 41-year-old woman from São Paulo, Brazil, a non-endemic area of Jorge Lobo's disease, with <it>L. loboi </it>skin infection most likely accidentally acquired while manipulating experimentally infected mice in the laboratory.</p> <p>Conclusion</p> <p>Because many patients with Jorge Lobo's disease do not recall accidental skin trauma before their infections, the possibility of accidentally acquired Jorge Lobo's disease through unnoticed broken skin should be considered during the clinical investigation of nodular skin diseases in people who have contact with the fungus or who live in endemic areas. This is the second report of animal to human transmission of this disease.</p

Ten years experience with Jorge Lobo's disease in the state of Acre, Amazon region, Brazil Dez anos de experiência com a Doença de Jorge Lobo no estado do Acre, região amazônica, Brasil

Jorge Lobo's disease is a cutaneous and subcutaneous mycosis that affects patients in the Amazon region. The number of patients is relatively small, but the real situation of the disease as public health problem is not known, because Jorge Lobo's disease is not a notifiable disease. This study aims to report the clinical evolution in patients affected and to determine the prevalence and areas of occurrence of the disease. A retrospective study was carried out based on the analysis of the clinical records, which included a collection of photographs of patients in the Department of Sanitary Dermatology, in Rio Branco, and patients seen in the interior of the state. In a decade, in Rio Branco, 249 cases of the disease were reported, 30 were females and 219 males. Of these patients, 153 had localized lesions, 94 of them were on one ear, 55 had multifocal lesions and 41 had disseminated lesions. The average time between the onset of symptoms and diagnosis was 19 years. The average age at the time of diagnosis was 53 years, and ages ranged from 14 to 96 years.<br>A doença de Jorge Lobo é micose cutânea e subcutânea que afeta pessoas na região Amazônica. O número de pacientes é relativamente pequeno, no entanto, a real prevalência da doença como problema de saúde pública é pouco conhecida. A doença de Jorge Lobo não é de notificação compulsória. Este estudo teve como objetivo determinar a prevalência, as áreas de ocorrência da doença de Jorge Lobo, além de sua evolução clínica. Um estudo retrospectivo foi desenvolvido com base na análise de prontuários de pacientes, incluindo documentação fotográfica dos mesmos, que foram atendidos no Departamento de Dermatologia Sanitária em Rio Branco e no interior do Estado. Foram registrados 249 casos em uma década em Rio Branco, 30 mulheres e 219 homens. Do total 153 apresentavam lesões localizadas, 94 lesões em apenas uma orelha, 55 lesões multifocais e 41 lesões disseminadas. A média de tempo entre o início dos sintomas e o diagnóstico foi de 19 anos. A média de idade no momento do diagnóstico foi de 53 anos, e as idades variaram de 14 a 96 anos