Histoplasmose crônica disseminada com lesões exclusivas na boca: relato de caso

We report a rare case of chronic disseminated histoplasmosis with several ulcerated lesions in the oral cavity in an alcoholic patient without human immunodeficiency virus infection, with no detectable signs and symptoms of systemic disease or extraoral manifestations. Histopathological analysis revealed chronic inflammatory process with granulomas containing Histoplasma-like organisms. The isolation of Histoplasma capsulatum provided the definitive diagnosis. Treatment with itraconazole resulted in complete remission of oral lesions. As far we aware, this is the second case report of oral histoplasmosis in an HIV negative patient described in Brazil.Reportamos um caso raro de histoplasmose crônica disseminada com diversas lesões ulceradas na cavidade oral de um paciente alcoólatra, sem o vírus da imunodeficiência humana, com nenhum outro sinal detectável ou sintomas de doença sistêmica ou manifestações extra-orais. Análise histopatológica revelou processo inflamatório crônico com granulomas contendo organismos fúngicos. O isolamento do Histoplasma capsulatum forneceu o diagnóstico definitivo. Tratamento com itraconazol resultou numa remissão completa das lesões orais. De acordo com nosso conhecimento, este é o segundo caso reportado de histoplasmose oral em um paciente HIV negativo descrito no Brasil

Different scenarios for Candida parapsilosis fungaemia reveal high numbers of mixed C-parapsilosis and Candida orthopsilosis infections

Nosocomial fungal bloodstream infections (BSI) are increasing significantly in hospitalized patients and Candida parapsilosis has emerged as an important pathogen responsible for numerous outbreaks. The objective of this study was to evaluate C. parapsilosis sensu lato infection scenarios, regarding species distribution and strain relatedness. One hundred isolates of C. parapsilosis sensu lato derived from blood cultures and catheter tips were analysed by multiplex microsatellite typing and by sequencing D1/D2 regions of the ribosomal DNA. Our results indicate that 9.5 % of patients presented infections due to C. parapsilosis and Candida orthopsilosis, 57.1 % due to C. parapsilosis, 28.3 % due to C. orthopsilosis and 4.8% due to Candida metapsilosis. Eighty per cent of the C. parapsilosis BSIs were due to a single strain that was also identified in the catheter, but in 10% of the cases C. parasilosis was identified in the catheter but the BSI was due to C. orthopsilosis. There is a significant probability that C. parapsilosis isolates collected from the same patient at more than 3 months interval are of different strains (P=0.0179). Moreover, several isolates were identified persistently in the same hospital, infecting six different patients. The incidence of polyfungal BSI infections with C. parapsilosis and C. orthopsilosis is reported herein for the first time, emphasizing the fact that the species identified in the catheter is not always responsible for the BSI, thus impacting the treatment strategy. The observation that strains can remain in the hospital environment for years highlights the possible existence of reservoirs and reinforces the need for accurate genotyping tools, such as the markers used for elucidating epidemiological associations and detecting outbreaks.Financial support was provided by CAPES Foundation (BEX 19194/12-9), Ministry of Education of Brazil, Brasilia (DF 70.040-020), by FEDER through POFC-COMPETE and by Portuguese funds from FCT (PEst-OE/BIA/UI4050/2014). R.M.Z.-O. is supported in part by CNPq (350338/2000-0) and FAPERJ E (26/103.157/2011). We are grateful to Ronaldo Rozembaun from HSE and SAM and Andrea Pussenti Derossi from HUPE for providing the Candida isolates and technical assistance in sampling. Automated sequencing was done using the genomic platform/DNA sequencing platform at Fundacao Oswaldo Cruz, PDTIS/FIOCRUZ (RPT01A), Brazil. The authors declare that they have no conflict of interest.info:eu-repo/semantics/publishedVersio

Mixed infection by Histoplasma capsulatum isolates with different mating types in Brazilian AIDS-patients

Mixed infection by Histoplasma capsulatum isolates with different mating types, in AIDS‑patients are described in this study. Morphological, mating type-specific PCR assay and multilocus sequencing type analysis of H. capsulatum isolates recovered from two Brazilian AIDS‑patients were performed. Five H. capsulatum isolates were recovered at different times from the two patients. Three isolates were obtained from bone marrow (day 1 – CE0411) and buffy coat cultures (day 1 – CE0311; day 2 – CE0511) of patient 1, and two isolates were isolated from buffy coat cultures (day 3 – CE2813; day 12 – CE2513) of patient 2. The mycelial colonies depicted different textures and pigmentation features. Dimorphic conversion to the yeast-phase in ML-Gema medium was achieved in all isolates. MAT1-1 idiomorph was identified in CE0311, CE0411 and CE2813 isolates; MAT1-2 idiomorph was found in CE0511 and CE2513 isolates. These H. capsulatum isolates were grouped within LAm A clade, highlighting that CE0311 and CE0411 isolates formed a subgroup supported by a high bootstrap value. The CE0511, CE2513, and CE2813 isolates clustered together with a Brazilian H151 isolate. This research reports mixed infections caused by H. capsulatum isolates with different mating types in Brazilian AIDS‑patients for the first time in the literature

International Society of Human and Animal Mycology (ISHAM)-ITS reference DNA barcoding database - the quality controlled standard tool for routine identification of human and animal pathogenic fungi

Human and animal fungal pathogens are a growing threat worldwide leading to emerging infections and creating new risks for established ones. There is a growing need for a rapid and accurate identification of pathogens to enable early diagnosis and targeted antifungal therapy. Morphological and biochemical identification methods are time-consuming and require trained experts. Alternatively, molecular methods, such as DNA barcoding, a powerful and easy tool for rapid monophasic identification, offer a practical approach for species identification and less demanding in terms of taxonomical expertise. However, its wide-spread use is still limited by a lack of quality-controlled reference databases and the evolving recognition and definition of new fungal species/complexes. An international consortium of medical mycology laboratories was formed aiming to establish a quality controlled ITS database under the umbrella of the ISHAM working group on "DNA barcoding of human and animal pathogenic fungi." A new database, containing 2800 ITS sequences representing 421 fungal species, providing the medical community with a freely accessible tool at http://www.isham.org and http://its.mycologylab.org/ to rapidly and reliably identify most agents of mycoses, was established. The generated sequences included in the new database were used to evaluate the variation and overall utility of the ITS region for the identification of pathogenic fungi at intra-and interspecies level. The average intraspecies variation ranged from 0 to 2.25%. This highlighted selected pathogenic fungal species, such as the dermatophytes and emerging yeast, for which additional molecular methods/genetic markers are required for their reliable identification from clinical and veterinary specimens.This study was supported by an National Health and Medical Research Council of Australia (NH&MRC) grant [#APP1031952] to W Meyer, S Chen, V Robert, and D Ellis; CNPq [350338/2000-0] and FAPERJ [E-26/103.157/2011] grants to RM Zancope-Oliveira; CNPq [308011/2010-4] and FAPESP [2007/08575-1] Fundacao de Amparo Pesquisa do Estado de So Paulo (FAPESP) grants to AL Colombo; PEst-OE/BIA/UI4050/2014 from Fundacao para a Ciencia e Tecnologia (FCT) to C Pais; the Belgian Science Policy Office (Belspo) to BCCM/IHEM; the MEXBOL program of CONACyT-Mexico, [ref. number: 1228961 to ML Taylor and [122481] to C Toriello; the Institut Pasteur and Institut de Veil le Sanitaire to F Dromer and D Garcia-Hermoso; and the grants from the Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) and the Fundacao de Amparo a Pesquisa do Estado de Goias (FAPEG) to CM de Almeida Soares and JA Parente Rocha. I Arthur would like to thank G Cherian, A Higgins and the staff of the Molecular Diagnostics Laboratory, Division of Microbiology and Infectious Diseases, Path West, QEII Medial Centre. Dromer would like to thank for the technical help of the sequencing facility and specifically that of I, Diancourt, A-S Delannoy-Vieillard, J-M Thiberge (Genotyping of Pathogens and Public Health, Institut Pasteur). RM Zancope-Oliveira would like to thank the Genomic/DNA Sequencing Platform at Fundacao Oswaldo Cruz-PDTIS/FIOCRUZ [RPT01A], Brazil for the sequencing. B Robbertse and CL Schoch acknowledge support from the Intramural Research Program of the NIH, National Library of Medicine. T Sorrell's work is funded by the NH&MRC of Australia; she is a Sydney Medical School Foundation Fellow.info:eu-repo/semantics/publishedVersio

Caracterização molecular de histoplasma capsulatum isolados no Brasil

Made available in DSpace on 2018-08-02T11:43:50Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) mauro_muniz_ipec_dout_2009.pdf: 3457867 bytes, checksum: b1a8bf8d15d28bf58c03eb2956001326 (MD5) Previous issue date: 2009Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Para estabelecer a relação genética entre isolados de Histoplasma capsulatum brasileiros obtidos de diferentes fontes, um ensaio de reação em cadeia de polimerase utilizando primers arbitrários (PCR-RAPD) foi usado para delinear o polimorfismo entre os isolados de diversas regiões geográficas do Brasil e o RAPD fingerprinting revelou distintos perfis genotípicos promovendo um alto nível de discriminação entre cepas de H. capsulatum de diferentes localidades. Este estudo foi pioneiro na estratificação de isolados de H. capsulatum do Brasil através da tipagem molecular e associação com a sua origem geográfica. Múltiplos métodos de tipagem foram desenvolvidos para estudo epidemiológico de H. capsulatum, porém as informações são limitadas quando comparados os resultados obtidos por metodologias diferentes usando o mesmo grupo de isolados. Para explorar a diversidade de H. capsulatum no Brasil e determinar a correlação entre três técnicas de tipagem molecular diferentes, examinamos 51 isolados de origem (ambiental, animal, e humano) por M13 PCR fingerprinting, PCR-RFLP da região ITS1-5.8S-ITS2 e sequenciamento parcial de quatro genes que codificam proteínas (ARF, H ANTI, OLE, TUB) Cada método identificou três agrupamentos genéticos principais com uma alta concordância entre si. Notavelmente, o método de sequenciamento parcial de gene resultou em altos valores de bootstrap sugerindo que o método apresenta grande sensibilidade. Além disso, análise filogenética dos 51 isolados brasileiros com 19 seqüências de H. capsulatum publicadas em bancos de dados de tais genes demonstrou um agrupamento genético singular, exibindo a natureza complexa e diversa do H. capsulatum. Diferentes métodos moleculares promovem informações complementares que podem conduzir a um entendimento mais amplo de epidemiologia molecular Neste trabalho, investigamos a possibilidade de utilização da técnica de qRT-PCR para quantificar a expressão de genes e elucidar a relação dos isolados brasileiros de H. capsulatum que se agruparam por perfis de PCR-RFLP, M13 DNA fingerprinting e por sequenciamento parcial do gene do antígeno H. Portanto, a expressão de seis genes associados à virulência do H. capsulatum e ficou evidenciado que este método permitiu o agrupamento dos isolados altamente relacionados. Além disso, os resultados sugerem que no modelo H. capsulatum, processos de microevoluções possam estar ocorrendo para possivelmente facilitar sua adaptação a seu ambiente local.To establish the genetic relationship among Histoplasma capsultum isolates obtained from different sources a PCR-based random amplified polymorphic DNA (RAPD) assay was used to delineate polymorphisms among isolates in geographically diverse regions in Brazil. RAPD fingerprinting revealed distinct DNA profiles and provided a high level of discrimination among H. capsulatum strains from different locations. This study was the first report that stratifies the clusters of H. capsulatum strains from Brazil by molecular typing and associates them with the geographical origin. Multiple typing methods have been developed to study H. capsulatum epidemiology, however there is limited information comparing results obtained from different methodologies using the same set of isolates. To explore the diversity of H. capsulatum in Brazil and determine the correlation between three different molecular typing techniques, we examined 51 environmental, animal, and human isolates by M13 PCR fingerprinting, PCR-RFLP analysis of the ITS1-5.8S-ITS2 region and nucleotide sequence polymorphism of four partial gene coding proteins (ARF, H ANTI, OLE, TUB). Each method identified three major genetic clusters with a high concordance between the results of each typing techniques. Notably, the partial gene sequencing method resulted in high bootstrap values suggesting that the genetic sequencing method has the greatest sensitivity. Furthermore, phylogenic analysis comparing the 51 Brazilian strains with 19 published H. capsulatum sequences of these genes showed unique genetic groups of the pathogenic fungus, demonstrating the complex and diverse nature of H. capsulatum. Different molecular approaches provide complementary information that can lead to a more complete understanding of molecular epidemiology. In this work we investigated whether quantitative real-time measurements of gene expression - qRT-PCR - could be utilized to dissect the relatedness of Brazilian Histoplasma capsulatum isolates that cluster by PCR-RFLP profiling, M13 DNA fingerprinting and by sequencing of their ITS1-8SITS2 region and H antigen gene. We examined the expression of six genes associated with H. capsulatum virulence and determined that this method allowed for the separation of closely related isolates. Furthermore, the results suggest that H. capsulatum undergoes microevolution to facilitate adaptation to its local environment

Eritema nodoso: estudo prospectivo de 32 casos

The results of 32 cases studied lead us to the conclusion that erythema nodosum's investigation routine is very important, once in our retrospective study, the percentage of cases of unknown etiology was 69.4%, and in this prospective study it is 21.8%. In 10 cases (31.2%), more than one causing agent was suspected. Infections (bacterial, helminthic, fungal, by protozoa) were diagnosed in 26 cases, streptococcal infection having predominated (12 cases). Drugs-dipirone, aspirin, anovulatory - were suspected as causing agents in 13 cases. The association of erythema nodosum and histoplasmosis capsulata is described for the first time in Brazil. We consider erythema nodosum to be a complex syndrome which should be regarded as a manifestation of underlying diseases. The fact that all 32 subjects were women, 26 of them during menacme, suggests that particular hormonal media may favor the action of various processes (infections and drugs), precipitating erythema nodosum's clinical picture.O estudo de 32 casos de eritema nodoso permite concluir que a rotina de investigação é extremamente importante já que em nosso estudo retrospectivo, o percentual de etiologia indeterminada foi de 69,4% e neste estudo prospectivo é de 21,8%. Em 10 casos (31,2%) mais de um agente causal foi suspeitado. Infecções (bacteriana, helmíntica, fúngica e por protozoário) foram diagnosticadas em 26 casos, tendo predominado a infecção estreptocócica com 12 casos. As drogas de suspeição foram dipirona, aspirina e anovulatório em 12 casos. A associação de eritema nodoso e histoplasmose capsulata é descrita pela primeira vez no Brasil. O eritema nodoso é síndrome complexa e deveria ser considerado sempre como manifestação de doença subjacente. A amostra de 32 pacientes exclusivamente do sexo feminino sendo que 26 em idade fértil sugere que vários processos (infecções e drogas) podem atuar em meio hormonal, particular e favorecedor, precipitando o quadro de eritema nodoso