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Summary: The authors report a case of tinea pedis with interdigital lesions of the feet, caused by Scytalidium lignicola, anamorphous state of Hendersonula toruloidea. Microscopic examination of pota-to-dextrose agar culture showed catenulate and bicellular ochreous arthroconidia. Initially diagnosed as dermatophytosis, the case showed no success with the use of itraconazole. The main taxonomic aspects referring to Scytalidium lignicola, S. hyalinum and Hendersonula toruloidea are discussed due to the mycological importance of the present case in dermatology. Scytalidium hyalinum, actually anamorph of Hendersonula toruloidea, should be incorporated in the future in a new genus (Dickinson et al. 1980, McGinnis 1985). Zusammenfassung: Die Autoren beschreiben einen Fall von Tinea pedis verursacht durch Scytalidium lignicola, die anamorphe Form von Hendersonula toruloidea. Das mikromorphologische Aussehen auf Kartoffel-Dextrose-Agar zeigte die Anwesenheit von ockerfarbigen, uni- und doppelzellularen langen Ketten von Arthrokonidien. Anfangs wurde die Diagnose einer Dermatophytose gestellt und deshalb mit Itraconazol behandelt, aber ohne klinische Besserung. Da dieser Fall fur die Dermatologie recht wichtig erscheint, wird die Taxonomie des Erregers naher erortert, insbesondere in Bezug auf die Pilze Scytalidium lignicola, S. hyalinum und Hendersonula toruloidea. Scytalidium hyalinum sollte kunftig nicht mehr nur als anamorphe Form von Hendersonula toruloidea (Dickinson et al. 1983; Mc Ginnis, 1985) aufgefast, sondern einer neuen Gattung zugeordnet werden.

The present review is a critical analysis of positive and negative reports of the isolation of Paracoccidioides brasiliensis from soil. The strains isolated from soil or soil-contaminated material (dogfood, penguin feces) by Batista et al. in Recife, Brazil, Negroni in the Argentinian Chaco, Albornoz in rural Venezuela, Silva-Vergara et al. in Ibiá, Brazil, Ferreira et al. in Uberlândia, Brazil, and Gezuele et al. at the Uruguayan base in the Antarctic region, presented mycological characteristics consistent with P. brasiliensis. In most of these studies, morphological characterization was complemented with an evaluation of virulence and antigenicity, and biochemical or molecular analysis. These isolations, therefore, can be considered true, supporting the concept of soil as an important element in the ecology of the pathogen. The large number of negative reports in attempts involving soil samples and the low repeatability of isolation of the fungus from the same area indicate that the specific conditions supporting growth of the pathogen in soil have not been fully clarified.

In this session, emphasis was placed on the diagnosis of various mycoses through the identification of antibodies and antigens in sera, as well as on new techniques to properly identify medically important fungi through molecular biological procedures. The use of restriction fragment length polymorphism (RFLP) on fungal mitochondrial DNA (mtDNA) has enabled the identification of different strains of Sporothrix schenkii, several dermatophytes, Candida spp. and black fungi according to their species-specific mtDNA-RFLP patterns. In some species, distinct specific types where found in relation to the geographic origin of the patients. These particular molecular diagnostic tests are useful in the identification of strains and in epidemiological studies. An account of the applications of serological methods in the diagnosis of paracoccidioidomycosis was presented. Serology has been used in the identification of paracoccidioidomycosis using a specific, sensitive and rapid antibody-based immunodiagnosis method. Using the gp43 antigen, the diagnostic coverage of inmunodifussion has been improved from the 93-95% achieved with crude antigens, to 100% in an enzyme-linked immunodiffusion assay capture test. Cross-reactions were eliminated by treatment of the antigen with sodium metaperiodate. Antibody detection is useful, especially in paracoccidioidomycosis and histoplasmosis.

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.

Nearly 800 nucleotides from the 5' terminus of the 28S ribosomal gene of Paracoccidioides brasiliensis were sequenced, and a 14-base DNA probe specific for this species was identified. Hybridization results showed that the probe identified P. brasiliensis ribosomal DNA in a panel of ribosomal DNAs representing a total of 48 species of fungi.

The authors report a case of subcutaneous mucormycosis in a diabetic patient with verrucous lesions in the fourth finger of the right hand. Initially diagnosed as a fixed cutaneous sporotrichosis case, success was obtained with the use of potassium iodide with healing of the lesion in a period of nearly 5 months. At present the patient remains under clinical observation with no treatment or relapse.

Registro de caso de criptococose do sistema nervoso central, cujo diagnóstico foi estabelecido pelo exame do liqüido cefalorraquidiano. A presença do criptococo, verificada no exame direto, foi confirmada por culturas. O paciente apresentava quadro irritativo meníngeo, ao qual se associaram, ulteriormente, distúrbios encefálicos difusos e síndrome de hipertensão intracraniana. Evolução fatal após 4 meses de doença; foi tentada a sulfamido-terapia, sem resultado. O exame necroscópico confirmou a existência de leptomeningite difusa e micro-abscessos disseminados no córtex cerebral; o óbito foi relacionado à compressão bulbar por hérnia das tonsilas cerebelares. Report of a case of cryptococcosis of central nervous system the diagnosis being established by cerebrospinal fluid examination. Direct evidence of Cryptococcus was comproved by cultures. The patient, a white man, 29 years old, presented meningeal symptoms with late association of diffuse encephalic disturbances and intracranial hypertension. The course (4 months) was fatal; sulphamidic therapy was tried with no results. Necroscopic findings confirmed diffuse leptomeningitis, disseminated microabscesses of cerebral cortex; death was related to the presence of medullar compression by herniation of cerebellar tonsyles.