33 results on '"Heins-Vaccari EM"'
Search Results
2. Onychoprotothecosis: report of the first case in Brazil.
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Zaitz C, Miranda Godoy A, de Sousa VM, Ruiz LR, Masada AS, Nobre MV, Santos AR, Marques AC, Muramatu LH, Arrigada GL, Heins-Vaccari EM, and Martins JE
- Subjects
- Brazil, Female, Humans, Imidazoles therapeutic use, Infections drug therapy, Infections microbiology, Middle Aged, Nail Diseases drug therapy, Nail Diseases microbiology, Prototheca drug effects, Prototheca isolation & purification, Treatment Outcome, Infections diagnosis, Nail Diseases diagnosis, Prototheca growth & development
- Abstract
The present report describes a case of onychoprotothecosis caused by Prototheca wickerhamii in a nonimmunocompromized female. Dermatological examination showed yellowish discoloration of the left and right forefinger nails, showing onicolysis and hyperkeratosis. The repeated isolation of the algae Prototheca (organisms morula-like) as well as the repeated culture in media, Sabouraud agar, confirmed the diagnosis. The patient was successfully treated with tioconazol 1% topic solution. The aim of this paper was to present a rare condition.
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- 2006
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3. Cutaneous protothecosis: report of a third Brazilian case.
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Zaitz C, Godoy AM, Colucci FM, de Sousa VM, Ruiz LR, Masada AS, Nobre MV, Muller H, Muramatu LH, Arrigada GL, Heins-Vaccari EM, and Martins JE
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- Aged, Antifungal Agents therapeutic use, Female, Forearm, Humans, Immunocompetence, Infections drug therapy, Itraconazole therapeutic use, Skin Diseases, Infectious drug therapy, Infections diagnosis, Prototheca isolation & purification, Skin Diseases, Infectious diagnosis
- Abstract
The present report describes a case of cutaneous protothecosis caused by Prototheca wickerhamii in a nonimmunocompromised Brazilian female. Dermatological examination revealed a 15-cm diffusely infiltrated eczema-like plaque recovered with many pustule-like lesions on the right forearm. We emphasize the mycological and pathological aspects of this infection that can lead to misdiagnosis. The patient was successfully treated with itraconazole.
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- 2006
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4. Trichosporon asahii fatal infection in a non-neutropenic patient after orthotopic liver transplantation.
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Abdala E, Lopes RI, Chaves CN, Heins-Vaccari EM, and Shikanai-Yasuda MA
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- Adult, Amphotericin B therapeutic use, Antifungal Agents therapeutic use, Fatal Outcome, Female, Humans, Male, Middle Aged, Mycoses diagnosis, Mycoses drug therapy, Neutropenia, Trichosporon isolation & purification, Liver Transplantation adverse effects, Mycoses microbiology
- Abstract
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.
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- 2005
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5. Phylogeography of the fungal pathogen Histoplasma capsulatum.
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Kasuga T, White TJ, Koenig G, McEwen J, Restrepo A, Castañeda E, Da Silva Lacaz C, Heins-Vaccari EM, De Freitas RS, Zancopé-Oliveira RM, Qin Z, Negroni R, Carter DA, Mikami Y, Tamura M, Taylor ML, Miller GF, Poonwan N, and Taylor JW
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- Cluster Analysis, Sequence Analysis, DNA, Species Specificity, Evolution, Molecular, Geography, Histoplasma classification, Histoplasma genetics, Models, Genetic, Phylogeny
- Abstract
Until recently, Histoplasma capsulatum was believed to harbour three varieties, var. capsulatum (chiefly a New World human pathogen), var. duboisii (an African human pathogen) and var. farciminosum (an Old World horse pathogen), which varied in clinical manifestations and geographical distribution. We analysed the phylogenetic relationships of 137 individuals representing the three varieties from six continents using DNA sequence variation in four independent protein-coding genes. At least eight clades were idengified: (i) North American class 1 clade; (ii) North American class 2 clade; (iii) Latin American group A clade; (iv) Latin American group B clade; (v) Australian clade; (vi) Netherlands (Indonesian?) clade; (vii) Eurasian clade and (viii) African clade. Seven of eight clades represented genetically isolated groups that may be recognized as phylogenetic species. The sole exception was the Eurasian clade which originated from within the Latin American group A clade. The phylogenetic relationships among the clades made a star phylogeny. Histoplasma capsulatum var. capsulatum individuals were found in all eight clades. The African clade included all of the H. capsulatum var. duboisii individuals as well as individuals of the other two varieties. The 13 individuals of var. farciminosum were distributed among three phylogenetic species. These findings suggest that the three varieties of Histoplasma are phylogenetically meaningless. Instead we have to recognize the existence of genetically distinct geographical populations or phylogenetic species. Combining DNA substitution rates of protein-coding genes with the phylogeny suggests that the radiation of Histoplasma started between 3 and 13 million years ago in Latin America.
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- 2003
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6. Fonsecaea pedrosoi cerebral phaeohyphomycosis ("chromoblastomycosis"): first human culture-proven case reported in Brazil.
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Nóbrega JP, Rosemberg S, Adami AM, Heins-Vaccari EM, Lacaz Cda S, and de Brito T
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- Adult, Brain Abscess pathology, Brain Abscess surgery, Central Nervous System Fungal Infections surgery, Chromoblastomycosis pathology, Chromoblastomycosis surgery, Fatal Outcome, Humans, Magnetic Resonance Imaging, Male, Mitosporic Fungi growth & development, Brain Abscess microbiology, Central Nervous System Fungal Infections microbiology, Chromoblastomycosis microbiology, Mitosporic Fungi isolation & purification
- Abstract
Cerebral phaeohyphomycosis ("chromoblastomycosis") is a rare intracranial lesion. We report the first human culture-proven case of brain abscesses due to Fonsecaea pedrosoi in Brazil. The patient, a 28 year-old immunocompetent white male, had ocular manifestations and a hypertensive intracranial syndrome. Magnetic resonance imaging (MRI) of the brain revealed a main tumoral mass involving the right temporo-occipital area and another smaller apparently healed lesion at the left occipital lobe. A cerebral biopsy was performed and the pathological report was cerebral chromoblastomycosis. The main lesion was enucleated surgically and culture of the necrotic and suppurative mass grew a fungus identified as Fonsecaea pedrosoi. The patient had received a knife wound sixteen years prior to his hospitalization and, more recently, manifested a pulmonary granulomatous lesion in the right lung with a single non-pigmented form of a fungus present. It was speculated that the fungus might have gained entrance to the host through the skin lesion, although a primary respiratory lesion was not excluded. The patient was discharged from the hospital still with ocular manifestations and on antimycotic therapy and was followed for eight months without disease recurrence. Few months after he had complications of the previous neuro-surgery and died. A complete autopsy was performed and no residual fungal disease was found.
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- 2003
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7. Comparative performance of two air samplers for monitoring airborne fungal propagules.
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Távora LG, Gambale W, Heins-Vaccari EM, Arriagada GL, Lacaz CS, Santos CR, and Levin AS
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- Centrifugation instrumentation, Environmental Monitoring methods, Filtration instrumentation, Fungi classification, Humans, Air Microbiology, Air Pollution, Indoor analysis, Environmental Monitoring instrumentation, Fungi isolation & purification, Hospitals
- Abstract
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.
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- 2003
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8. Serotype, mating type and ploidy of Cryptococcus neoformans strains isolated from patients in Brazil.
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Ohkusu M, Tangonan N, Takeo K, Kishida E, Ohkubo M, Aoki S, Nakamura K, Fujii T, Siqueira IC, Maciel EA, Sakabe S, Almeida GM, Heins-Vaccari EM, and Lacaz Cda S
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- Brazil, Cryptococcus neoformans classification, Cryptococcus neoformans pathogenicity, Genetic Variation, Humans, Serotyping, AIDS-Related Opportunistic Infections microbiology, Cryptococcosis microbiology, Cryptococcus neoformans genetics, Ploidies
- Abstract
Serotype, mating type and ploidy of 84 strains of Cryptococcus neoformans isolated from 61 AIDS and 23 non-AIDS patients admitted in a tertiary teaching hospital in São Paulo, Brazil were examined. Among 61 strains isolated from AIDS patients, 60 strains were var. grubii (serotype A). Only one strain was var. gattii (serotype B). No var. neoformans (serotype D) was found. Among 23 strains isolated from non-AIDS patients, 15 were var. grubii (serotype A) and the remaining 8 were var. gattii, all of which were serotype B. Seventy-three of the 75 serotype A strains were the heterothallic alpha type (MATalpha) and the remaining 2 were untypable (asexual). Most of the MATalpha strains (69/73) were haploid and the remaining 4 strains were diploid. Similarly, both of the 2 asexual strains among the 75 serotype A strains were haploid. There were no alpha-mating type (MATalpha) strains among the 84 isolates. All of the 8 var. gattii strains were serotype B and haploid. Among a total of 84 strains tested, neither serotype AD nor serotype D were found. Neither triploid nor tetraploid were found. These results suggest that the serological, sexual and ploidy characteristics in C. neoformans strains isolated from AIDS patients in São Paulo were rather simple, whereas strains isolated from non-AIDS patients presented serotype A and B with predominance of serotype A.
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- 2002
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9. Primary cutaneous cryptococcosis due to Cryptococcus neoformans var. gattii serotype B, in an immunocompetent patient.
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Lacaz Cda S, Heins-Vaccari EM, Hernandez-Arriagada GL, Martins EL, Prearo CA, Corim SM, and Martins Mdos A
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- Aged, Cryptococcus neoformans isolation & purification, Humans, Immunocompromised Host, Male, Cryptococcosis microbiology, Dermatomycoses microbiology
- Abstract
The authors report a male patient, a seller with no detected immunosuppression, with an extensive ulcerated skin lesion localized on the left forearm, caused by Cryptococcus neoformans var. gattii serotype B. Oral treatment with fluconazole was successful. A review of the literature showed the rarity of this localization in HIV-negative patients. In contrast, skin lesions frequently occurs in HIV-positive patients, with Cryptococcus neoformans var. neoformans serotype A predominating as the etiological agent. In this paper, the pathogenicity of C. neoformans to skin lesions in patients immunocompromised or not, is discussed, showing the efficacy of fluconazole for the treatment of these processes.
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- 2002
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10. [An AIDS patient with Trichoderma].
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Amato JG, Amato VS, Amato Neto V, and Heins-Vaccari EM
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- Humans, Male, Middle Aged, Acquired Immunodeficiency Syndrome complications, Mycoses complications, Trichoderma
- Published
- 2002
11. Phaeohyphomycotic cyst caused by Colletotrichum crassipes.
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Castro LG, da Silva Lacaz C, Guarro J, Gené J, Heins-Vaccari EM, de Freitas Leite RS, Arriagada GL, Reguera MM, Ito EM, Valente NY, and Nunes R
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- Adult, Colletotrichum classification, Colletotrichum growth & development, Culture Media, Cysts microbiology, Cysts surgery, Dermatomycoses microbiology, Dermatomycoses surgery, Humans, Kidney Transplantation, Male, Colletotrichum isolation & purification, Cysts diagnosis, Dermatomycoses diagnosis
- Abstract
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.
- Published
- 2001
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12. Phialemonium curvatum infection after bone marrow transplantation.
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Heins-Vaccari EM, Machado CM, Saboya RS, Silva RL, Dulley FL, Lacaz CS, Freitas Leite RS, and Hernandez Arriagada GL
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- Adult, Dermatomycoses drug therapy, Humans, Immunocompromised Host, Male, Bone Marrow Transplantation adverse effects, Dermatomycoses microbiology, Mitosporic Fungi isolation & purification, Opportunistic Infections complications
- Abstract
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.
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- 2001
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13. Dermatophytosis caused by Trichophyton raubitschekii. Report of the first case in São Paulo, Brazil.
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Lacaz CS, Zaitz C, Ruiz LR, de Souza VM, Santos AR, Muramatu LH, de Melo NT, Heins-Vaccari EM, Hernández-Arriagada GL, and de Freitas-Leite RS
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- Antifungal Agents therapeutic use, Brazil epidemiology, Female, Fluconazole therapeutic use, Humans, Miconazole analogs & derivatives, Miconazole therapeutic use, Tinea drug therapy, Tinea epidemiology, Trichophyton classification, Trichophyton cytology, Tinea microbiology, Trichophyton isolation & purification
- Abstract
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.
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- 1999
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14. Onychomycosis caused by Scytalidium dimidiatum. Report of two cases. Review of the taxonomy of the synanamorph and anamorph forms of this coelomycete.
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Lacaz CS, Pereira AD, Heins-Vaccari EM, Cucé LC, Benatti C, Nunes RS, de Melo NT, de Freitas-Leite RS, and Hernández-Arriagada GL
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- Adult, Antifungal Agents therapeutic use, Female, Foot Dermatoses drug therapy, Foot Dermatoses microbiology, Hand Dermatoses drug therapy, Hand Dermatoses microbiology, Humans, Itraconazole therapeutic use, Ketoconazole therapeutic use, Male, Mitosporic Fungi isolation & purification, Onychomycosis drug therapy, Mitosporic Fungi classification, Onychomycosis microbiology
- Abstract
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.
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- 1999
15. Atypical disseminated cutaneous histoplasmosis in an immunocompetent child, caused by an "aberrant" variant of histoplasma capsulatum var. capsulatum
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Lacaz Cd, Del Negro GM, Vidal MS, Heins-Vaccari EM, Santos RF, Martins MA, Ozaki MM, Romiti R, Proenca R, and Castro LG
- Abstract
A case of atypical disseminated cutaneous histoplasmosis in a five-year old, otherwise healthy child, native and resident in Sao Paulo metropolitan area is reported. Cutaneous lesions were clinically atypical. Histologic examination disclosed a granulomatous reaction but no fungal structures could be demonstrated by specific staining nor by immunohistochemical reaction. The fungus was isolated from biopsy material on two different occasions, confirming diagnosis of an unusual fungal infection. The fungus, originally thought to be a Sepedonium sp. due to the large sized, hyaline or brownish colored tuberculated macroconidia and to lack of dimorphism (yeast form at 37 degrees C) produce H and M antigens, visualized by the immunodiffusion with rabbit anti-Histoplasma capsulatum hyperimmune serum. Patient's serum sample was non reactive with H. capsulatum antigen by immunodiffusion, counterimmunoelectrophoresis and complement fixation tests, and immunoenzymatic assay failed to detect the specific circulating antigen. This serum was tested negative by double immunodiffusion when antigen obtained from one of the isolated samples was used. Both cultures were sent to Dr. Leo Kaufman, Ph.D. (Mycoses Immunodiagnostic Laboratory, CDC-Atlanta/USA), who identified them as H. capsulatum by the exoantigen and gen-probe tests. Both clinic and mycologic characteristics of the present case were atypical, suggesting the fungus isolated is an "aberrant variant" of H. capsulatum var. capsulatum, as described by SUTTON et al. in 1997. Treatment with itraconazole 100 mg/day led to cure within 90 days
- Published
- 1999
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16. Paracoccidioides brasiliensis. A mycologic and immunochemical study of two strains.
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Lacaz Cda S, Vidal MS, Heins-Vaccari EM, de Melo NT, Del Negro GM, Arriagada GL, and Freitas Rdos S
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- Animals, Guinea Pigs, Humans, Immunochemistry methods, Mycological Typing Techniques, Paracoccidioides isolation & purification, Paracoccidioides classification, Paracoccidioides immunology
- Abstract
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.
- Published
- 1999
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17. Scedosporium apiospermum sinusitis after bone marrow transplantation: report of a case.
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Machado CM, Martins MA, Heins-Vaccari EM, Lacaz Cda S, Macedo MC, Castelli JB, Medeiros RS, Silva RL, and Dulley FL
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- Adult, Fatal Outcome, Graft vs Host Disease complications, Humans, Male, Postoperative Complications, Bone Marrow Transplantation, Dermatomycoses diagnosis, Pseudallescheria, Sinusitis microbiology
- Abstract
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.
- Published
- 1998
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18. Coccidioidomycosis in Brazil. A case report.
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Martins Mdos A, de Araújo Eda M, Kuwakino MH, Heins-Vaccari EM, Del Negro GM, Vozza Júnior JA, and Lacaz Cda S
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- Adult, Brazil, Humans, Male, Coccidioidomycosis diagnosis, Lung Diseases, Fungal diagnosis
- Abstract
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.
- Published
- 1997
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19. Paracoccidioides cerebriformis Moore, 1935. Mycologic and immunochemical study.
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Lacaz Cda S, Vidal MS, Pereira CN, Heins-Vaccari EM, de Melo NT, Sakai-Valente N, and Arriagada GL
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- Animals, Guinea Pigs, Humans, Immunohistochemistry, Paracoccidioides classification, Paracoccidioides immunology
- Abstract
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.
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- 1997
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20. Subcutaneous phaeohyphomycosis caused by Phoma cava. Report of a case and review of the literature.
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Zaitz C, Heins-Vaccari EM, de Freitas RS, Arriagada GL, Ruiz L, Totoli SA, Marques AC, Rezze GG, Müller H, Valente NS, and Lacaz Cda S
- Subjects
- Amphotericin B therapeutic use, Antifungal Agents therapeutic use, Humans, Itraconazole therapeutic use, Male, Middle Aged, Mitosporic Fungi isolation & purification, Mycoses drug therapy, Mycoses microbiology
- Abstract
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.
- Published
- 1997
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21. Basidiomycosis: a review of the literature.
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Lacaz Cda S, Heins-Vaccari EM, De Melo NT, and Hernandez-Arriagada GL
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- Humans, Basidiomycota classification, Mycoses diagnosis, Mycoses microbiology
- Abstract
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.
- Published
- 1996
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22. Subcutaneous hyalohyphomycosis caused by Acremonium recifei: case report.
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Zaitz C, Porto E, Heins-Vaccari EM, Sadahiro A, Ruiz LR, Müller H, and Lacaz Cda S
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- Aged, Brazil, Female, Humans, Itraconazole therapeutic use, Mycetoma drug therapy, Mycetoma pathology, Soil Microbiology, Acremonium isolation & purification, Mycetoma diagnosis
- Abstract
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.
- Published
- 1995
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23. Paracoccidioides brasiliensis. A mycologic and immunochemical study of a sample isolated from an armadillo (Dasipus novencinctus).
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Vidal MS, de Melo NT, Garcia NM, Del Negro GM, de Assis CM, Heins-Vaccari EM, Naiff RD, Mendes RP, and Lacaz Cda S
- Subjects
- Animals, Antigens, Fungal isolation & purification, Cricetinae, Disease Reservoirs, Guinea Pigs, Immunochemistry, Immunoglobulin G, Male, Paracoccidioides immunology, Rats, Rats, Wistar, Armadillos microbiology, Paracoccidioides isolation & purification
- Abstract
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.
- Published
- 1995
- Full Text
- View/download PDF
24. Aspergillosis in immunocompromised children with acute myeloid leukemia and bone marrow aplasia. Report of two cases.
- Author
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de Aquino MZ, Brasciner A, Cristófani LM, Maluf PT, Odone Filho V, Marques HH, Heins-Vaccari EM, Lacaz Cda S, and de Melo NT
- Subjects
- Adolescent, Amphotericin B therapeutic use, Aspergillosis diagnosis, Aspergillosis drug therapy, Aspergillosis immunology, Aspergillus flavus isolation & purification, Bone Marrow Diseases immunology, Child, Female, Humans, Immunocompromised Host, Itraconazole therapeutic use, Leukemia, Myeloid, Acute immunology, Aspergillosis complications, Bone Marrow Diseases complications, Leukemia, Myeloid, Acute complications
- Abstract
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.
- Published
- 1994
- Full Text
- View/download PDF
25. [Subcutaneous phaeohyphomycose due to Exophiala jeanselmir. Report of 3 cases in patients with a kidney transplant].
- Author
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Sabbaga E, Tedesco-Marchesi LM, Lacaz Cda S, Cucé LC, Salebian A, Heins-Vaccari EM, Sotto MN, Valente NY, Porto E, and Levy Neto M
- Subjects
- Adult, Cyclosporine therapeutic use, Dermatomycoses pathology, Dermatomycoses therapy, Exophiala pathogenicity, Female, Humans, Immunosuppression Therapy adverse effects, Male, Middle Aged, Dermatomycoses microbiology, Exophiala isolation & purification, Kidney Transplantation adverse effects, Opportunistic Infections microbiology
- Abstract
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.
- Published
- 1994
26. [Neurocryptococcosis caused by nonencapsulated Cryptococcus neoformans].
- Author
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Lacaz CS, Heins-Vaccari EM, Melo NT, Moreno-Carvalho OA, Sampaio ML, Nogueira LS, Badaró RJ, and Livramento JA
- Subjects
- Aged, Cryptococcosis cerebrospinal fluid, Cryptococcus neoformans ultrastructure, Humans, Male, Meningoencephalitis cerebrospinal fluid, Microscopy, Electron, Scanning, Cryptococcosis diagnosis, Meningoencephalitis diagnosis
- Abstract
The case of a patient with meningoencephafalitis due to a nonencapsulated strain of Cryptococcus neoformans is reported; he had no risk factors for the disease or AIDS. Clinical examination showed a chronic meningoencephalitis first diagnosed as tuberculosis. In the second cerebrospinal fluid (CSF) examination after a week from admission yeasts appeared inside macrophage cells. CSF culture in Sabouraud medium disclosed nonencapsulated Cryptococcus neoformans (biochemical identification). Sample inoculation in mouse (intraperitoneal) evidenced a capsule that disappeared in several consecutive cultures. The morphology of the yeast was studied by electronic microscopy. After treatment with amphotericin B and 5-fluorocytosine the patient had a favorable evolution. The significance of capsular material is discussed.
- Published
- 1993
- Full Text
- View/download PDF
27. [Cryptococcus neoformans chemotyping. Review of the literature. New epidemiologic data on cryptococcosis. Our experience with the use of C.G.B. media in the study of this yeast].
- Author
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de Melo NT, Lacaz Cda S, Charbel CE, Pereira AD, Heins-Vaccari EM, França-Netto AS, Machado Ldos R, and Livramento JA
- Subjects
- Animals, Bromthymol Blue, Canavanine, Cryptococcosis physiopathology, Cryptococcus neoformans isolation & purification, Culture Media, Glycine, Serotyping, Cryptococcosis epidemiology, Cryptococcus neoformans classification
- Abstract
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.
- Published
- 1993
28. [Paracoccidioides brasiliensis, a new sample isolated from feces of a penguin (Pygoscelis adeliae)].
- Author
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Garcia NM, Del Negro GM, Heins-Vaccari EM, de Melo NT, de Assis CM, and Lacaz Cda S
- Subjects
- Animals, Immunochemistry, Immunodiffusion, Immunoelectrophoresis, Male, Mycological Typing Techniques, Paracoccidioides classification, Paracoccidioides immunology, Testis pathology, Birds, Feces microbiology, Paracoccidioides isolation & purification
- Abstract
The Authors show the results obtained through the study of a Paracoccidioides strain isolated from a penguin in the Uruguaian Antartide by GEZUELE et al. (1989). From the fecal mater it was isolated a fungus which was recently considered as a new species of the genus Paracoccidioides--P. antarcticus. However, the mycological and immunochemical studies including the demonstration of the 43 kDa glycoprotein by immunodiffusion test, SDS-PAGE and immunoelectrophoresis disclosed that such strain is similar to P. brasiliensis. Other studies, based on molecular taxonomy, including karyotyping, are the only tools to confirm the possibility of such strain to be a variant of P. brasiliensis. The Authors report the epidemiological significance of that finding and suggest a review in the knowledge of the ecological "niche" of P. brasiliensis.
- Published
- 1993
- Full Text
- View/download PDF
29. [Black-grain eumycetoma due to Madurella grisea. A report of 2 cases].
- Author
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Machado LA, Rivitti MC, Cucé LC, Salebian A, Lacaz Cda S, Heins-Vaccari EM, Belda Júnior W, and de Melo NT
- Subjects
- Adult, Humans, Itraconazole administration & dosage, Male, Middle Aged, Mycetoma drug therapy, Mycetoma microbiology, Mycoses drug therapy, Mycoses microbiology, Terminology as Topic, Mitosporic Fungi isolation & purification, Mycetoma diagnosis, Mycoses diagnosis
- Abstract
Two cases of black grains eumycotic mycetoma, occurring on a foot, are reported. Both proceeded from the state of Bahia (Brazil), and in both the etiologic agent was Madurella grisea Mackinnon et al., 1949. The grains structure as well as the micromorphologic characteristics of the fungus in saprophytic life were studied. It is the author's belief that these observations correspond to the 7th and 8th cases reported in the Brazilian medical literature. The authors do consider the following Madurella species as nomen dubium or nomina confusa: M. ramiroi, M. oswaldoi, M. bovoi, M. tozeuri, M. mansonii, M. brumpti, M. reynieri, M. americana, M. lackawanna e M. ikedae and the same for Rubromadurella mycetomi. The only valid species must be Madurella mycetomatis McGinnis, 1980 (= Madurella mycetomi Brumpt, 1905) and Madurella grisea Mackinnon et al., 1949. Treatment with itraconazole in both reported cases, for a 3 month duration, did not produce any regression of the lesions, the clinical improvement being meager.
- Published
- 1992
30. [Rhinofacial entomophthoromycosis due to Conidiobolus coronatus. A report of a case treated successfully with fluconazole].
- Author
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de Castro e Souza Filho LG, Nico MM, Salebian A, Heins-Vaccari EM, de Castro LG, Sotto MN, Lacaz Cda S, Martins JE, Wu SL, and Cucé LC
- Subjects
- Adult, Face, Humans, Male, Mucormycosis drug therapy, Mucormycosis microbiology, Mucormycosis pathology, Mycoses drug therapy, Mycoses microbiology, Nose Diseases drug therapy, Nose Diseases microbiology, Entomophthora isolation & purification, Fluconazole therapeutic use, Mycoses pathology, Nose Diseases pathology
- Abstract
A case of rhinofacial entomophthoromycosis caused by Conidiobolus coronatus is reported in a 30-years-old male from São Paulo, Brazil. The patient was successfully treated with oral fluconazole in a prolonged regimen. The diagnosis was confirmed by histopathological and mycological data.
- Published
- 1992
31. Isolation and characterization of a Paracoccidioides brasiliensis strain from a dogfood probably contaminated with soil in Uberlândia, Brazil.
- Author
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Ferreira MS, Freitas LH, Lacaz Cda S, del Negro GM, de Melo NT, Garcia NM, de Assis CM, Salebian A, and Heins-Vaccari EM
- Subjects
- Animals, Brazil, Dogs, Food Contamination, Guinea Pigs, Male, Orchitis microbiology, Orchitis pathology, Paracoccidioides pathogenicity, Paracoccidioidomycosis microbiology, Paracoccidioidomycosis pathology, Animal Feed, Food Microbiology, Paracoccidioides isolation & purification, Soil Microbiology
- Abstract
We report the isolation of a strain of Paracoccidioides brasiliensis from a dogfood, probably contaminated with soil, in a Brazilian city. The fungus was isolated on appropriate culture media, and when inoculated into a guinea-pig testis produced orchitis with abundant fungal elements. Histopathology of sections of the testicle showed an inflammatory reaction with P. brasiliensis inside monocytes. Immunological identification confirmed the identity of the isolate.
- Published
- 1990
- Full Text
- View/download PDF
32. [Black-grain eumycetoma caused by Madurella grisea. Report of a case].
- Author
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Heins-Vaccari EM, Takahashi N, de Oliveira NR, Lacaz Cda S, and Porto E
- Subjects
- Adult, Foot Dermatoses microbiology, Humans, Male, Mitosporic Fungi isolation & purification, Mycetoma microbiology, Mycetoma therapy, Foot Dermatoses pathology, Mycetoma pathology
- Published
- 1982
33. Interdigital, cutaneous phaeohyphomycosis due to Scytalidium lignicola Pesante 1957. A case report.
- Author
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Costa AR, Pires MC, Porto E, Lacaz Cda S, Heins-Vaccari EM, and Maranhão WM
- Subjects
- Adult, Humans, Male, Mitosporic Fungi growth & development, Mitosporic Fungi classification, Tinea Pedis microbiology
- Published
- 1988
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