卡氏枝孢霉致着色芽生菌病2例

着色芽生菌病是一种慢性难治的皮肤及皮下组织真菌感染性疾病,其病原菌为暗色真菌属,最常见的是裴氏着色霉、卡氏枝孢霉及疣状瓶霉,常以孢子形态寄生于腐生植物或土壤中,人多通过外伤接触植入感染。其诊断依据病原学检查,治疗为以抗真菌为主的综合治疗方法。现报告2例我科诊断的由卡氏枝孢霉感染的着色芽生菌病。     

裴氏着色霉致着色芽生菌病1例并文献复习

报道1例裴氏着色霉致左手背及腕部着色芽生菌病,通过文献复习统计并分析该病在我国的流行病学及临床特点.患者男,48岁,左手背部红斑、疣状增生伴瘙痒10 a.皮损组织病理检查示真皮中下层有炎细胞及多核巨细胞,PAS染色见硬壳小体.经真菌培养和分子鉴定为裴氏着色霉.经伊曲康唑600 mg每日口服,治疗3个月后好转.     

Granulomatous reactions induced by lipids extracted from Fonsecaea pedrosoi, Fonsecaea compactum, Cladosporium carrionii and Phialophora verrucosum

Granulomatous reactions induced by lipid extracts from the dermatophyte fungi Fonsecaea pedrosoi, Fonsecaea compactum, Cladosporium carrionii and Phialophora verrucosum, the causal organisms of chromoblastomycosis, were studied. Charcoal particles coated with the lipid extracts were prepared and injected intravenously into mice. Inflammation was characterized by an intense mononuclear cell infiltrate that lodged in the lung from 4 to 8 d after inoculation.     

Detection of circulating antibodies in patients affected by Chromoblastomycosis by Cladosporium carrionii using double immunodiffusion

The antibodies in sera of patients affected by Chromoblastomycosis are detected using the technique of double immunodiffusion and the mycelial somatic antigens and the culture filtrates antigens of Cladosporium carrionii. From the 13 sera tested 8 have given positive results. The fresh serum from a patient under treatment gives 2 bands, while fresh serum from a non-treated patient gives 3 bands. The titre of antibodies was also determined for the two fresh sera, having found 1/4 for the patient under treatment and 1/32 for the non-treated one.     

Case Report: A Case of Chromoblastomycosis Caused by Fonsecaea pedrosoi in Vietnam

Mycopathologia - Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissues caused by different melanized fungi. The disease occurs worldwide, particularly in tropical...     

Chromoblastomycosis Caused by Fonsecaea nubica: First Report in Northern China and Literature Review

Mycopathologia - Chromoblastomycosis is found worldwide with higher incidence in tropical and subtropical regions. Fonsecaea spp. is one of the major causative agents of this disease. First case of...     

首次报道中国北方Fonsecaea monophora所致着色芽生菌病1例及其相关实验研究

目的首次报道中国北方1例由Fonsecaea monophora所致着色芽生菌病。方法患者男性,58岁,主因"右腕部皮损伴瘙痒8~9a"就诊。对皮损脓液直接镜检,皮损组织病理检查,真菌培养,并对培养获得菌株进行形态学,分子生物学鉴定等实验室研究。结果脓液直接镜检可见多个圆形、厚壁、棕色硬壳细胞,皮损组织病理表现为慢性肉芽肿样改变,并可见硬壳小体。真菌培养可见暗棕色,橄榄色至黑色菌落生长,生长速度较慢,镜下可见枝孢型和喙枝孢型产孢。ITS区序列分析鉴定为Fonsecaea monophora。依据临床及实验室检查确诊该例为Fonsecaea monophora所致的着色芽生菌病。口服伊曲康唑200mg,1次/d;特比萘芬250mg,1次/d。治疗3个月后,皮损消退痊愈。结论 Fonsecaea monophora感染也可见于我国北方地区的着色芽生菌病患者,而ITS区序列分析是该菌种鉴定的重要手段,伊曲康唑联合特比萘芬治疗本例患者显示较好疗效。     

Collapse of a Marine Mammal Species Driven by Human Impacts

Understanding historical roles of species in ecosystems can be crucial for assessing long term human impacts on environments, providing context for management or restoration objectives, and making conservation evaluations of species status. In most cases limited historical abundance data impedes quantitative investigations, but harvested species may have long-term data accessible from hunting records. Here we make use of annual hunting records for Caspian seals (Pusa caspica) dating back to the mid-19^th century, and current census data from aerial surveys, to reconstruct historical abundance using a hind-casting model. We estimate the minimum numbers of seals in 1867 to have been 1–1.6 million, but the population declined by at least 90% to around 100,000 individuals by 2005, primarily due to unsustainable hunting throughout the 20^th century. This collapse is part of a broader picture of catastrophic ecological change in the Caspian over the 20^th Century. Our results combined with fisheries data show that the current biomass of top predators in the Caspian is much reduced compared to historical conditions. The potential for the Caspian and other similar perturbed ecosystems to sustain natural resources of much greater biological and economic value than at present depends on the extent to which a number of anthropogenic impacts can be harnessed.     

HIV Sexual Transmission Is Predominantly Driven by Single Individuals Rather than Discordant Couples: A Model-Based Approach

Understanding the relative contribution to HIV transmission from different social groups is important for public-health policy. Information about the importance of stable serodiscordant couples (when one partner is infected but not the other) relative to contacts outside of stable partnerships in spreading disease can aid in designing and targeting interventions. However, the overall importance of within-couple transmission, and the determinants and correlates of this importance, are not well understood. Here, we explore how mechanistic factors – like partnership dynamics and rates of extra-couple transmission – affect various routes of transmission, using a compartmental model with parameters based on estimates from Sub-Saharan Africa. Under our assumptions, when sampling model parameters within a realistic range, we find that infection of uncoupled individuals is usually the predominant route (median 0.62, 2.5%–97.5% quantiles: 0.26–0.88), while transmission within discordant couples is usually important, but rarely represents the majority of transmissions (median 0.33, 2.5%–97.5% quantiles: 0.10–0.67). We find a strong correlation between long-term HIV prevalence and the contact rate of uncoupled individuals, implying that this rate may be a key driver of HIV prevalence. For a given level of prevalence, we find a negative correlation between the proportion of discordant couples and the within-couple transmission rate, indicating that low discordance in a population may reflect a relatively high rate of within-couple transmission. Transmission within or outside couples and among uncoupled individuals are all likely to be important in sustaining heterosexual HIV transmission in Sub-Saharan Africa. Hence, intervention policies should be broadly targeted when practical.     

Inhibition of Nitric Oxide Production by Macrophages in Chromoblastomycosis: A Role for Fonsecaea pedrosoi Melanin

Chromoblastomycosis is a chronic and progressive deep mycosis that is usually found in tropical and subtropical areas. Fonsecaea pedrosoi is considered its most frequent etiologic agent and causes a typical granulomatous inflammatory response, whose degree reflects the immune status of the host. Since macrophages play a fundamental role in the control of the infection, this study aimed at investigating the production of oxygen reactive specimens, the phagocytic capacity and the production of nitric oxide (NO) by macrophages employing in vitro assays and an in vivo model of chromoblastomycosis. Our results demonstrated that, during the infection, peritoneal macrophages show an increased phagocytic capacity and H₂O₂ production, but also a reduced ability to produce NO. Moreover, F. pedrosoi stimulated H₂O₂ production in vitro but not the synthesis of NO. The incubation of IFNγ and LPS-stimulated macrophages with melanin, obtained from the fungus, inhibited NO production. Examination of the liver and spleen of infected animals, at day 30 or 60 following inoculation, showed a progressive increase in the number and size of granulomas, indicating that macrophages are properly mobilized and activated. Our data suggest that the inability of the host to clear F. pedrosoi, leading to a chronic disease, is due, at least in part, to the inhibition of NO synthesis by macrophages by fungus-produced melanin.     

A Case of Relapsed Chromoblastomycosis Due to Fonsecaea monophora: Antifungal Susceptibility and Phylogenetic Analysis

Chromoblastomycosis is a chronic cutaneous and subcutaneous mycosis. The management of this infection continues to be challenging because there is no consensus on the therapeutic regimen. We report here a case of a 69-year-old male patient with cauliflower-like lesions on his left leg and foot. He had already been treated with itraconazole at a dose of 200 mg/day for 5 months, with mycological cure for all the affected areas. However, the lesions relapsed at both sites, and treatment with itraconazole was resumed at the dose previously used. Initially, direct mycological examination, cultural, and microculture slide observation were performed. Afterward, sequencing of the ITS1-5.8S rDNA-ITS2 region of the fungal DNA and evaluation of its susceptibility to antifungal agents alone and in combination were performed. In direct mycological examination, the presence of sclerotic cells was verified, and the fungus was identified as Fonsecaea based on cultural and microscopic examinations. Identification as Fonsecaea monophora was confirmed after sequencing of the ITS region and phylogenetic analysis. The isolate was susceptible to itraconazole and terbinafine. The combinations of amphotericin B and terbinafine and terbinafine and voriconazole were synergistic. The use of drugs for which the causative agent is susceptible to singly or in combination may be an alternative for the treatment of mycosis. Furthermore, the identification of the agent by molecular techniques is important for epidemiological purposes. To the best of our knowledge, this is the first case of relapsed chromoblastomycosis caused by F. monophora in Brazil.     

Use of Rolling Circle Amplification to Rapidly Identify Species of Cladophialophora Potentially Causing Human Infection

The genus Cladophialophora comprises etiologic agents of disease in immunocompetent patients, ranging from mild cutaneous colonization to cerebral encephalitis, in addition to saprobic species. Due to the high degree of phenotypic similarity between closely related species of the genus, identification problems are imminent. In the present study, we described rapid and sensitive rolling circle amplification (RCA) method based on species-specific padlock probes targeted for the internal transcribed spacer regions of rDNA. ITS regions of 12 Cladophialophora species were sequenced, and subsequently, 10 specific padlock probes were designed for the detection of single nucleotide polymorphisms. The majority of circularizable padlock probes were designed based on single nucleotide polymorphisms (SNPs), while for C. bantiana, C. immunda and C. devriesii were characterized by two or more nucleotides. Individual species-specific probes correctly identified in all ten Cladophialophora species correctly by visualization on 1.2 % agarose gels used to verify specificity of probe-template binding; no cross-reactivity was observed. Simplicity, sensitivity, robustness and low costs provide RCA a distinct place among isothermal techniques for DNA diagnostics. However, restriction and specificity and sensitivity should be lowered and increased, respectively, to be useful for a wide variety of clinical applications.     

Autoimmune Diabetes Is Suppressed by Treatment with Recombinant Human Tissue Kallikrein-1

The kallikrein-kinin system (KKS) comprises a cascade of proteolytic enzymes and biogenic peptides that regulate several physiological processes. Over-expression of tissue kallikrein-1 and modulation of the KKS shows beneficial effects on insulin sensitivity and other parameters relevant to type 2 diabetes mellitus. However, much less is known about the role of kallikreins, in particular tissue kallikrein-1, in type 1 diabetes mellitus (T1D). We report that chronic administration of recombinant human tissue kallikrein-1 protein (DM199) to non-obese diabetic mice delayed the onset of T1D, attenuated the degree of insulitis, and improved pancreatic beta cell mass in a dose- and treatment frequency-dependent manner. Suppression of the autoimmune reaction against pancreatic beta cells was evidenced by a reduction in the relative numbers of infiltrating cytotoxic lymphocytes and an increase in the relative numbers of regulatory T cells in the pancreas and pancreatic lymph nodes. These effects may be due in part to a DM199 treatment-dependent increase in active TGF-beta1. Treatment with DM199 also resulted in elevated C-peptide levels, elevated glucagon like peptide-1 levels and a reduction in dipeptidyl peptidase-4 activity. Overall, the data suggest that DM199 may have a beneficial effect on T1D by attenuating the autoimmune reaction and improving beta cell health.     

The rpoS Gene Is Predominantly Inactivated during Laboratory Storage and Undergoes Source-Sink Evolution in Escherichia coli Species

The rpoS gene codes for an alternative RNA polymerase sigma factor, which acts as a general regulator of the stress response. Inactivating alleles of rpoS in collections of natural Escherichia coli isolates have been observed at very variable frequencies, from less than 1% to more than 70% of strains. rpoS is easily inactivated in nutrient-deprived environments such as stab storage, which makes it difficult to determine the true frequency of rpoS inactivation in nature. We studied the evolutionary history of rpoS and compared it to the phylogenetic history of bacteria in two collections of 82 human commensal and extraintestinal E. coli strains. These strains were representative of the phylogenetic diversity of the species and differed only by their storage conditions. In both collections, the phylogenetic histories of rpoS and of the strains were congruent, indicating that horizontal gene transfer had not occurred at the rpoS locus, and rpoS was under strong purifying selection, with a ratio of the nonsynonymous mutation rate (Ka) to the synonymous substitution rate (Ks) substantially smaller than 1. Stab storage was associated with a high frequency of inactivating alleles, whereas almost no amino acid sequence variation was observed in RpoS in the collection studied directly after isolation of the strains from the host. Furthermore, the accumulation of variations in rpoS was typical of source-sink dynamics. In conclusion, rpoS is rarely inactivated in natural E. coli isolates within their mammalian hosts, probably because such strains rapidly become evolutionary dead ends. Our data should encourage bacteriologists to freeze isolates immediately and to avoid the use of stab storage.