Publications by authors named "Javier Araiza"

26 Publications

  • Page 1 of 1

Tinea gladiatorum due to in a school wrestling team in Mexico: A case series.

Curr Med Mycol 2020 Dec;6(4):62-65

Department of Internal Medicine, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico.

Background And Purpose: Tinea gladiatorum is a type of dermatophytosis that occurs in combat athletes, such as wrestlers and judo fighters, as a result of Trichophyton species. Herein, we aimed to present a small outbreak of tinea gladiatorum in a high school in Mexico.

Materials And Methods: Seven individuals belonging to the school fighting team were mycologically studied with direct examinations and cultures. In four cases, was isolated and identified by morphological and proteomic methods (Matrix-assisted laser desorption/ionization- time-of-flight mass spectrometry). Out of the four subjects, two cases had clinical lesions presented as tinea corporis, and two cases were healthy carriers. was also isolated from one of the four training mats (25%). All positive patients were treated with systemic or topical antifungals and achieved clinical and mycological cure.

Conclusion: We report the first outbreak of tinea gladiatorum caused by among a group of high school wrestlers in Mexico.
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http://dx.doi.org/10.18502/cmm.6.4.5439DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226048PMC
December 2020

Actinomycetoma by : Clinical Characteristics and Treatment of 47 Cases.

Indian Dermatol Online J 2021 Mar-Apr;12(2):285-289. Epub 2021 Feb 22.

Department of Ecology of Pathogen Agents, Hospital Manuel Gea González, Mexico City, Mexico.

Context: Mycetoma is a chronic, granulomatous disease caused by fungi (eumycetoma) or aerobic filamentous actinomycetes (actinomycetoma). is one of the most frequent actinomycetes.

Aim: The study aims to provide an update on clinical, diagnostic, therapeutic, and outcome data for patients with actinomycetoma in a single center in Mexico.

Settings And Design: This was a retrospective study of 47 cases diagnosed with actinomycetoma.

Subjects And Methods: The cases were selected from a total of 536 mycetoma obtained during 35 years (from 1985 to 2019). Clinical data were retrieved from the clinical records of our department. Microbiological data were obtained from our Mycology laboratory.

Statistical Analysis: Frequencies and percentages were used for categorical variables. Normality was determined with the Kolmogorov-Smirnov test. We used means and medians to describe the variables.

Results: Forty-seven patients with actinomycetoma were included; female:male ratio 1.9:1; median age 38 years. The foot was the most affected region in 76.5% of cases. The bone invasion was observed in 89%. The time between symptoms onset and diagnosis was 5.5 years. Grain detection by direct examination was positive in 95% of cases. The most commonly used, as well as the most effective treatment scheme was streptomycin + sulfamethoxazole-trimethoprim with dapsone. Sixty-three percent (30 patients) achieved clinical and mycological cure, and 10.6% (5 patients) had treatment failure.

Conclusions: We highlight the importance of designing therapeutic strategies to standardize treatments and gain more experience to improve the care of these patients.
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http://dx.doi.org/10.4103/idoj.IDOJ_474_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088182PMC
February 2021

Clinical and mycological study of 42 cases of dermatophytic granuloma (Majocchi granuloma).

J Dtsch Dermatol Ges 2021 05 22;19(5):758-761. Epub 2021 Apr 22.

Microbiology Department, Medicine Faculty, Universidad Autónoma de Nuevo León, Mexico.

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http://dx.doi.org/10.1111/ddg.14453DOI Listing
May 2021

Thoracic actinomycetoma: a retrospective clinical-epidemiological study of 64 cases.

Trans R Soc Trop Med Hyg 2021 04;115(4):337-339

Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Av. Vasco de Quiroga 15, Belisario Domínguez Sección XVI, Tlalpan, 14080 México City, México.

Background: Actinomycetoma is a chronic granulomatous infection that follows traumatic implantation. Thoracic actinomycetoma (TA) is rare and may lead to severe complications.

Methods: A retrospective study of cases of TA diagnosed from 1985 to 2019 was carried out. Each case underwent direct examination, culture and biopsy.

Results: Sixty-four cases (12.8%) were included, with a male predominance (84.3%); the main occupation was peasant farmer (71.8%) and the main site was the back (76.5%). Vertebral involvement was observed in 21.8% and pulmonary involvement in 7.8%. Nocardia brasiliensis was the main aetiological agent (53 cases, 74.5%).

Conclusions: TA is a poorly studied disease that can cause neurological and lung complications.
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http://dx.doi.org/10.1093/trstmh/trab037DOI Listing
April 2021

Deep mycoses and pseudomycoses of the foot: a single-center retrospective study of 160 cases, in a tertiary-care center in Mexico.

Foot (Edinb) 2021 Mar 13;46:101770. Epub 2021 Jan 13.

Microbiology Department, Universidad Autónoma De Nuevo León, Mexico.

Background: Deep mycoses and pseudomycoses (DMP) may cause significant disability and even death; however, the reports regarding these diseases, mainly affecting the foot, are scarce.

Objective: To describe the epidemiological, clinical, and diagnostic characteristics of DMP of the foot in 160 patients.

Methods: A retrospective and observational study of DMP affecting the foot was carried out in a tertiary-care center in Mexico for 20 years (from January 2000 to December 2019). Cases with confirmatory microbiological studies were included; the identification of the isolated fungi was based on the forms of reproduction. For actinomycetes, morphological analysis in an automated system ATB Vitek® 1574 (Biomèrieux) was used. The fungi were identified by PCR, using several primers from the ITS regions and for actinomycetes in the 16S rRNA region. Data from histopathological studies were also collected.

Results: One hundred and sixty proven cases of DMP of the foot were included. The cases were categorized into nine types of infections including mycetoma (actinomycetoma and eumycetoma) in 102 cases (63.7%); sporotrichosis in 21 cases (13.1%); chromoblastomycosis, 18 cases (11.2%); phaeohyphomycosis, 3 cases (1.8%); histoplasmosis, 12 cases (7.5%); coccidioidomycosis 2 cases (1.2%) and botryomycosis and nocardiosis with one case respectively (0.6%). Most cases developed after traumatic implantation (147 cases, 91.8%). One hundred fifteen cases (71.8%) were men. The evolution was chronic in 125 cases (78.2%); bone involvement was observed in 64 cases (40%). Parasitic forms were observed In 139 cases (86.8%). The isolation and identification of the etiological agents were confirmed in all cases.

Conclusion: The main DMP affecting the foot were infections due to traumatic implantation; most were endemic mycoses. The clinical characteristics and the evolution of the diseases are easily misdiagnosed, and thus, diagnostic tests are usually required.
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http://dx.doi.org/10.1016/j.foot.2020.101770DOI Listing
March 2021

Mucormycosis at a tertiary-care center in Mexico. A 35-year retrospective study of 214 cases.

Mycoses 2021 Apr 13;64(4):372-380. Epub 2020 Dec 13.

Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico.

Background: Mucormycosis is a rare, invasive disease associated with high mortality rates, produced by opportunistic pathogens related to the Mucorales order and characterised by a diverse range of clinical forms; acute rhino-orbital-cerebral and pulmonary symptoms are the most reported ones.

Objectives: To report the experience of mucormycosis observed in a tertiary-care hospital in Mexico for 35 years.

Methods: This was a retrospective, descriptive and observational study on mucormycosis at a tertiary-care hospital in Mexico from January 1985 to December 2019. Demographic and clinical data and mycological and histopathological records were selected.

Results: Two hundred fourteen proven cases of mucormycosis for 35 years at a tertiary-care hospital in Mexico were included. Most of the cases were male patients with a median age of 45 years. The two most associated underlying diseases were diabetes mellitus (76.6%) and haematologic malignancy (15.4%). The three primary clinical forms were as follows: rhino-orbito-cerebral (75.9%), cutaneous (8.41%) and pulmonary (7.47%) mucormycosis. The most isolated agents were Rhizopus arrhizus (58.4%) and Lichtheimia corymbifera (12.3%). The overall therapeutic response was 58.5%, and the best response was observed with amphotericin B deoxycholate and surgical debridement.

Conclusion: Mucormycosis is an emerging disease, and its incidence has increased at our hospital over the years. In this study, the rhino-cerebral clinical type was the most frequent in patients with uncontrolled diabetes; the main aetiological agent was R. arrhizus. Early diagnosis, control of the underlying disease and prompt management may increase the survival rate.
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http://dx.doi.org/10.1111/myc.13222DOI Listing
April 2021

Mucormycosis with cutaneous involvement. A retrospective study of 115 cases at a tertiary care hospital in Mexico.

Australas J Dermatol 2021 May 22;62(2):162-167. Epub 2020 Nov 22.

Facultad de Medicina, Microbiology Department, Universidad Autónoma de Nuevo León, San Nicolas de los Garza, Mexico.

Background/objectives: Cutaneous mucormycosis is an emerging opportunistic mycosis caused by Mucorales. It can be divided into primary caused by trauma and secondary by extension of rhino-cerebral and disseminated cases. The objective is to present a retrospective study of cases of mucormycosis with cutaneous involvement.

Methods: A retrospective and descriptive study was carried out. Mucormycosis patients were included and divided into two groups: a) Primary Cutaneous and b) Secondary Cutaneous. Mycological tests were performed; the agents were identified by morphology and molecular studies (PCR and sequencing); some cases underwent histopathology. Clinical data and response to treatment were collected.

Results: 115 cases were included, 18 of primary, and 97 of secondary cutaneous mucormycosis. Primary cutaneous mucormycosis was most associated with adhesive bands (44.4%) and trauma from traffic accidents (33.3%). The principal clinical form was extensive and deep necrotic ulcers. Secondary cutaneous mucormycosis cases were rhino-cerebral with uncontrolled diabetes (81.4%) The most frequent clinical presentation was necrosis of the eyelid and the nose (65.9%). In both groups, the principal agent was Rhizopus arrhizus, 38.8% and 74.2% respectively. The most effective treatment was the combination of amphotericin B with surgical debridement. The clinical and mycological cure was achieved in 31.0% of primary cases, and 44.4% for secondary cases.

Conclusion: Primary cutaneous mucormycosis is caused by implantation of the Mucorales due to trauma or rupture of the cutaneous barrier-breach, and secondary cutaneous mucormycosis develops as part of the rhino-cerebral process. The response to treatment depends on the extension and depth, as well as the predisposing factors.
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http://dx.doi.org/10.1111/ajd.13508DOI Listing
May 2021

Oral involvement in mucormycosis. A retrospective study of 55 cases.

Enferm Infecc Microbiol Clin (Engl Ed) 2020 Nov 3. Epub 2020 Nov 3.

Microbiology Department, Universidad Autónoma de Nuevo León, Mexico.

Introduction: Mucormycosis with oral involvement (OIM) is a rare opportunistic and lethal mycosis, which has increased in the last decade and is generally associated with uncontrolled diabetes and neutropenia.

Methods: A retrospective study of cases with OIM was carried out in a tertiary-care center. Mycological and histological examinations were performed, and the isolated organisms were identified by morphology and molecular biology.

Results: Fifty-five OIM patients were included, with a median age of 38 years (61.8% males). The most frequent associated disease was type-2 diabetes mellitus (61%), followed by neutropenia due to acute lymphocytic leukemia (27%). The main presentation was palatal and mandibular ulcers (92.7%) and, to a lesser extent, gingival and lingual necrosis. The diagnosis was established by mycological and histopathological studies. The most frequent fungi isolated was Rhizopus arrhizus (67.2%).

Conclusion: OIM is a rapidly progressing disease, therefore, an early diagnosis and the proper control of predisposing factors is necessary, and consequently, contributing to improve the outcome of mucormycosis.
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http://dx.doi.org/10.1016/j.eimc.2020.09.003DOI Listing
November 2020

Actinomycetoma by . Clinical and therapeutic characteristics of 18 cases with two treatment modalities.

J Dermatolog Treat 2020 Jul 20:1-5. Epub 2020 Jul 20.

Microbiology Department, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico.

Background: Actinomycetoma due to is susceptible to numerous chemotherapeutic agents, however, the response to those treatments is variable and closely related to several factors.

Objective: We aimed to evaluate the clinical-therapeutic characteristics of patients with actinomycetoma due to with two treatment modalities.

Methods: This was a retrospective study of eighteen patients with a diagnosis of actinomycetoma. The most widely used therapeutic scheme was streptomycin 1 g every third day plus TMP/SMX 800 mg/160 mg/12h, followed by TMP/SMX with DDS 100 mg/day. In six patients (33%), ciprofloxacin 500 mg every 12 h was used instead of DDS.

Results: Conventional scheme achieved clinical and mycological cure in 58% of the cases, improvement in 16%, and 25% of the patients failed to treatment; in the cases treated with ciprofloxacin, clinical and microbiological cure was achieved in 83% of patients and clinical improvement in 16%. The treatment time to achieve clinical and mycological did not have a statistically significant difference (median 10 ± 1.38 vs. 12 ± 4.6).

Conclusion: Treatment based on streptomycin + TMP/SMX with ciprofloxacin was found to be effective in treating patients with actinomycetoma, and comparable to the conventional treatment with DDS in actinomycetoma due to with minimal bone involvement.
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http://dx.doi.org/10.1080/09546634.2020.1793887DOI Listing
July 2020

[Evaluation of MALDI-TOF MS for the identification of opportunistic pathogenic yeasts of clinical samples].

Rev Chilena Infectol 2019 Dec;36(6):790-793

Servicio de Dermatología, Laboratorio de Micología, Hospital General de México, México.

MALDI-TOF MS mass spectrometry is a rapid and straightforward technique to identify microorganisms by protein analysis. The study was performed in 304 yeast isolates from superficial and deep mycoses, in order to compare three methods: conventional (biochemical and morphological), MALDI-TOF MS, and polymerase chain reaction (PCR, reference). We included 24 species with predominance of Candida spp and Cryptococcus spp. The identification by conventional methods was 258/304 strains, while by MALDI-TOF MS was: 277/304 strains (84.8% versus 91.2%, P = not significant). The Kappa coefficient comparing MALDI-TOF-MS with PCR reported excellent concordance (0.99). The sensitivity and specificity of MALDI-TOF MS for the diagnosis of opportunistic pathogenic yeasts of clinical samples were 94.6% and 99% respectively. MALDI-TOF MS is a simple, fast and reliable tool for pathogenic yeasts.
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http://dx.doi.org/10.4067/S0716-10182019000600790DOI Listing
December 2019

White Piedra: Clinical, Mycological, and Therapeutic Experience of Fourteen Cases.

Skin Appendage Disord 2019 Apr 13;5(3):135-141. Epub 2018 Dec 13.

Private practice, Culiacán, Mexico.

Background: White piedra (WP) is an asymptomatic superficial mycosis that affects the hair stems, forming whitish nodules caused by various species of the genus .

Objective: To present a case series of WP of the head, its epidemiological data, as well as clinical, mycological, and therapeutic experience.

Methods: We conducted a 12-year retrospective and observational study of WP cases tested by dermoscopy, mycological study, and the identification of species through morphology, biochemistry, and proteomics (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). The treatment was based on ketoco-nazole shampoo as well as keratolytics.

Results: We included 14 cases of WP, all located in the head and 1 case with both head and scrotum affected. Nine cases (64.3%) presented in children aged < 15 years. The majority of the cases (13/14, 92.8%) were women. Two cases were associated with hyperkeratosis and intertrigo. Most patients had long hair and excessive moisture. In all cases hair nodules were observed and (11/14, 78.6%) was usually isolated. Eleven cases (78.6%) were cured by administering 2% ketoconazole shampoo.

Conclusion: WP was observed in school-age girls. The diagnosis was based on the observation of hair nodules and its main etiologic agent was , with good response to treatment in most cases.
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http://dx.doi.org/10.1159/000493374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489071PMC
April 2019

Sporotrichin Skin Test for the Diagnosis of Sporotrichosis.

J Fungi (Basel) 2018 May 9;4(2). Epub 2018 May 9.

Dermatology Service & Mycology Department, Hospital General de México, "Dr. Eduardo Liceaga", Balmis 148, Colonia Doctores, Ciudad de México 06726, Mexico.

Sporotrichosis is the most common implantation mycosis caused by several species of the complex. The gold standard for diagnosis is concerned with the isolation of the fungus; although, fresh examinations, staining, and biopsies are also helpful for this purpose. The sporotrichin is an antigenic complex comprised of a peptide-rhamnomannan, which is relevant with respect to pathogenic fungi; it is primarily used for serological and skin testing. We present a study regarding the use of sporotrichin as a diagnostic aid for cutaneous sporotrichosis. Furthermore, 138 cases with suspicion of sporotrichosis were included, 55 of which were proven through cultures. Moreover, out of these 55 cases, 52 (94.5%) tested positive for sporotrichin, while the negative cases corresponded to the disseminated cutaneous forms. We observed a sensitivity of 94.5% and a specificity of 95.2%. We consider that the use of sporotrichin as a skin test helps us as an auxiliary diagnosis before a positive sample culture.
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http://dx.doi.org/10.3390/jof4020055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023300PMC
May 2018

Two simultaneous mycetomas caused by Fusarium verticillioides and Madurella mycetomatis.

Rev Inst Med Trop Sao Paulo 2017 3;59:e55. Epub 2017 Aug 3.

Hospital General de México "Dr. Eduardo Liceaga", Servicio de Dermatología, Ciudad de México, México.

Mycetoma is a chronic granulomatous disease, classified into eumycetoma caused by fungi and actinomycetoma due to aerobic filamentous actinomycetes. Mycetoma can be found in geographic areas near the Tropic of Cancer. Mexico is one of the countries in which actinomycetoma is endemic. We report an extraordinary case of an adult male with double eumycetoma caused by Madurella mycetomatis and Fusarium verticillioides on both feet.
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http://dx.doi.org/10.1590/S1678-9946201759055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626227PMC
November 2017

Cutaneous blastomycosis. An imported case with good response to itraconazole.

Rev Iberoam Micol 2016 Jan-Mar;33(1):51-4. Epub 2015 Aug 21.

Departamento de Micología, Mexico; Servicio de Dermatología del Hospital General de México, Mexico.

Background: Blastomycosis is a subacute or chronic deep mycosis caused by a dimorphic fungus called Blastomyces dermatitidis, which generally produces a pulmonary form of the disease and, to a lesser extent, extra-pulmonary forms such as cutaneous, osteoarticular and genitourinary, among others. Cutaneous blastomycosis is the second clinical presentation in frequency. It is considered as primary when it begins by inoculation of the fungus due to traumas, and secondary when the lung fails to contain the infection.

Case-report: We present the case of a 57 year-old male who had a 5 year-history of an irregularly shaped verrucous infiltrative plaque related to and insect bite and posterior trauma due to the manipulation of the lesion. B. dermatitidis was identified using direct examination, stains, isolation in culture media, histopathology, and molecular studies. An antifungal susceptibility test was performed using method M38-A2 (CLSI). Clinical and mycological cure was achieved with itraconazole.

Conclusions: This cutaneous blastomycosis case acquired in the United States (Indianapolis) is rather interesting and looks quite similar to other mycoses such as coccidioidomycosis or sporotrichosis. The presented case shows one of the multiple issues concerning migration between neighboring countries.
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http://dx.doi.org/10.1016/j.riam.2015.05.001DOI Listing
December 2016

Mycetoma: experience of 482 cases in a single center in Mexico.

PLoS Negl Trop Dis 2014 Aug 21;8(8):e3102. Epub 2014 Aug 21.

Department of Mycology, Dermatology Service, General Hospital of Mexico, Mexico City, Mexico.

Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013). A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11%) were actinomycetomas and 38 cases (7.88%) were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3:1. The mean age was 34.5 years old (most ranged from 21 to 40 years). The main affected localization was lower and upper limbs (70.74% and 14.52% respectively). Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported). The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%). Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21%) and Actinomadura madurae (8.7%); meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii) were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.
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http://dx.doi.org/10.1371/journal.pntd.0003102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140667PMC
August 2014

Trichomycosis (trichobacteriosis): clinical and microbiological experience with 56 cases.

Int J Trichology 2013 Jan;5(1):12-6

Department of Mycology, Hospital General de México, O.D, Mexico City, Mexico ; Dermatology Service, Hospital General de México, O.D, Mexico City, Mexico.

Background: Trichomycosis is asymptomatic bacterial infection of the axillary hairs caused by Corynebacterium sp.

Objective: to bring a series of cases of trichomycosis, its clinical and microbiological experience.

Materials And Methods: This report consists in a linear and observational retrospective study of 15 years of cases of trichomycosis confirmed clinically and microbiologically.

Results: Fifty six confirmed cases of trichomycosis were included in this report. The majority were men 53/56 (94.6%), mean age was 32.5 years. The most commonly affected area was the axilla (92%), trichomycosis flava was the principal variant 55/56 (98.2%) and signs and symptoms associated were hyperhidrosis (87.5%), hairs' texture change (57.1%) and odor (35.7%). Bacterial concretions were observed in all cases, and the predominant causative agent in 89.3% of all cases was Corynebacterium sp. Thirty patients were included in therapeutic portion of the study, and 28 (93.3%) of them experienced a clinical and microbiological cure.

Conclusion: Trichomycosis is asymptomatic, superficial infection, which primarily affects axillary hairs.
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http://dx.doi.org/10.4103/0974-7753.114704DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746219PMC
January 2013

Comparison of direct microscopy, culture and calcofluor white for the diagnosis of onychomycosis.

Rev Iberoam Micol 2013 Apr-Jun;30(2):109-11. Epub 2012 Jul 20.

Servicio de Dermatología y Departamento de Micología, Hospital General de México, Mexico City, Mexico.

Background: Mycological diagnosis of onychomycosis can be performed by direct microcopy (KOH), cultures and calcofluor white.

Aims: To compare the percentage of positivity and the degree of correlation of KOH, cultures and calcofluor white for the diagnosis of onychomycosis.

Methods: Descriptive, transversal and comparative study. Samples of toenails with onychomycosis were used for KOH, cultures and calcofluor white under fluorescence. The percentage of positivity of the different techniques was calculated and the degree of correlation between them was determined (Epi Info v 3.4.3(©)).

Results: KOH was positive in 66.67% of the cases, cultures in 33.33% and calcofluor white in 57.58%. KOH and calcofluor white had a higher percentage of positivity than culture (p<0.01 and p<0.05 respectively). The degree of correlation between KOH and calcofluor white was excellent (κ=0.8085; p<0.0001); however, the degree of correlation between KOH and culture and between calcofluor white and culture was poor.

Conclusions: The use of calcofluor white is not recommended in routine laboratories because it does not seem to bring any additional benefits when comparing with KOH. This is especially important when funding is a great problem.
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http://dx.doi.org/10.1016/j.riam.2012.07.001DOI Listing
December 2013

Oral geotrichosis: report of 12 cases.

J Oral Sci 2010 Sep;52(3):477-83

Department of Mycology, General Hospital of Mexico, Col. Doctores, Mexico, D.F.

Oral geotrichosis is an uncommon opportunistic infection caused by Geotrichum candidum, a habitual contaminant and component of the flora of various parts of the body. This communication reports both a 20-year retrospective study of clinically and mycologically proven cases of oral geotrichosis, and a prospective study of fungal oral flora in 200 individuals divided into two groups: normal individuals and individuals with associated conditions. Twelve patients with proven oral geotrichosis were included: 9 females and 3 males, with a mean age of 48.5 years; the associated conditions were diabetes mellitus (66.6%), leukemia, Hodgkin's lymphoma and HIV/AIDS infection. The oral geotrichoses showed three clinical varieties: pseudomembranous (75%), hyperplastic, and palatine ulcer. G. candidum was isolated in 11 cases and G. capitatum in one. Positive fungal cultures were obtained from the two groups, and 48% and 78% of cultures were positive, respectively, for Candida spp. In 2.8% and 6.33% of the cases, G. candidum was isolated, respectively, together with one strain of G. capitatum. Oral geotrichosis is an exceptional infection that clinically presents, and is treated, as oral candidiasis. G. candidum may be isolated from the oral flora of a small proportion of patients, either normal individuals or those with associated conditions.
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http://dx.doi.org/10.2334/josnusd.52.477DOI Listing
September 2010

Actinomycetoma by Nocardia brasiliensis in a girl with Down syndrome.

Dermatol Online J 2008 Aug 15;14(8). Epub 2008 Aug 15.

Dermatology Department, Hospital Infantil de Mexico Federico Gomez.

We describe the case of a 14-year-old girl with Down syndrome and a large cutaneous plaque localized to the right neck and shoulder that had enlarged over five years after a minor traumatic injury. The plaque was characterized by numerous inflammatory nodules and fistulae that secreted purulent discharge. Nocardia grains were identified and Nocardia brasiliensis was identified by culture. Histopathology examination showed a chronic inflammatory infiltrate with granuloma development. The treatment scheme was with Diaminodiphenylsulfone 50/mg/d and Trimethoprim-Sulfamethoxazole 800/160 mg BID. Therapy was continued over 1(1/2) years, with a tapering dose. After 2(1/2) years of continuous treatment, clinical and microbiological healing was achieved.
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August 2008

Eumycetoma caused by Cladophialophora bantiana successfully treated with itraconazole.

Med Mycol 2009 Feb 22;47(1):111-4. Epub 2008 Nov 22.

Dermatology Service & Mycology Department, General Hospital of Mexico, Del Valle, Mexico.

A 57-year-old male presented with dermatosis of the dorsum of the foot consisting of tumefaction, deformity and sinus tract formation. The direct examination of exudates as well as the biopsy tissue, demonstrated the presence of black granules. A dematiaceous fungus was isolated from the lesions and was identified by ribosomal DNA sequencing as Cladophialophora bantiana. This is the second report of this fungus as an etiologic agent of eumycetoma in humans. Clinical and mycologic cure was achieved after 20 months of treatment with itraconazole at a starting dose of 300 mg/day that was tapered during the course of therapy. The patient's isolate had an itraconazole MIC of 0.012 microg/ml.
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http://dx.doi.org/10.1080/13693780802430639DOI Listing
February 2009

Sporotrichosis in childhood: clinical and therapeutic experience in 25 patients.

Pediatr Dermatol 2007 Jul-Aug;24(4):369-72

Mycology Department, Hospital General de Mexico, Mexico City, Mexico.

Sporotrichosis in an uncommon mycoses in childhood and is generally associated with injuries received as a consequence of farm work. We undertook a retrospective study of sporotrichosis in children and adolescents seen over a 10-year period, focusing on their clinical, epidemiologic, and mycologic features as well as treatment. We included 25 children with a mean age of 9.3 years. Most of those affected were schoolchildren (84%) from rural areas. The main clinical variety of sporotrichosis seen was the lymphocutaneous form (64%), followed by the fixed cutaneous form (36%), and one instance of the disseminated cutaneous form. Most lesions were located on the upper limbs (40%) and the face (36%). Sporothrix schenckii was isolated in all patients and 24 of 25 had a positive sporotrichin skin test. Nineteen patients were treated and cured clinically and mycologically with potassium iodide, three were cured with itraconazole and one with heat therapy.
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http://dx.doi.org/10.1111/j.1525-1470.2007.00452.xDOI Listing
November 2007

[Correlation between clinical characteristics and mycological tests in the vulvovaginitis by Candida].

Ginecol Obstet Mex 2007 Feb;75(2):68-72

Hospital General de México, OD, México DF.

Background: Vulvovaginitis caused by Candida sp is one of the most frequent infections.

Objectives: To culture and to identify the fungi related to clinical manifestations of patients based on a suspected diagnosis of vulvovaginal candidiasis.

Patients And Methods: A prospective, transversal and comparative study was performed on 181 women older than 18 years with vulvovaginitis by Candida sp. A correlation was made between the clinical characteristics of this entity and mycological tests such as direct examination and cultures.

Results: The direct exam or fresh vaginal exam and cervical sample was positive for the different microscopic forms of Candida (blastoconidia, pseudohyphye or pseudomycelia) in 60.8% (110 women); at the same time that cultures were positive for Candida sp in 51.9% (94 patients).

Conclusions: The direct examination and the cultures of vaginal and cervical exudate are mandatory tests for diagnosis of Candida sp in women with vulvovaginitis.
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February 2007

Cytobrush-culture method to diagnose tinea capitis.

Mycopathologia 2007 Jun 23;163(6):309-13. Epub 2007 May 23.

Dermatology Service & Mycology Department, Hospital General de México OD, Sanchez Azcona 317 int 202, Col del Valle, Mexico, DF, Mexico.

This is a comparative study to isolate the dermatophytes of tinea capitis using the cytobrush and comparing it versus the standard method. A prospective, observational, comparative trial of 178 probable cases of tinea capitis was conducted in two dermatological centers. Each patient underwent mycological tests that included direct exam with KOH and cultures with either of two methods: scraping the scalp to remove hair and cell debris, and the cytobrush. A total of 135 clinically and mycologically proven cases of tinea capitis were included; 119 were non-inflammatory and 16 inflammatory tinea. A total of 131 had a positive direct exam and subsequent primary isolation cultures were obtained in 135 cases. The main dermatophytes isolated were Microsporum canis (68%) and Trichophyton tonsurans (20%). A total of 115/135 (85.1%), were detected with the traditional method, with an average of 11.2 days until positive, while the number detected with the cytobrush was 132/135 (97.7%) with an average of 8.5 days until positive. The chi-square statistical method showed that the cytobrush culture was superior to the standard one with a chi-square of 5.078 (P = 0.025), with a statistically significant difference versus the standard method.
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http://dx.doi.org/10.1007/s11046-007-9019-6DOI Listing
June 2007

[Isolation and characterization of wild Sporothrix schenkii strains and investigation of sporototrichin reactors].

Gac Med Mex 2004 Sep-Oct;140(5):507-12

Laboratorio de Micología Médica del Servicio de Dermatología, Hospital General de México OD.

We conducted a study in the southern mountains of the Mexican State of Oaxaca that consisted of isolation of wild Sporothrix schenckii strains obtained from soil samples and investigation of positive reactors to skin test reaction with sprotrichin antigen. The study was conducted by means of recollection of soil samples and processing of these with dilution methods and fungal isolation in ordinary culture media Sabouraud simple Agar with and without antibiotics (SS, SA). Suspected strains underwent dimorphism, melanin formation, and virulence confirmation tests. Investigation of positive reactors to sporotrichin Y (yeast) was also conducted. Three supposed strains were identified due to their reproductive characteristics, melanin production, and virulence. In the community, 144 individuals were studied, of whom 6.25% were positive to sporotichin. Isolation of virulent strains of Sporothrix schenkii from nature (soil) and primoinfection of a percentage of the studied population were confirmed.
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February 2005
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