Human and animal fungal pathogens are a growing threat worldwide leading to emerging infections and creating new risks for established ones. There is a growing need for a rapid and accurate identification of pathogens to enable early diagnosis and targeted antifungal therapy. Morphological and biochemical identification methods are time-consuming and require trained experts. Alternatively, molecular methods, such as DNA barcoding, a powerful and easy tool for rapid monophasic identification, offer a practical approach for species identification and less demanding in terms of taxonomical expertise. However, its wide-spread use is still limited by a lack of quality-controlled reference databases and the evolving recognition and definition of new fungal species/complexes. An international consortium of medical mycology laboratories was formed aiming to establish a quality controlled ITS database under the umbrella of the ISHAM working group on "DNA barcoding of human and animal pathogenic fungi." A new database, containing 2800 ITS sequences representing 421 fungal species, providing the medical community with a freely accessible tool at http://www.isham.org/ and http://its.mycologylab.org/ to rapidly and reliably identify most agents of mycoses, was established. The generated sequences included in the new database were used to evaluate the variation and overall utility of the ITS region for the identification of pathogenic fungi at intra-and interspecies level. The average intraspecies variation ranged from 0 to 2.25%. This highlighted selected pathogenic fungal species, such as the dermatophytes and emerging yeast, for which additional molecular methods/genetic markers are required for their reliable identification from clinical and veterinary specimens.
This report describes the first isolation of Sporothrix globosa from a Brazilian patient. A 77-year-old woman was examined for sporotrichosis infection. Histopathological examination of skin biopsy revealed chronic granulomatous infiltrate with microabcess. Furthermore, S. schenckii-like yeasts were evident as demonstrated by PAS and Grocott stains. The fungus was identified based on colony morphology on Sabouraud Dextrose Agar slants, Potato Dextrose Agar, and Corn Meal Agar, microscopic morphology on slides cultures, and assimilation of different carbon sources. The species confirmation was made by molecular methodology.
The major diagnostic antigens of Histoplasma capsulatum var. capsulatum are the H and M antigens, pluripotent glycoproteins that elicit both humoral and T-cell-mediated immune responses. The gene encoding the M antigen has previously been sequenced, and its sequence has significant overall homology to those of the genes for fungal catalases. Regions of the M-antigen gene with little or no homology were used to design four oligonucleotide sequences for application in the PCR detection and identification of H. capsulatum var. capsulatum. The PCR correctly identified the 31 H. capsulatum var. capsulatum strains isolated from human, animal, and soil specimens and 1 H. capsulatum var. duboisii isolate. PCR products of 111 and 279 bp were amplified with primers Msp1F-Msp1R and Msp2F-Msp2R, respectively. No amplification product was obtained from DNA extracted from an H. capsulatum var. farciminosum isolate. The specificity of the PCR with the M-antigen-derived primers was confirmed by the total absence of amplification products when genomic DNA from Paracoccidioides brasiliensis, Candida spp., Sporothrix schenckii, Cryptococcus neoformans, Blastomyces dermatitidis, Coccidioides immitis, Aspergillus niger, and Aspergillus fumigatus were applied in the reaction. This rapid, sensitive, and specific assay provides a way to identify typical and atypical isolates of H. capsulatum var. capsulatum.Histoplasmosis, a systemic fungal disease caused by Histoplasma capsulatum var. capsulatum (15), is an important health problem worldwide. Although the majority of cases present as a mild to moderate flu-like disease requiring only supportive therapy, approximately 5% of patients develop a more serious pulmonary and extrapulmonary disease that can be life-threatening if diagnosis is delayed or if treatment is not initiated rapidly. Histoplasmosis is most prevalent in the midwestern states of the United States (27-30), although smaller regions of endemicity are scattered throughout most of Latin America (17,22,24). The disease is one of the most common systemic mycoses in Brazil, where epidemiological surveys carried out by use of the histoplasmin skin test indicate that this mycosis is endemic in all areas surveyed (9). These data suggest that the numbers of cases of histoplasmosis in Brazil may be underestimated and that the areas of endemicity are more widespread than previously thought.The diagnosis of histoplasmosis is based on the results of clinical evaluation, culture of the organism, and various laboratory tests. Isolation and culture of H. capsulatum var. capsulatum provide a definitive diagnosis (15, 30), although complement fixation and precipitin tests that detect antibodies against the major serodiagnostic marker (the M antigen) play a significant role in the identification of infection (10,11,18,(33)(34)(35)(36).The Histoplasma urine antigen test is also useful, particularly in cases of disseminated disease (31). However, serodiagnostic methods have limitations associated with false positivity, which arises from the pr...
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