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Abstract

A retrospective study of 325 cases of chromoblastomycosis diagnosed in the last 55 years in the Amazon region was carried out by the main Mycology services of the state of Pará, Brazil (Department of Tropical Pathology--UFPA and Mycology Department of the Evandro Chagas Institute/FNS). The data obtained showed that: (a) the main age group affected by the diseases range from 41 to 70 years-old, (b) 86.1% of the patients were agricultural-workers, (c) 93.2% of them were males and (d) 80.7% showed lesions on the lower limbs (feet and legs). The diagnosis of 62% of the cases was confirmed by laboratory studies considering the tissue form in histopathological analysis. In 24% of patients (78 cases), the etiological agent was isolated and identified through culture. Fonsecaea pedrosoi was present in 77 cases and Phialophora verucosa in only one case.

Chromoblastomycosis

“…The sex distribution in a case series reported in the southern region of Brazil showed that disease was prevalent in males (4:1) (126). In two other studies involving 390 cases in the same region, the sex ratio distribution was much higher for males (17:1) (123,124). The difference related to sex distribution in patients with CBM may be related to hormonal protection, as observed for paracoccidioidomycosis patients (150).…”

“…After Brazil, Venezuela and Colombia account for most cases of CBM. Within Brazil, CBM is endemic in many geographical areas, especially in the northern regions, where 872 cases were retrospectively reported during the last decades (3,79,123,124). Although 332 cases were reported from other provinces, a significant decrease in the number of new CBM cases has been observed, especially in the southern regions of this country (125,126).…”

“…Although 332 cases were reported from other provinces, a significant decrease in the number of new CBM cases has been observed, especially in the southern regions of this country (125,126). The mean annual incidences of cases of CBM reported in Brazil were 6.4/year (71 cases/11 years) for the state of Paraná (southern region), 5.9/year (325 cases/55 years) for Pará 45 (northern region), 4.3/year (13 cases/3 years) for Maranhão (northeastern region), and 2.6/year (73 cases/28 years) for Rio Grande do Sul (southern region) (8,13,(123)(124)(125)(126). The principal etiological agent of CBM in Brazil is F. pedrosoi (which may include its molecular siblings), followed by sporadic reports of P. verrucosa and E. spinifera.…”

“…In the Amazon, the age distribution ranged from 25 to 85 years, with the most affected group being between 41 and 70 years old (86%) (123,124). In Mexico, in a series of 603 cases, the disease predominated in adult males (66%) Ͼ38 years of age.…”

Fonsecaea pugnacius, a Novel Agent of Disseminated Chromoblastomycosis

“…The state of Maranhão in northeast Brazil is a region of chromoblastomycosis hyperendemicity. Fonsecaea pedrosoi is classically assumed to be responsible for almost 99% of the clinical cases (21,22). However, since Fonsecaea agents of the disease are morphologically indistinguishable (2,5,23) and specimens from cases have mostly not been cultured, it is possible that other agents have a higher prevalence than currently thought.…”