A case of Exophiala spinifera infection in Southern Brazil: Molecular identification and antifungal susceptibility

Daboit, Tatiane Caroline; Duquia, Rodrigo Pereira; Magagnin, Cibele Massotti; Mendes, Sandra Denise Camargo; Castrillón, Mauricio Ramírez; Steglich, Raquel Bissacotti; Santos, Inajara Silveira dos; Vettorato, Gérson; Valente, Patrícia; Scroferneker, Maria Lúcia

doi:10.1016/j.mmcr.2012.08.006

Cited by 15 publications

(23 citation statements)

References 15 publications

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“…As in previous studies, E. spinifera showed resistance to TRB and high susceptibility to ITZ, suggesting the latter as the indicated drug for the treatment of infections caused by this agent …”

Section: Discussionsupporting

confidence: 81%

“…Antifungal activity assays are useful for detecting resistance that may arise during treatment and predicting clinical response . One of the first attempts at testing the susceptibility of these agents was reported by Oliveira et al .…”

Section: Discussionmentioning

confidence: 99%

“…The interaction coefficient among drugs was quantitatively evaluated by means of the fractional inhibitory concentration index (FICI). The interaction was defined as synergistic, if the FICI was ≤0.5, no interaction, if 0.5 > FICI ≤ 4.0 and antagonistic, if FICI was >4.0, as applied in recent studies …”

Section: Methodsmentioning

confidence: 99%

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In vitro susceptibility of chromoblastomycosis agents to five antifungal drugs and to the combination of terbinafine and amphotericin B

Daboit

Magagnin

Heidrich

et al. 2013

Mycoses

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Chromoblastomycosis is a chronic mycosis that affects the skin and subcutaneous tissues caused by several genera of dematiaceous fungi. There is not a treatment of choice. Thus, tools that help guide clinical practice are fundamental. In this sense, antifungal activity tests in vitro could be useful. However, trials with chromoblastomycosis agents are scarce. The aim of this study was to evaluate both the in vitro susceptibility of 60 chromoblastomycosis agents to five antifungals and the combination of amphotericin B (AMB) and terbinafine (TRB). TRB, itraconazole (ITZ) and ketoconazole (KTZ) were, in this order, the drugs which showed better activity against the chromoblastomycosis agents. The less active drugs were voriconazole (VRZ) and AMB. The more differentiated group was Exophiala spinifera. Cladophialophora carrionii and Fonsecaea spp. are significantly more susceptible to KTZ than Phialophora verrucosa, whereas C. carrionii is significantly more sensitive to VRZ than P. verrucosa and E. spinifera. Assays in this direction allow the knowledge of the susceptibility of the causative agents which may help the management of patients with this disease. This study includes the largest number of these agents and of genera found in the literature.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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In vitro susceptibility of chromoblastomycosis agents to five antifungal drugs and to the combination of terbinafine and amphotericin B

Daboit

Magagnin

Heidrich

et al. 2013

Mycoses

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“…The tissue excised should be sent for histopathological and microbiological examination to rule out infectious and non-infectious causes. The treatment strategy in case of Exophiala infections involves multiple avenues like medical treatment with associated surgical excision and in case of smaller lesion may be cryosurgery or electrocautery [7,8]. The abscess due to bacterial cause may involve treatment for shorter duration in comparison to the antifungal therapy.…”

Section: Discussionmentioning

confidence: 99%

“…The antifungal therapy takes a longer time and has far more side effects like hepatic and renal involvement. Drugs like voriconazole, itraconazole, flucytosine, amphotericin B and posaconazole have been tried after determining the invitro susceptibility testing [7,9].…”

Section: Discussionmentioning

confidence: 99%

Phaeohyphomycotic cyst in the Foot by Exophiala

Thejaswids

Kini

et al. 2014

JCDR

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

et al. 2013

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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.

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A case of Exophiala spinifera infection in Southern Brazil: Molecular identification and antifungal susceptibility

Cited by 15 publications

References 15 publications

In vitro susceptibility of chromoblastomycosis agents to five antifungal drugs and to the combination of terbinafine and amphotericin B

In vitro susceptibility of chromoblastomycosis agents to five antifungal drugs and to the combination of terbinafine and amphotericin B

Phaeohyphomycotic cyst in the Foot by Exophiala

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

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