Human Case of Lobomycosis

Elsayed, Sameer; Kuhn, Susan; Barber, Duane; Church, Deirdre L.; Adams, Stewart; Kasper, Richard

doi:10.3201/eid1004.030416

Cited by 56 publications

(61 citation statements)

References 11 publications

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“…Both chromoblastomycosis and lacaziosis show a high incidence in hot and humid regions and, although chromoblastomycosis presents a more cosmopolitan distribution compared to lacaziosis, both diseases are endemic in the Amazon region. The incidence of lacaziosis is especially high in the Brazilian Amazon region and in bordering countries, while cases of the human disease become rarer as the distance from these regions increases [11] . The great challenge in the understanding and management of these subcutaneous mycoses is represented by the poorly effective therapeutic procedures [13] .…”

Section: Resultsmentioning

confidence: 99%

An Unusual Association between Chromoblastomycosis and Jorge Loboâ€™s Disease in the Same Patient from the Amazon Region

Costa¹,

Silva²,

Almeida³

et al. 2008

American J. of Agricultural and Biological Sciences

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Abstract:A clinical case of co-infection Cladophialophora sp. and Lacazia loboi is described and in a same patient with an 18-year history of verrucous plaques and parakeloidal nodular lesions. A 50-yearold man, a laborer, living in the Anajás city, Para, Brazil (rural Amazon region), was seen at the Evandro Chagas Institute's ambulatory. Histopathological analysis revealed intense hyperplasia and hyperkeratosis of the epidermis, sometimes showing well-circumscribed areas of an intraepidermal suppurative content intermingled with round and brownish structures. The papillary and reticular dermis was characterized by fibrosis and a granulomatous reaction consisting of lymphocytes, histiocytes and giant cells permeated by suppurative inflammatory foci and multiple round fungal structures mainly arranged amidst a neutrophilic inflammatory infiltrate. The clinical material collected from the lesion was submitted to direct mycological examination using 20% KOH solution and lactophenol cotton blue, which revealed the presence of yeast-like cells with a double membrane arranged in groups, a characteristic of Lacazia loboi, as well as sclerotic cells characteristic of chromoblastomycosis. Culture of the specimen on Mycosel agar and microculture on potato agar showed the typical morphology of Cladophialophora sp. The association of these two fungi causing lesions and inducing long-term disease may indicate a similarity in the characteristics of the habitat of these agents in the Amazon region.

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Section: Resultsmentioning

confidence: 99%

An Unusual Association between Chromoblastomycosis and Jorge Loboâ€™s Disease in the Same Patient from the Amazon Region

Costa¹,

Silva²,

Almeida³

et al. 2008

American J. of Agricultural and Biological Sciences

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“…Lesions in humans develop on the exposed areas of the body, particularly the extremities, face and ears (Fuchs et al 1990, Rodriguez-Toro 1993. Human lacaziosis is endemic in rural areas of South and Central America among persons with contact with water, soil and vegetation (RodriguezToro 1993) and has also occurred among persons who have traveled to an endemic area (Elsayed et al 2004).…”

Section: Introductionmentioning

confidence: 99%

Lacaziosis in bottlenose dolphins Tursiops truncatus along the coastal Atlantic Ocean, Florida, USA

Murdoch¹,

Mazzoil²,

McCulloch³

et al. 2010

Dis. Aquat. Org.

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This study represents the first systematic study of lacaziosis (lobomycosis) in bottlenose dolphins Tursiops truncatus in the Atlantic Ocean along the east-central coast of Florida, USA. Lacaziosis is a chronic infection of the skin caused by the fungus Lacazia loboi, which affects only dolphins and humans. Previous studies have shown a high prevalence (6.8 to 12.0%) of lacaziosis in resident dolphins from the adjacent Indian River Lagoon Estuary (IRL), where the disease is endemic. We examined the prevalence of lacaziosis in this coastal area using photo-identification data collected between 2002 and 2008 to determine the prevalence of lacaziosis in coastal dolphins using photographic methodology shown to have high sensitivity and specificity in prior research. The prevalence of skin lesions compatible with lacaziosis estimated from photographic data was 2.1% (6/284), approximately 3 times lower than that described for the estuarine population using similar methods. To exclude potential bias introduced by differences in study duration and survey effort among areas, an 18 mo period when effort was most equal (January 2006 to June 2007) was chosen for statistical comparison. The prevalence of lacaziosis estimated from photographic data was significantly lower (3.8%: n = 6/160) in the Atlantic Ocean compared to the IRL (12.0%: n = 20/167) (risk ratio = 3.19, 95% CI 1.32 to 7.75, p < 0.01 by chi-square analysis). The lower prevalence of lacaziosis in dolphins found in the Atlantic Ocean and the overall lack of movement of dolphins between these habitats suggests that environmental conditions within the estuary may favor viability of L. loboi, and/or that immune compromise in resident estuarine dolphins is a precursor to the disease.

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“…The optimal therapy for localized lesions is cryosurgery or wide surgical excision in health margins to avoid recurrence. 1,2,15,16 In cases where lesions are disseminated treatment with itraconazole, clofazimine or combination of both drugs is recommended. 15,16 Unfortunately, the disease has no tendency to heal spontaneously whereas none of the above treatments are proved to be satisfactory.…”

Section: 21314mentioning

confidence: 99%

“…1,3,5 The human disease appears to be endemic in Central and Western Brazil, Bolivia, Colombia, Costa Rica, Ecuador, Guyana, Mexico, Panama, Peru, Suriname and Venezuela. [1][2][3][4][5][6]8,11,13,21 However, there have been isolated cases in the United States, 22 Canada, 16 Africa, 23 the Netherlands, 24 France 25 and Germany. 15 More than 550 human cases have been reported to date, especially in patients with a history of travel or residence in the areas of endemicity or in communities along rivers.…”

Section: 241819mentioning

confidence: 99%

Lobomycosis: A case from Southeastern Europe and review of the literature

Papadavid¹,

Dalamaga²,

Kapniari³

et al. 2012

J Dermatol Case Rep

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Background: Lobomycosis, also known as Jorge Lobo's disease, represents a rare chronic subcutaneous mycosis caused by the fungus Lacazia loboi, an organism that is found within lesions but has not been cultured to date. The natural reservoir of L. loboi is unknown but it is believed to be aquatic, or associated with soil and vegetation. More than 550 human cases have been reported, especially in patients with a history of travel or residence in endemic areas (Central and South America, particularly Brazil) or in communities along rivers. Main observations:We describe a 64-year-old Greek female farmer living in a coastal region, who presented with an erythematous plaque on her left inner thigh resembling a keloid. The diagnosis was based on the triad: 1) absence of fungal growth in cultures, 2) positive direct microscopic examination of the lesion and 3) histopathology, all consistent with lobomycosis. Particularly, skin biopsy showed deep cutaneous fungal infection with granulomatous reaction. Fungal cells were found inside giant cells. The fungi were thick-walled with some budding, isolated or in short chains. Dermal fibrosis was present. Our patient had a medical history of common variable immunodeficiency but no history of travel to South or Central America. She probably acquired this rare infection by injury during her agricultural works. Conclusion:Our case represents probably the first documented case of human lobomycosis in Southeastern Europe. This case is unusual due to the rarity of lobomycosis in Mediterranean countries, particularly in Southeastern Europe. (J Dermatol Case Rep. 2012; 6(3): 65-69)

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Human Case of Lobomycosis

Abstract: We describe a 42-year-old woman with histologically confirmed lobomycosis, a cutaneous fungal infection rarely reported outside of Latin America. Our case represents the first published report of imported human lobomycosis in Canada and the fifth in an industrialized country.

Cited by 56 publications

References 11 publications

An Unusual Association between Chromoblastomycosis and Jorge Loboâ€™s Disease in the Same Patient from the Amazon Region

An Unusual Association between Chromoblastomycosis and Jorge Loboâ€™s Disease in the Same Patient from the Amazon Region

Lacaziosis in bottlenose dolphins Tursiops truncatus along the coastal Atlantic Ocean, Florida, USA

Lobomycosis: A case from Southeastern Europe and review of the literature

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