Cutaneous blastomycosis. An imported case with good response to itraconazole

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• 作者：Alexandro Bonifaz^a ; ^b ; ^{a_bonifaz@yahoo.com.mx" class="auth_mail" title="E-mail the corresponding author} ; ^{alexandrobonifaz@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Diana Morales^b ; Neredi Morales^b ; Patricia Mercadillo^b ; Gloria M. Gonzá ; lez^c ; Francisca Herná ; ndez-Herná ; ndez^d ; Javier Araiza^a ; ^b ; Denisse Vá ; zquez-Gonzá ; lez^a ; ^b
• 关键词：Cutaneous blastomycosis ; Blastomyces dermatitidis ; Ajellomyces dermatitidis ; Dimorphic ; Itraconazole
• 刊名：Revista Iberoamericana de Micología
• 出版年：2016
• 出版时间：January-March 2016
• 年：2016
• 卷：33
• 期：1
• 页码：51-54
• 全文大小：1102 K

文摘

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.