We report six cases of female patients who, after the application by mesotherapy with platelet-rich plasma, as well as of an intradermal filler material of unknown origin, developed infection at the injection sites associated to Mycobacterium massiliense, as well as granuloma with reaction to foreign body. Although the cultures were negative, the identification of the microorganism was achieved by extraction of soft tissue DNA obtained by biopsy and sequencing the obtained product, with which the therapy was redirected against the particular species. Due to the great similarity in the culture between M. massiliense with the related species M. abscessus, to the required time for its growth, and to the different therapeutic response of each strain, molecular diagnostic techniques are a real option to consider to administer in an early way the appropriate treatment against the pathogen and prevent infection progression.

Resumen Comunicamos seis casos de mujeres quienes, tras la aplicación mediante mesoterapia con plasma rico en plaquetas, así como de un material de relleno intradérmico de origen desconocido, desarrollaron una infección en los sitios de inyección asociada a Mycobacterium massiliense, así como granulomas con reacción a cuerpo extraño. Aunque los cultivos fueron negativos, se logró la identificación del microorganismo por extracción de ADN de tejidos blandos obtenido por biopsia y posterior secuenciación del producto obtenido. Debido a la gran similitud en los cultivos de M. massiliense con la especie relacionada Mycobacterium abscessus, y a que tienen diferente respuesta terapéutica, las técnicas moleculares de diagnóstico son una opción real a considerar para administrar en forma precoz el tratamiento específico contra el patógeno y evitar la progresión de la infección.

Abstract Background Malassezia, a skin saprophyte, is frequently isolated from patients with seborrheic dermatitis, which is one of the most common dermatoses in HIV-infected patients. Its role in pathophysiology has not been defined. Objective To determine whether patients living with HIV and seborrheic dermatitis have more Malassezia than those without seborrheic dermatitis. Method This is an descriptive, observational, prospective cross-sectional study to which all adult patients living with HIV that attend the infectious disease outpatient clinic at the Dr. Manuel Gea González General Hospital were invited. Patients presenting with scale and erythema were included in Group 1, while patients without erythema were included in Group 2. Samples were taken from all patients for smear and culture. Results Thirty patients were included in each group. All patients with seborrheic dermatitis had a positive smear, with varying amounts of yeasts. In the control group, 36.7% of patients had a negative smear. The results are statistically significant, as well as the number of colonies in the cultures.Study limitations The study used a small sample size and the subspecies were not identified. Conclusions Patients with clinical manifestations of seborrheic dermatitis have larger amounts of Malassezia. Further studies need to be performed to analyze if the greater amount is related to imbalances in the microbiota of the skin.

Abstract: BACKGROUND: Superficial mycoses are generated by direct contact with the fungus or with an infected person or animal, and affect the skin, the attachments and mucous membranes; pregnant patients are susceptible to skin changes, both physiological and pathological. OBJECTIVE: To know the frequency of superficial mycoses in pregnant patients from the obstetrics service of the Hospital General Dr. Manuel Gea González. MATERIAL AND METHOD: A descriptive, observational, prospective and crosssectional study carried out in pregnant patients of the Gineco-Obstetrics Service of the Hospital General Dr. Manuel Gea González, Mexico City, from July 2016 to July 2017. RESULTS: Twenty-three patients were included in the mycology department for their physical examination; the most affected group was between 21 and 40 age years (86.9%); 17 patients presented tinea pedis (73.9%) and 4 (17.9%) onychomycosis. CONCLUSIONS: Superficial mycosis were not frequent in the group of study: 17 patients had tinea pedis and 4 onychomycosis. The causal agent isolated was Trichophyton rubrum.

Resumen: ANTECEDENTES: Las micosis superficiales se generan por contacto directo con el hongo o con una persona o animal infectado, y afectan la piel, los anexos y las mucosas; las pacientes embarazadas son susceptibles a cambios cutáneos fisiológicos y patológicos. OBJETIVO: Describir las micosis superficiales en pacientes embarazadas del Servicio de Obstetricia del Hospital General Dr. Manuel Gea González. MATERIAL Y MÉTODO: Estudio descriptivo, observacional, prospectivo y transversal realizado en pacientes embarazadas de la consulta externa del Servicio de Gineco-obstetricia del Hospital General Dr. Manuel Gea González de julio de 2016 a julio de 2017. RESULTADOS: Se incluyeron 23 pacientes que acudieron al Servicio de Micología; el grupo de edad más afectado fue de 21 a 40 años de edad (86.9%); 17 tuvieron tiña plantar (73.9%) y 4 (17.9%) tuvieron onicomicosis distrófica total. Dos cultivos fueron positivos para Trichophyton rubrum. CONCLUSIONES: Las micosis superficiales fueron poco frecuentes en el grupo estudiado: 17 pacientes con tiña de los pies y 4 con onicomicosis. El agente aislado fue Trichophyton rubrum.

Dermatophytes are pathogen fungi of skin and its appendages. One of them, Microsporum spp. has micro and macroscopic characteristics mainly based on the shape and size of macrocon id ia and echinulations that allow the identification of the species. The macro and micromorphological characteristics of 45 M. canis strains were analized with the intention of classifying them into subspecies. All samples had a previous positive direct exam with KOH and were cultured in both Sabouraud dextrose agar with antibiotic and rice media. Thirty five percent grew by the second week. A white velvety colony with a yellowish color on the reversal side was the usual phenotype. Fifteen percent of cultures on rice media were negative. The typical M. canis morphology was seen in 81.1% and macroconidia had an average of 9.08 septa. Sixteen cases had a mixed morphology. Microsporum canis strains are easily identified in most cases, however, in atypical specimens, M. audouinii should be ruled out.

Los dermatofitos son hongos que parasitan la piel y sus anexos. Uno de ellos, Microsporum spp., tiene características macro y microscópicas como forma y tamaño de macroconidios y equinulaciones que permiten su identificación entre las diferentes especies. Se analizaron estas características en 45 cepas de M. canis para intentar su clasificación en subespecies. Todas las muestras provenían de pacientes con un examen directo con KOH positivo y los cultivos se realizaron en agar dextrosa de Sabouraud con antibióticos y en un medio con arroz. El 35% de las cepas crecieron en dos semanas. Predominaron colonias blancas y vellosas con reverso amarillento. El 15% no crecieron en el medio con arroz. El 81.1% presentaron características típicas de M. canis y los macroconidios tuvieron en promedio 9.08 septos. En 16 casos las características morfológicas fueron variadas. Los cultivos de Microsporum canis se identifican fácilmente en la mayoría de los casos, sin embargo, en casos dudosos se debe considerar diagnóstico diferencial con M. audouinii.