Abstract Background Sporotrichosis is the most frequent subcutaneous mycosis in Latin America, where it is considered endemic. At the end of the 20th century, the first cases of zoonotic transmission were described in Rio de Janeiro, triggering an epidemic outbreak that spread to other regions of Brazil. The lack of disease notification omits its real occurrence in the country, which happens in its most populous city, São Paulo. Objective To evaluate the epidemiological aspects of the patients seen at a hospital in São Paulo aiming at establishing the geographic distribution of this disease. Methods This is a retrospective study that analyzed data from medical records of patients with a clinical and laboratory diagnosis of sporotrichosis attended at a tertiary hospital in the city of São Paulo between 2012 and 2020. Results Twenty patients were included. As for zoonotic surveillance, 30% denied contact with an animal, and 70% reported previous contact with a sick cat, with no other animals being mentioned. One case was allochthonous and the others autochthonous, showing a dissemination behavior from a focus in the eastern area of the capital. Study limitations The present study was based on data from only one hospital. Studies that include data from other hospitals and other regions must be carried out to obtain a complete picture of this disease. Conclusions As in other regions of the country, zoonotic sporotrichosis presents itself as an endemic disease with an increase in the number of cases. The findings highlight epidemiological characteristics of great importance so that public health policies can contain disease progression.

Abstract Pseudomycetoma is an extremely rare deep mycosis, caused by dermatophytic fungi that penetrate the tissue from infected follicles of tinea capitis. Both clinically and histopathology are similar to eumycetoma, being distinguished through the isolation of the fungus, which in the case of pseudomycetoma can be Microsporum spp. or Trichophyton spp. genre. We present a 24-year-old man with an exuberant tumor in the occipital region with fistula, whose histopathological examination evidenced grains composed of hyaline hyphae and the culture for fungi isolated the agent Microsporum canis. Combined treatment of surgical excision followed by oral griseofulvin for two years was performed, with resolution of the condition.

FUNDAMENTO: Leveduras do gênero Candida determinam colonização, infecções superficiais e infecções sistêmicas em imunodeprimidos. As várias apresentações da doença levam à necessidade de utilizar diferentes métodos diagnósticos e tratamentos. OBJETIVOS: Diferenciar as espécies de Candida e correlacioná-las com as regiões anatômicas. Avaliar a susceptibilidade a cetoconazol, fluconazol, itraconazol e anfotericina B. MÉTODOS: Foram avaliados 100 pacientes imunocompetentes com candidíase cutânea ou mucosa atendidos na Santa Casa de S. Paulo entre maio de 1999 e julho de 2001. Correlacionou-se a região acometida e a espécie de Candida, isolada através técnica CHROMagar Candida®. Avaliou-se a susceptibilidade das espécies a cetoconazol, fluconazol, itraconazol e anfotericina B, através do Etest®. RESULTADOS: C. albicans foi isolada em 76,0% dos materiais, C. krusei em 19% e C. tropicalis em 1%. Não houve correlação significante entre a região acometida e as espécies. A maioria das amostras mostrou susceptibilidade aos antifúngicos. CONCLUSÃO: C. albicans foi a espécie mais observada. A maioria das amostras de Candida mostrou-se susceptível aos antifúngicos.

BACKGROUND: Yeasts of the genus Candida create colonization, superficial infections and systemic infections in immunodeficient individuals. The presentations of the disease lead to the necessity of using various diagnostic methods and treatments. OBJECTIVES: To differentiate among the Candida species, correlate them with the anatomical region involved and evaluate in vitro susceptibility to ketoconazole, fluconazole, itraconazole and amphotericin B. METHODS: An evaluation of 100 cases of immunocompetent patients with cutaneous or mucous candidiasis attended at the Santa Casa de Sao Paulo Hospital from May 1999 to July 2001. This study attempted to correlate the site of the involvement and the Candida species, isolated using the CHROMagar Candida® technique. The species were evaluated using the Etest® antifungal susceptibility to ketoconazole, fluconazole, itraconazole and amphotericin B. RESULTS: C. albicans was isolated in 76% of the material, C. krusei in 19% and C. tropicalis in 1%. It was not possible to establish a significant correlation between the involved area and the species isolated. Most of the samples proved to be susceptible to the antifungals tested. CONCLUSIONS: C. albicans was the most commonly observed species. The majority of samples presented susceptibility to the tested antifungals.

Os Autores registram o primeiro caso de dermatofitose por Trichophyton raubitschekii em paciente do Estado de São Paulo, com lesões de Tinea corporis localizada nas nádegas. O cultivo em ágar-Sabouraud com cicloheximida permitiu o isolamento e identificação do fungo, cujo diagnóstico foi confirmado pela Drª Lynne Sigler, da Universidade de Alberta, Canadá. O tratamento sistêmico com fluconazol, 150mg/semana por 4 semanas, associado ao tratamento tópico com isoconazol ofereceu inicialmente resultados favoráveis, com recidiva das lesões, após suspensão do medicamento. Trata-se do quinto caso publicado na literatura médica nacional.

The authors report the first case of dermatophytosis caused by Trichophyton raubitschekii in a patient from the State of São Paulo with Tinea corporis lesions localized on the buttocks. Culture on Sabouraud-agar with cycloheximide permitted the isolation and identification of the fungus, and the diagnosis was confirmed by Dr. Lynne Sigler, University of Alberta, Canada. Systemic treatment with fluconazole, 150 mg/week for 4 weeks, in combination with topical treatment with isoconazole initially yielded favorable results, with recurrence of the lesions after the medication was discontinued. This is the fifth case of this dermatophytosis published in the Brazilian medical literature.

O presente trabalho registra um caso de feo-hifomicose subcutânea em paciente do sexo masculino com o diagnóstico de sarcoidose pulmonar, submetido à terapêutica por corticosteróides quando apresentou no dorso da mão direita lesões cutâneas nodulares, eritêmato-violáceas, de aspecto infiltrado, exigindo biópsia para o diagnóstico. O exame histopatológico revelou processo granulomatoso, com a presença de hifas e células arredondadas demácias. Cultivo positivo para fungo identificado com Phoma cava. Os Autores fizeram revisão da literatura sobre as infecções fúngicas provocadas por diversas espécies de Phoma, mostrando a raridade desta observação. A evolução foi favorável com a administração da anfotericina B (via venosa) seguida do itraconazol (via oral)

We report a case of subcutaneous pheohyphomycosis observed in a male patient presenting pulmonary sarcoidosis and submitted to corticosteroid treatment. He presented nodular erythematous-violaceous skin lesions in the dorsum of the right hand. Histopathological examination of the biopsied lesion revealed dematiaceous hyphae and yeast-like cells, with a granulomatous tissual reaction. The isolated fungus was identified as Phoma cava. A review of the literature on fungal infection caused by different Phoma species, is presented. The patient healed after therapy with amphotericin B, followed by itraconazole

Os autores registram caso de hialo-hifomicose subcutânea por Acremonium recifei em paciente branca, imunocompetente, natural da Bahia, com história de traumatismo no dorso da mão direita. A lesão era indolor, com edema, inflamação, presença de fístulas, secreção seropurulenta, e ausência de grãos. O exame histopatológico mostrou hifas septadas hialinas pela hematoxilina-eosina. Cultura positiva para Acremonium recifei, espécie identificada em 1934, pela primeira vez, por Arêa Leão & Lobo, com o nome de Cephalosporium recifei, de um caso de eumicetoma podai por grãos branco-amarelados. Tratamento com itraconazol, 200 mg ao dia, com evolução favorável e cura do processo. No Brasil, trata-se do primeiro registro de hialohifomicose provocado por esta espécie, cujo habitat deve ser o solo.

We present a case of subcutaneous hyalohyphomycosis due to Acremonium recifei, a species whose habitat is probably the soil, first identified in 1934 by Arêa Leão and Lobo in a case of podal eumycetoma with white-yellowish grains and initially named Cephalosporium recifei. A white immunocompetent female patient from the state of Bahia, Brazil, with a history of traumatic injury to the right hand is reported. The lesion was painless, with edema, inflammation and the presence of fistulae. Seropurulent secretion with the absence of grains was present. Histopathological examination of material stained with hematoxylin-eosin showed hyaline septate hyphae. A culture was positive for Acremonium recifei. Treatment with itraconazole, 200 mg/day, for two months led to a favorable course and cure of the process. We report for the first time in the literature a case of subcutaneous hyalohyphomycosis due to Acremonium recifei in a immunocompetent woman. Treatment with itraconazole 200 mg/day, for two months, resulted in cure.

Os autores estudaram 31 pacientes portadores de tinhas crural, do corpo e do pé interdigital, tratados com 100 mg de itraconazol, administrados junto com o almoço, durante 15 dias. Foram realizadas 3 avaliações clínicas e micológicas: no pré-tratamento, no final do tratamento e 2 semanas após o tratamento. O itraconazol mostrou-se eficaz para o tratamento das dermatofitoses estudadas, na dose empregada, com 100% de cura micológica. Em relação a evolução clínica, houve diminuição estatística significante (teste de Friedman - p < 0,001) dos sinais e sintomas avaliados. Não foi observada ocorrência de efeitos colaterais.

The authors studied 31 patients with Tinea cruris, corporis or pedis interdigital. The patients were treated with 100 mg of itraconazole, once a day, during the lunch, for 15 days. Mycological and clinical evaluations were performed at the pre-treatment, by the end of treatment and 2 weeks after finishing the treatment. The results showed that itraconazole is effective for the treatment of dermatophytosis, at the studied posology. with 100% of mycological cure. Clinical evaluation showed a significant reduction (Friedman test - p < 0.001) of signs and symptoms. No side-effect was registered.