Positive Montenegro skin test among patients with sporotrichosis in Rio De Janeiro.
We studied 52 patients with sporotrichosis confirmed by isolation of Sporothrix schenckii and reactivity to the Montenegro skin test (MST) during an ongoing outbreak of this mycosis in Rio de Janeiro. The objective was to emphasize the importance of parasitological confirmation and the possibility of incorrect diagnosis based on the lesion's appearance, epidemiological information, and immunological tests. The antigen used for the MST was conserved in either thimerosal 1:10,000 (group 1) or 0.4% phenol (group 2). Nineteen patients (39%) in group 1 and seven (12%) in group 2 presented an induration>or=10 mm (p<0.001). Sera from three patients (6.7%) reacted to indirect immunofluorescence (IIF) for leishmaniasis, while sera from 10 patients (22.2%) reacted to enzyme-linked immunosorbent assay (ELISA). Fifteen patients (28.8%) presented up to two lesions, with a predominance of ulcers. Forty-four patients (84.6%) were treated with itraconazole. In the differential diagnosis between sporotrichosis and cutaneous leishmaniasis, the possibility of co-infection, allergy to the reagent diluent, and cross-reactions should be further investigated, especially in regions with limited laboratory facilities.
de Lima Barros
Mônica Bastos
MB
Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz (Fiocruz), Av. Brasil 4365, Manguinhos, Rio de Janeiro CEP 21045-900, Brazil. monica@ipec.fiocruz.br
Schubach
Armando
A
Francesconi-do-Valle
Antônio Carlos
AC
Gutierrez-Galhardo
Maria Clara
MC
Schubach
Tânia Maria Pacheco
TM
Conceição-Silva
Fátima
F
de Matos Salgueiro
Mariza
M
Mouta-Confort
Eliame
E
Reis
Rosani Santos
RS
de Fátima Madeira
Maria
M
Cuzzi
Tullia
T
Quintella
Leonardo Pereira
LP
da Silva Passos
Janaína Pinho
JP
Conceição
Maria José
MJ
de Almeida Marzochi
Mauro Célio
MC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000908:Antibodies, Fungal / Q000097:blood; D000935:Antifungal Agents / Q000627:therapeutic use; D000953:Antigens, Protozoan; D001938:Brazil; D002648:Child; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D007892:Leishmania braziliensis / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012882:Skin Tests / Q000379:methods; D013175:Sporothrix / Q000302:isolation & purification*; D013174:Sporotrichosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology
D000908:Antibodies, Fungal; D000935:Antifungal Agents; D000953:Antigens, Protozoan; C032127:leishmanin; D017964:Itraconazole