title: Positive Montenegro skin test among patients with sporotrichosis in Rio De Janeiro.
abstract: 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.
authors.affiliation: 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
authors.forename: Mônica Bastos
authors.initials: MB
authors.lastname: de Lima Barros
authors.forename: Armando
authors.initials: A
authors.lastname: Schubach
authors.forename: Antônio Carlos
authors.initials: AC
authors.lastname: Francesconi-do-Valle
authors.forename: Maria Clara
authors.initials: MC
authors.lastname: Gutierrez-Galhardo
authors.forename: Tânia Maria Pacheco
authors.initials: TM
authors.lastname: Schubach
authors.forename: Fátima
authors.initials: F
authors.lastname: Conceição-Silva
authors.forename: Mariza
authors.initials: M
authors.lastname: de Matos Salgueiro
authors.forename: Eliame
authors.initials: E
authors.lastname: Mouta-Confort
authors.forename: Rosani Santos
authors.initials: RS
authors.lastname: Reis
authors.forename: Maria
authors.initials: M
authors.lastname: de Fátima Madeira
authors.forename: Tullia
authors.initials: T
authors.lastname: Cuzzi
authors.forename: Leonardo Pereira
authors.initials: LP
authors.lastname: Quintella
authors.forename: Janaína Pinho
authors.initials: JP
authors.lastname: da Silva Passos
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Conceição
authors.forename: Mauro Célio
authors.initials: MC
authors.lastname: de Almeida Marzochi
mesh_terms: 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
chemical_list: D000908:Antibodies, Fungal; D000935:Antifungal Agents; D000953:Antigens, Protozoan; C032127:leishmanin; D017964:Itraconazole