Clinical, epidemiological and mycological report on 65 patients from the Eastern Amazon region with chromoblastomycosis.
BACKGROUND
Chromoblastomycosis is a chronic fungal infection caused by fungi from the Dematiaceae family. According to several studies, Fonsecaea pedrosoi is the most common of these fungi. The infection is more common in tropical countries, with the Brazilian state of Pará having one of the largest infected populations worldwide. The disease is difficult to treat and recurrences are common.


OBJECTIVE
To describe the epidemiological and mycological aspects of cases of chromoblastomycosis and its clinical forms in the state of Pará, Brazil.


METHODS
Mycological exams (direct mycological examinations, culture and microculture) were performed and a clinical/epidemiological evaluation was made of 65 patients receiving care at the Dermatology Department of the Federal University of Pará between 2000 and 2007. The clinical classification proposed by Carrión in 1950 was used in this study.


RESULTS
The majority of the patients were male (93.8%), agricultural workers (89.2%) of 45 to 55 years of age, and the majority of lesions (55.4%) were of the verrucous type, located principally on the lower limbs (81.5%). In the majority of the cases investigated (61.5%), the infection had been present for a long time, with a mean duration of 11 years. Direct mycological examination was performed in 86.2% of the patients (n=56). Of these, 96.4% (n=54) tested positive. Culture and microculture were performed in vitro in 47 cases of those that tested positive at direct microscopy, results showing Fonsecaea pedrosoi to be the only agent present in this sample.


CONCLUSIONS
This study highlighted the extent to which chromoblastomycosis still affects the quality of life of the local population, principally individuals working in agriculture. This is a chronic disease for which there is no effective treatment. The importance of continuing to investigate this disease should be emphasized, as further studies may lead to new clinical or epidemiological findings.
Federal University of Pará, Belem, Brazil. carlaavelarpires@bol.com.br
Carla Andréa Avelar
CA
Pires
Marilia Brasil
MB
Xavier
Juarez Antônio Simões
JA
Quaresma
Geraldo Mariano Moraes de
GM
Macedo
Bruna Ranyelle de Marinho
BR
Sousa
Arival Cardoso de
AC
Brito
D000368:Aged; D001203:Ascomycota / Q000145:classification / Q000302:isolation & purification*; D001938:Brazil / Q000453:epidemiology; D002862:Chromoblastomycosis / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged