title: Fonsecaea pugnacius, a Novel Agent of Disseminated Chromoblastomycosis.
abstract: We report a fatal case of a chromoblastomycosis-like infection caused by a novel species of Fonsecaea in a 52-year-old immunocompetent Caucasian male from an area of chromoblastomycosis endemicity in Brazil. The patient had a 30-year history of slowly evolving, verrucous lesions on the right upper arm which gradually affected the entire arm, the left hemifacial area, and the nose. Subsequent dissemination to the brain was observed, which led to death of the patient. The internal transcribed spacer (ITS) and partial large subunit (LSU), BT2, and CDC42 genes of the isolates recovered from skin and brain were sequenced, confirming the novelty of the species. The species is clinically unique in causing brain abscesses secondary to chromoblastomycosis lesions despite the apparent intact immunity of the patient. Histopathologic appearances were very different, showing muriform cells in skin and hyphae in brain.
authors.affiliation: Department of Medicine, Federal University of Maranhão, Brazil, São Luis, MA, Brazil.
authors.forename: Conceição M P S
authors.initials: CM
authors.lastname: de Azevedo
authors.affiliation: Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Renata R
authors.initials: RR
authors.lastname: Gomes
authors.affiliation: Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil vicente@ufpr.br s.hoog@cbs.knaw.nl.
authors.forename: Vania A
authors.initials: VA
authors.lastname: Vicente
authors.affiliation: Institute of Infectious Diseases Emilio Ribas, São Paulo, SP, Brazil.
authors.forename: Daniel W C L
authors.initials: DW
authors.lastname: Santos
authors.affiliation: University Hospital of Federal University of Maranhão and Cedro Laboratories Maranhão, São Luis, MA, Brazil.
authors.forename: Sirlei G
authors.initials: SG
authors.lastname: Marques
authors.affiliation: Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Mariana M F
authors.initials: MM
authors.lastname: do Nascimento
authors.affiliation: Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Caroline E W
authors.initials: CE
authors.lastname: Andrade
authors.affiliation: Department of Medicine, Federal University of Maranhão, Brazil, São Luis, MA, Brazil.
authors.forename: Raimunda R
authors.initials: RR
authors.lastname: Silva
authors.affiliation: Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil Clinical Hospital of the Federal University of Paraná, Curitiba, PR, Brazil.
authors.forename: Flávio
authors.initials: F
authors.lastname: Queiroz-Telles
authors.affiliation: Microbiology, Parasitology and Pathology Post-graduation Program, Department of Basic Pathology, Federal University of Paraná, Curitiba, PR, Brazil Centraalbureau voor Schimmelcultures KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands vicente@ufpr.br s.hoog@cbs.knaw.nl.
authors.forename: G Sybren
authors.initials: GS
authors.lastname: de Hoog
mesh_terms: D001203:Ascomycota / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D001921:Brain / Q000382:microbiology / Q000473:pathology; D001938:Brazil; D002862:Chromoblastomycosis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D016000:Cluster Analysis; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D017809:Fatal Outcome; D006257:Head / Q000000981:diagnostic imaging; D006651:Histocytochemistry; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D012335:RNA, Ribosomal / Q000235:genetics; D011859:Radiography; D017422:Sequence Analysis, DNA; D012867:Skin / Q000382:microbiology / Q000473:pathology; D044465:White People
chemical_list: D004271:DNA, Fungal; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer; D012335:RNA, Ribosomal; C065096:RNA, ribosomal, 26S