Chromoblastomycosis in Latin America and the Caribbean: Epidemiology over the past 50 years

Author:

Guevara Armando1,Siqueira Nathan Pereira1,Nery Andreia Ferreira23,Cavalcante Leticia Rossetto da Silva3,Hagen Ferry45ORCID,Hahn Rosane Christine13

Affiliation:

1. Mycology/Research Laboratory, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, CEP 78060-900, Brazil

2. Department of Internal Medicine, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, CEP 78048-902, Brazil

3. Júlio Muller University Hospital, Federal University of Mato Grosso, Cuiabá, Mato Grosso, CEP 78048-902, Brazil

4. Westerdijk Fungal Biodiversity Institute, Utrecht, 3584CT, the Netherlands

5. Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, 3584CX, the Netherlands

Abstract

Abstract Chromoblastomycosis is a chronic disease caused by melanized fungi that mainly affect individuals performing soil-related labor. The objective of this study was to analyze the epidemiological and clinical characteristics of chromoblastomycosis in Latin America and the Caribbean by an extensive literature review. An integrative review was performed of English, French, Portuguese, and Spanish publications in LILACS, SciELO, PubMed, SCOPUS and Web of Science databases covering the period 1969–2019. A total of 1211 articles were identified, of which 132 were included in the review, covering 2081 patients, 80.3% were males, the mean age was 56.1 years. The mean duration of the disease was 10.8 years. The lesions were mainly described in the lower limbs (60%). The most frequent clinical forms were verrucous (46.4%) and tumorous (21.7%). Major disease symptoms and signs consisted of itching and pain. Bacterial infection and functional limitation were important complications. Immunosuppression post-kidney transplantation was the most frequent comorbidity while leprosy was the main concomitant infectious disease. Fonsecaea pedrosoi and Cladophialophora carrionii were the predominant etiological agents. Majority of the cured cases were treated with itraconazole as monotherapy or in combination with other antifungals, surgery or cryosurgery. Chromoblastomycosis affects hundreds of rural workers in Latin America and the Caribbean, causing disability and personal, family and economic losses. It is important to prioritize epidemiological surveillance and early diagnosis of this disease in order to reveal its real prevalence and direct resources to preventive actions, diagnosis and early treatment. Lay summary Chromoblastomycosis is a slowly progressing chronic disease caused by melanized fungi. We collected data from South America and the Caribbean covering 1969–2019, the 132 articles included 2081 patients, mean disease duration was 10.8 years. Fonsecaea pedrosoi and Cladophialophora carrionii predominated.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,General Medicine

Reference212 articles.

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