Abstract
Implantation or subcutaneous mycoses are a frequent health problem in Latin American countries and other tropical and subtropical areas. Although such infections rarely cause disseminated or invasive disease, they have an important impact on public health, and timely diagnosis and appropriate treatment remain important. Although some implantation mycoses are found in immunocompromised persons, the immunocompetent population is the principal target in Latin America. Most etiologic agents are found in soil, vegetation, and decaying matter in tropical, subtropical, and humid environments and infection is commonly the result of penetrating injury. Infections primarily occur (1) among low socioeconomic groups, (2) among those living in rural areas or involved in farming, hunting, or other outdoor activities, and (3) particularly among adult men. This review focuses on the epidemiology of the most clinically significant implantation mycoses in Latin America, i.e., sporotrichosis, eumycetoma, chromoblastomycosis, subcutaneous phaeohyphomycosis, subcutaneous zygomycosis, and lacaziosis. Main epidemiologic findings, clinical manifestations, diagnosis, and treatment options are also discussed.
Acknowledgments
None.
Financial support: Schering-Plough, a subsidiary of Merck & Co., Inc.
Manuscript preparation: The authors wish to thank Sheena Hunt, PhD, for editorial assistance, with funding provided by Schering-Plough, a subsidiary of Merck & Co., Inc.
Potential conflicts of interest: F.Q.-T. has received research grants from Astellas, Janssen, Merck, and Pfizer; is a consultant for Pfizer, Merck, and Astellas; and has served as a speaker for Pfizer. M.N. has received research grants from Merck and Pfizer and served as a speaker and consultant for Merck, Pfizer, and Astellas. A.L.C. has received educational and research grants from United Medical, Merck, and Pfizer and is a consultant for Merck and Pfizer. A.T. has served as a speaker for Janssen and Merck. A.R. has no affiliation with and has received no grants from pharmaceutical companies.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
This paper was first published online on Early Online on 3 December 2010.