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IDENTIFICATION BY MALDI-TOF MS OF SPOROTHRIX BRASILIENSIS ISOLATED FROM A SUBCONJUNCTIVAL INFILTRATIVE LESION IN AN IMMUNOCOMPETENT PATIENT
Sporothrix brasiliensis
Ocular sporotrichosis
Fungal identification
MALDI-TOF-MS
Author
Affilliation
Universidade Federal de Juiz de Fora. Hospital Universitário. Departamento de Oftalmologia. Juiz de Fora, MG, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Juiz de Fora. Hospital Universitário. Departamento de Oftalmologia. Juiz de Fora, MG, Brasil.
Universidade Federal de Juiz de Fora. Hospital Universitário. Departamento de Oftalmologia. Juiz de Fora, MG, Brasil.
Universidade Federal de Juiz de Fora. Hospital Universitário. Departamento de Oftalmologia. Juiz de Fora, MG Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Juiz de Fora. Departamento de Farmácia. Juiz de Fora, MG, Brasil.
Universidade Federal do Rio de Janeiro. Instituto de Microbiologia Paulo de Goes. Rio de Janeiro, RJ, Brasil.
Universidade do Minho. CEB-Biological Engineering Centre. Campus Braga, Portugal.
Hospital Nove de Julho. Instituto Oncológico. Departamento de Imagem. São Paulo, SP, Brasil.
Universidade Federal de Juiz de Fora. Faculdade de Medicina. Departamento de Patologia. Juiz de Fora, MG, Brasil.
Universidad de La Feontera. BIOIREN-UFRO. Department of Chemical Science and Natural Resources. Temuco, Chile.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Taxonomia, Bioquímíca e Bioprospecção de Fungos. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Juiz de Fora. Hospital Universitário. Departamento de Oftalmologia. Juiz de Fora, MG, Brasil.
Universidade Federal de Juiz de Fora. Hospital Universitário. Departamento de Oftalmologia. Juiz de Fora, MG, Brasil.
Universidade Federal de Juiz de Fora. Hospital Universitário. Departamento de Oftalmologia. Juiz de Fora, MG Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Juiz de Fora. Departamento de Farmácia. Juiz de Fora, MG, Brasil.
Universidade Federal do Rio de Janeiro. Instituto de Microbiologia Paulo de Goes. Rio de Janeiro, RJ, Brasil.
Universidade do Minho. CEB-Biological Engineering Centre. Campus Braga, Portugal.
Hospital Nove de Julho. Instituto Oncológico. Departamento de Imagem. São Paulo, SP, Brasil.
Universidade Federal de Juiz de Fora. Faculdade de Medicina. Departamento de Patologia. Juiz de Fora, MG, Brasil.
Universidad de La Feontera. BIOIREN-UFRO. Department of Chemical Science and Natural Resources. Temuco, Chile.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Taxonomia, Bioquímíca e Bioprospecção de Fungos. Rio de Janeiro, RJ, Brasil.
Abstract
Sporotrichosis is a globally distributed subcutaneous fungal infection caused by dimorphic fungi belonging to the Sporothrix species complex that a ects the skin of limbs predominantly, but not exclusively. A rare case of ocular sporotrichosis in an immunocompetent Brazilian patient from the countryside of Rio de Janeiro State is reported. A 68-year-old woman presented with a subconjunctival infiltrative lesion in the right eye with pre-auricular lymphadenopathy of onset 4 months ago that evolved to suppurative nodular lesions on the eyelids. Conjunctival secretion was evaluated by histopathological examination and inoculated on Sabouraud Dextrose Agar (SDA). Histopathology showed oval bodies within giant cells and other mononucleated histiocytes. Fungus grown on SDA was identified as Sporothrix sp. by morphological observations. The isolated strain was finally identified by Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) associated with an in-house database enriched with reference Sporothrix complex spectra. The strain presented a MALDI spectrum with the ion peaks of the molecular mass profile of S. brasiliensis. The patient was adequately treated with amphotericin B subsequently replaced byAbstract: Sporotrichosis is a globally distributed subcutaneous fungal infection caused by dimorphic fungi belonging to the Sporothrix species complex that a ects the skin of limbs predominantly, but not exclusively. A rare case of ocular sporotrichosis in an immunocompetent Brazilian patient from the countryside of Rio de Janeiro State is reported. A 68-year-old woman presented with a subconjunctival infiltrative lesion in the right eye with pre-auricular lymphadenopathy of onset 4 months ago that evolved to suppurative nodular lesions on the eyelids. Conjunctival secretion was evaluated by histopathological examination and inoculated on Sabouraud Dextrose Agar (SDA). Histopathology showed oval bodies within giant cells and other mononucleated histiocytes. Fungus grown on SDA was identified as Sporothrix sp. by morphological observations. The isolated strain was finally identified by Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) associated with an in-house database enriched with reference Sporothrix complex spectra. The strain presented a MALDI spectrum with the ion peaks of the molecular mass profile of S. brasiliensis. The patient was adequately treated with amphotericin B subsequently replaced by itraconazole. Due to scars left by the suppurative process, the patient presented poor final visual acuity. The present work presents an overview of ocular sporotrichosis and discusses the diagnostic di culty that can lead to visual sequelae in these cases.
Keywords
SporotrichosisSporothrix brasiliensis
Ocular sporotrichosis
Fungal identification
MALDI-TOF-MS
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