EDITORIAL ESPANOL:

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Hola amigos Dermatólogos, micólogos de la red,,, DERMAGIC en el aire,,, 

Hace unas semanas he estado leyendo en la lista FUNGI, la sugerencia para trabajos sobre ESPOROTRICOSIS, me gustó el tema y me fui a buscar referencias, encontré unas 80, que irán en dos (2) correos, espero que la disfruten TODOS, especialmente los amantes de la micología. 

Saludos a Todos...

Como datos interesantes de la esporotricosis te puedo comentar que:

La causa central de la infección es la introducción del hongo en el cuerpo a través de pequeñas heridas en la piel, generalmente tras el contacto con plantas, espinas o tierra contaminada. También puede adquirirse por mordeduras o arañazos de animales infectados, como gatos. Las lesiones tiende a ser lineales porque el hongo se desplaza a través de las cadenas linfáticas.

los gatos son una fuente importante de transmisión de esporotricosis, especialmente en áreas urbanas. Los felinos infectados pueden desarrollar lesiones ulcerativas y transmitir el hongo a través de mordeduras o arañazos. Otros animales, como perros, también pueden infectarse, aunque es menos común. La transmisión animal-humano es particularmente preocupante en el caso de los gatos, debido a la alta carga fúngica en sus lesiones y el contacto frecuente con humanos.

La etiología implica una infección subcutánea que puede progresar lentamente. Comienza con la formación de nódulos en la piel que pueden ulcerarse, extendiéndose a lo largo de los vasos linfáticos cercanos. En casos severos o en personas inmunodeprimidas, puede haber diseminación sistémica. 

El tratamiento estándar incluye el uso de antifúngicos como el itraconazol. En casos graves o resistentes, se pueden usar anfotericina B o terapias combinadas. La prevención incluye evitar lesiones al manipular plantas y animales. Además del itraconazol, se utilizan otros antifúngicos para tratar la esporotricosis. La anfotericina B es el tratamiento de elección en casos graves o diseminados, especialmente en pacientes inmunocomprometidos. 

El yoduro de potasio en solución saturada también ha sido empleado, aunque su uso ha disminuido debido a efectos secundarios. En casos resistentes, se puede considerar el uso de posaconazol o voriconazol. El tratamiento puede durar varias semanas o meses, dependiendo de la gravedad y localización de la infección.

Próximas ediciones: * ESPOROTRICOSIS II

* LA TOXINA BOTULÍNICA

 EDITORIAL ENGLISH:

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Hello friends, dermatologists, mycologists of the network,,, DERMAGIC in the air,,,

A few weeks ago I was reading on the FUNGI list, the suggestion for works on SPOROTHRICOSIS, I liked the topic and I went to look for references, I found about 80, which will go in two (2) emails, I hope that EVERYONE enjoys it, especially lovers of mycology.

Greetings to All...

As interesting data on sporotrichosis I can tell you that:

The central cause of the infection is the introduction of the fungus into the body through small wounds in the skin, generally after contact with plants, thorns or contaminated soil. It can also be acquired through bites or scratches from infected animals, such as cats. The lesions tend to be linear because the fungus moves through the lymphatic chains.

Cats are an important source of transmission of sporotrichosis, especially in urban areas. Infected felines may develop ulcerative lesions and transmit the fungus through bites or scratches. Other animals, such as dogs, can also become infected, although it is less common. Animal-human transmission is particularly concerning in cats, due to the high fungal load in their lesions and frequent contact with humans.

The etiology involves a subcutaneous infection that may progress slowly. It begins with the formation of nodules on the skin that may ulcerate, spreading along nearby lymphatic vessels. In severe cases or in immunosuppressed individuals, there may be systemic dissemination.

Standard treatment includes the use of antifungals such as itraconazole. In severe or resistant cases, amphotericin B or combination therapies may be used. Prevention includes avoiding injury when handling plants and animals. In addition to itraconazole, other antifungals are used to treat sporotrichosis. Amphotericin B is the treatment of choice in severe or disseminated cases, especially in immunocompromised patients.

Potassium iodide in saturated solution has also been used, although its use has decreased due to side effects. In resistant cases, the use of posaconazole or voriconazole may be considered. Treatment may last several weeks or months, depending on the severity and location of the infection.

Upcoming issues: * SPOROTHRICOSIS II

* BOTULINUM TOXIN

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DERMAGIC/EXPRESS(20)

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ESPOROTRICOSIS I // SPOROTRICHOSIS I 

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1.) Cutaneous sporotrichosis and distant autoinoculation.

2.) Disturbances in the production of interleukin-1 and tumor necrosis factor in disseminated murine sporotrichosis.

3.) A case of sporotrichosis treated successfully with oral fluconazole 200 mg once weekly.

4.) Subclinical hypothyroidism during potassium iodide therapy for lymphocutaneous sporotrichosis.

5.) Epidemiological study of sporotrichosis and histoplasmosis in captive Latin American wild mammals, Sao Paulo, Brazil.

6.) Epidemic cutaneous sporotrichosis.

7.) Therapy of sporotrichosis.

8.) Treatment of sporotrichosis with itraconazole. NIAID Mycoses Study Group.

9.) Effects of proteinase inhibitors on the cutaneous lesion of Sporothrix schenckii inoculated hairless mice.

10.) Antibody raised against extracellular proteinases of Sporothrix schenckii in S. schenckii inoculated hairless mice.

11.) Systemic sporotrichosis treated with itraconazole.

12.) [Experience with 241 sporotrichosis cases in Chiba/Japan]

13.) Nodular lymphangitis: a distinctive but often unrecognized syndrome.

14.) Cutaneous sporotrichosis in the period 1978-1992 in the province of Bari, Apulia, Southern Italy.

15.) Zoonotic transmission of sporotrichosis: case report and review [see comments]

16.) Successful treatment of sporotrichosis with oral fluconazole: a report of three cases.

17.) Comparison between histochemical and immunohistochemical methods 

for diagnosis of sporotrichosis.

18.) Hyperthermic treatment of sporotrichosis: experimental use of infrared and far infrared rays. Japan

19.) Role of cell-mediated immunity in the resistance to experimental sporotrichosis in mice.

20.) Saperconazole in the treatment of systemic and subcutaneous mycoses.

21.) Treatment of human cutaneous sporotrichosis with itraconazole.

22.) Detection of cellular immunity with the soluble antigen of the fungus Sporothrix schenckii in the systemic form of the disease.

23.) Treatment of cutaneous sporotrichosis with terbinafine.

24.) Tissue response in sporotrichosis: light and electron microscopy studies.

25.) Sporotrichosis presenting as pyoderma gangrenosum.

26.) An unusual presentation of fixed cutaneous sporotrichosis: a case report and review of the literature.

27.) Disseminated sporotrichosis in patients with AIDS: case report and review of the literature.

28.) Sporotrichosis following a rodent bite. A case report.

29.) Concurrent infection with sporotrichosis and blastomycosis: an unusual case.

30.) Ultrastructure of asteroid bodies in sporotrichosis.

31.) Sporotrichosis in Nepal.

32.) Cutaneous sporotrichosis in Thailand: first reported case.

33.) A case of sporotrichosis caused by two genetically different Sporothrix schenckii strains.

34.) Sporotrichosis with bilateral lesions. A case report.

35.) Sporotrichosis in the metropolitan area of Cusco, Peru, and in its region.

36.) A familial occurrence of sporotrichosis.

37.) Mother-and-child cases of sporotrichosis infection.

38.) Feline sporotrichosis: a case report.

39.) Epidemiology of sporotrichosis in Latin America.

40.) Sporotrichosis in the acquired immunodeficiency syndrome.

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1.) Cutaneous sporotrichosis and distant autoinoculation.

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SO - J Dermatol 1995 Jan;22(1):72-3

AU - Kim HU; Yun SK; Ihm CW

AD - Chonbuk National University Medical School, Chonju, Republic of Korea.

PT - JOURNAL ARTICLE

AB - A 56-year-old woman suffering from cutaneous sporotrichosis on the right cheek and right knee is described. The sporotrichotic nodule of the knee was thought to have been caused by distant autoinoculation.

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2.) Disturbances in the production of interleukin-1 and tumor necrosis factor in disseminated murine sporotrichosis.

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SO - Mycopathologia 1994 Sep;127(3):189-94

AU - Carlos IZ; Zini MM; Sgarbi DB; Angluster J; Alviano CS; Silva CL

PT - JOURNAL ARTICLE

AB - Production of Interleukin-1 (IL-1) and Tumor Necrosis Factor (TNF) by adherent peritoneal cells from BALB/c mice was measured at week 2, 4, 6, 8 and 10 after intravenous inoculation with 10(6) Sporothrix schenckii yeasts. As compared with age-matched controls, IL-1 and TNF production by adherent peritoneal cells from S. schenckii-infected mice was reduced severely at week 4 and 6 of infection and greater than normal at week 8 and 10. Moreover, between week 4 and 6 of infection there was a depression of delayed type hypersensitivity response to a specific whole soluble antigen, and an increase in fungal multiplication in the livers and spleens of infected mice. Thus, the deficits of cell-mediated immunity in mice with systemic S. schenckii infection may derive, in part, from impaired amplification of the immune response consequent to abnormal generation of IL-1 and TNF.

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3.) A case of sporotrichosis treated successfully with oral fluconazole 200 mg once weekly.

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SO - Mycoses 1994 Jul-Aug;37(7-8):281-3

AU - Yoshida M; Hiruma M; Tezuka T

AD - Department of Dermatology, Kinki University School of Medicine, Osaka, Japan.

PT - JOURNAL ARTICLE

AB - A case of fixed cutaneous sporotrichosis that developed on the extensor aspect of the left wrist of an 83-year-old woman was treated once a week with 200 mg of oral fluconazole. This dermatological lesion healed within 4 months, leaving a scar. No side-effects were seen. At the time of writing, 7 months after the end of treatment, there has been no recurrence. Reports on the efficacy of once-weekly fluconazole administration in cases of sporotrichosis have appeared, but it would be valuable to study more such cases.

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4.) Subclinical hypothyroidism during potassium iodide therapy for lymphocutaneous sporotrichosis.

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SO - Cutis 1994 Mar;53(3):128-30

AU - Lesher JL Jr; Fitch MH; Dunlap DB

AD - Department of Dermatology, Medical College of Georgia, Augusta 

PT - JOURNAL ARTICLE

AB - This report describes a high school football player with an unusual ulcerative lesion on the upper leg that was treated initially as pyoderma gangrenosum, but later proved to be due to Sporothrix schenckii. His treatment with potassium iodide solution was complicated by the occurrence of subclinical hypothyroidism.

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5.) Epidemiological study of sporotrichosis and histoplasmosis in captive Latin American wild mammals, Sao Paulo, Brazil.

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SO - Mycopathologia 1994 Jan;125(1):19-22

AU - Costa EO; Diniz LS; Netto CF; Arruda C; Dagli ML

AD - Fac. Medicina Veterinaria da Universidade de Sao Paulo, Dep. Medicina Preventiva a Saude Animal-Doencas Infecciosas, Brazil.

PT - JOURNAL ARTICLE

AB - Sporotrichosis and histoplasmosis are deep mycosis with a high incidence in human beings in Brazil. In domestic animals histoplasmosis has been described only in dogs, but the occurrence of sporotrichosis among domestic animals in Brazil has been described in dogs, cats, mules and asses. There is also a case of this disease reported in a chimpanzee (Pan troglodites). The purpose of this research was to perform an epidomiological study of these mycoses using delayed hypersensitivity tests (histoplasmin and sporotrichin) in Latin American wild mammals. This research was assayed using 96 healthy animals at Parque Zoologico de Sao Paulo, Brazil: Primates: 33 Cebus apella--weeping-capuchin and 16 Callithrix jacchus--marmoset; Procyonidae: 37 Nasua nasua--coatimundi and 10 Felidae (Panthera onca--jaguar; Felis pardalis--ocelot Felis wiedii--margay; Felis tigrina--wild cat). For intradermic tests, the following antigens were used: Sporothrix schenkii cell suspension (sporotrichin, histoplasmin-filtrate), Histoplasma capsulatum cell suspension (histoplasmin), and Histoplasma capsulatum (polysaccharide). The positivity to histoplasmin was 44.79% (Cebidae 15.15%; Callithricidae 6.25%; Procyonidae 86.49% and Felidae 50.00%, respectively). With respect to sporotrichin, 30.21% (Cebidae 6.06%, Callithricidae 0.0%; Procyonidae 64.86% and Felidae 30.00% respectively). The pattern of infection is similar to that shown by human beings and this may suggest that these animals could be involved in the epidemiologic chain of sporotrichosis and histoplasmosis, the second most prevalent human deep mycoses in Brazil. It is important to point out the absence of similar studies in Latin American wild animals.

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6.) Epidemic cutaneous sporotrichosis.

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SO - Int J Dermatol 1994 Jan;33(1):38-41

AU - Campos P; Arenas R; Coronado H

AD - Department of Dermatology, Aranda de la Parra Hospital, Leon, Mexico.

PT - JOURNAL ARTICLE

AB - BACKGROUND. Sporotrichosis is a subcutaneous fungal infection. Lymphocutaneous and fixed sporotrichosis are the most common forms; cases of disseminated sporotrichosis are rare. There have been isolated reports and some epidemic familial outbreaks of the infection. METHODS. We studied four members of two families who contracted sporotrichosis after sleeping in an old and rust-stained camping tent. RESULTS. All cases presented with polymorphic lesions, three of them with multiple sites of inoculation. The camping tent was shown to be the source of infection. CONCLUSIONS. We report an epidemic of sporotrichosis in a family. In three cases disseminated cutaneous sporotrichosis occurred in nonimmunodeficient patients. The isolate of Sporothrix schenckii from a camping tent is extremely rare.

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7.) Therapy of sporotrichosis.

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SO - Semin Dermatol 1993 Dec;12(4):285-9

AU - Mercurio MG; Elewski BE

AD - Department of Dermatology, University Hospitals of Cleveland, Case Western Reserve University, OH 44106.

PT - JOURNAL ARTICLE; REVIEW (24 references); REVIEW, TUTORIAL

AB - Sporotrichosis is a fungal infection caused by the dimorphic organism, Sporothrix schenkii. This etiologic agent typically gains entrance into the skin by traumatic implantation of infected soil or plant materials. The majority of cases are of the fixed cutaneous or lymphangitic cutaneous varieties, and less commonly, hematogenous dissemination to skin or viscera occurs. Untreated, the disease may spontaneously resolve or persist and gradually progress over time, its virulence being less than that of other dimorphic fungi. Potassium iodide remains a favored treatment for uncomplicated cutaneous disease. Amphotericin B, with its high toxicity, has historically been reserved for recalcitrant cutaneous or disseminated disease. Itraconazole, the newest triazole antifungal to become available in the United States, seems to be highly effective against Sporothrix schenkii without significant adverse effects and will likely become the first line therapy for all forms of this disease in the future.

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8.) Treatment of sporotrichosis with itraconazole. NIAID Mycoses Study Group.

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SO - Am J Med 1993 Sep;95(3):279-85

AU - Sharkey-Mathis PK; Kauffman CA; Graybill JR; Stevens DA; Hostetler JS; Cloud G; Dismukes WE

AD - Audie L. Murphy Memorial Veterans Hospital, San Antonio, Texas.

PT - JOURNAL ARTICLE

AB - PURPOSE: To describe the clinical presentation and outcomes of treatment with itraconazole in patients with sporotrichosis. METHODS: A culture for Sporothrix schenckii or compatible histopathology was required for inclusion in the study. Patients with both cutaneous and systemic sporotrichosis were treated. Patients received from 100 to 600 mg of itraconazole daily for 3 to 18 months. Patients were classified as responders or nonresponders. Responders were further classified as remaining on treatment, relapsed, or free of disease. Nonresponders included patients who failed to respond or progressed during treatment with itraconazole. RESULTS: Twenty-seven patients (mean age: 53 years) were treated with 30 courses of itraconazole. Diabetes mellitus and alcoholism were present in eight and seven patients, respectively. Sites of involvement included lymphocutaneous alone in 9 patients, articular/osseous in 15 (multifocal in 3), and lung in 3. Prior therapy was unsuccessful in 11 patients. Among the 30 courses, there were 25 responders and 5 nonresponders. All 5 nonresponders received at least 200 mg daily of itraconazole for durations that ranged from 6 to 18 months. Of the 25 responders, 7 relapsed 1 to 7 months after treatment durations of 6 to 18 months. Of the 7 who relapsed, 2 are responding to a second course. One responder was lost to follow-up after 10 months of treatment with itraconazole. Of the remaining 17 responders, 3 remain on treatment, and 14 are free of disease over follow-up durations of 6 to 42 months (mean: 17.6 months). Itraconazole was well tolerated with few side effects noted. CONCLUSIONS: These results document the efficacy of itraconazole in the treatment of cutaneous and systemic sporotrichosis.

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9.) Effects of proteinase inhibitors on the cutaneous lesion of Sporothrix schenckii inoculated hairless mice.

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SO - Mycopathologia 1993 Aug;123(2):81-5

AU - Lei PC; Yoshiike T; Ogawa H

AD - Department of Dermatology, Juntendo University School of Medicine, Tokyo, Japan.

PT - JOURNAL ARTICLE

AB - Sporothrix schenckii produces two extracellular proteinases, namely proteinase I and II. Proteinase I is a serine proteinase, inhibited by chymostatin. On the other hand, proteinase II is an aspartic proteinase, inhibited by pepstatin. The addition of either pepstatin or chymostatin to the culture medium did not inhibit cell growth, however the addition of both inhibitors strongly inhibited fungal growth. Accordingly, this suggested that extracellular proteinases play an important role in cell growth and that such cell growth may be suppressed if these proteinases are inhibited. In order to substantiate this speculation in sporotrichosis, the effects of proteinase inhibitors on the cutaneous lesions of mice were studied. Ointments containing 0.1% chymostatin, 0.1% pepstatin and 0.1% chymostatin-0.1% pepstatin were applied twice daily on the inoculation sites of hairless mouse skin, and the time courses of the lesions examined. The inhibitory effect in vivo on S. schenckii was similar to that demonstrated in our previous in vitro study. Compared to the control, the time course curve of the number of nodules present after the application of either pepstatin or chymostatin was slightly suppressed. The application of both pepstatin and chymostatin, however, strongly suppressed nodule formation. This study not only confirmed the role of 2 proteinases of S, schenckii for fungal growth in vivo, but also may lead to their use as new topical therapeutic agents.

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10.) Antibody raised against extracellular proteinases of Sporothrix schenckii in S. schenckii inoculated hairless mice.

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SO - Mycopathologia 1993 Aug;123(2):69-73

AU - Yoshiike T; Lei PC; Komatsuzaki H; Ogawa H

AD - Department of Dermatology, Juntendo University School of Medicine, Tokyo, Japan.

PT - JOURNAL ARTICLE

AB - Sporothrix schenckii produces two extracellular proteinases, namely proteinase I and II. Proteinase I is a serine proteinase, inhibited by chymostatin, while proteinase II is an aspartic proteinase, inhibited by pepstatin. Studies on substrate specificity and the effect of proteinase inhibitors on cell growth suggest an important role for these proteinases in terms of fungal invasion and growth. There has, however, been no evidence presented demonstrating that S. schenckii produces 2 extracellular proteinases in vivo. In order to substantiate the in vivo production of proteinases and to attempt a preliminary serodiagnosis of sporotrichosis, serum antibodies against 2 proteinases were assayed using S. schenckii inoculated hairless mice. Subsequent to an intracutaneous injection of S. schenckii to the mouse skin, nodules spontaneously formed and disappeared for a period of 4 weeks. Histopathological examination results were in accordance with the microscopic observations. Micro-organisms disappeared during the fourth week. Serum antibody titers against purified proteinases I and II were measured weekly, using enzyme-linked immunosorbent assay (EIA). As a result, the time course of the antibody titers to both proteinases I and II were parallel to that of macroscopic and microscopic observations in an experimental mouse sporotrichosis model. These results suggest that S. schenckii produces both proteinases I and II in vivo. Moreover, the detection of antibodies against these proteinases can contribute to a serodiagnosis of sporotrichosis.

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11.) Systemic sporotrichosis treated with itraconazole.

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SO - Clin Infect Dis 1993 Aug;17(2):210-7

AU - Winn RE; Anderson J; Piper J; Aronson NE; Pluss J

AD - Department of Medicine, Fitzsimons Army Medical Center, Aurora, Colorado 80045.

PT - JOURNAL ARTICLE

AB - Amphotericin B is recommended for the treatment of systemic infection caused by Sporothrix schenckii. However, this agent is toxic, its use is frequently followed by relapse, and some isolates of S. schenckii are resistant. Recent studies suggest that newer azole compounds, such as itraconazole, are effective in cutaneous and lymphocutaneous sporotrichosis, but data on their efficacy in systemic infections are scarce. We used itraconazole in the sequential treatment of six patients with systemic sporotrichosis: three with bone and joint disease and three with disseminated infection manifested by subcutaneous nodules. In all six cases, symptoms and signs of infection improved, with resolution of subcutaneous nodules, normalization of imaging studies, cessation of wound drainage, and return of joint mobility and function. No toxicity was noted. One patient with disseminated infection had a relapse while receiving 100 mg of itraconazole daily. The average duration of follow-up was 18 months. Thus itraconazole appears promising for the treatment of systemic sporotrichosis. A dose of at least 200 mg/d appears to be needed to prevent relapse.

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12.) [Experience with 241 sporotrichosis cases in Chiba/Japan]

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TT - [Erfarungen mit 241 Sporotrichose-Fallen in Chiba/Japan.]

SO - Hautarzt 1993 Aug;44(8):524-8

AU - Eisfelder M; Okamoto S; Toyama K

AD - Department of Dermatology, School of Medicine, Chiba University.

PT - JOURNAL ARTICLE

AB - Between 1965 and 1991, 241 cases of sporotrichosis have been seen in the Department of Dermatology at Chiba University Hospital. Children under the age of 12 and patients older than 40 years had a higher rate of infection. Most affected were the upper extremities, followed by lesions of the face. One hundred twenty-four patients (51.5%) were farmers. The decrease in the number of patients observed since 1983 is attributed mainly to a drop in the percentage of the local population involved in agriculture. There was no correlation between the number of infections and the amount of precipitation, as had been suggested earlier. The patients were treated with potassium iodide and in some cases with additional thermotherapy.

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13.) Nodular lymphangitis: a distinctive but often unrecognized syndrome.

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SO - Ann Intern Med 1993 Jun 1;118(11):883-8

AU - Kostman JR; Di Nubile MJ

AD - Cooper Hospital/University Medical Center, Robert Wood Johnson Medical School, Camden, New Jersey.

PT - JOURNAL ARTICLE; REVIEW (78 references); REVIEW, MULTICASE

AB - PURPOSE: To describe nodular lymphangitis by reviewing the clinical and epidemiologic features of this disease with an emphasis on distinguishing specific etiologic agents. DATA SOURCES: English-language articles were identified through a MEDLINE search (1966 to September 1992) using sporotrichosis, lymphangitis, and sporotrichoid as key words; additional references were selected from the bibliographies of identified articles. In addition, three new patients with nodular lymphangitis are described. STUDY SELECTION: One hundred fifty articles were reviewed to determine details of the etiologic agents and clinical signs and symptoms of patients with nodular lymphangitis. DATA SYNTHESIS: Nodular lymphangitis develops most commonly after cutaneous inoculation with Sporothrix schenckii, Nocardia brasiliensis, Mycobacterium marinum, Leishmania braziliensis, and Francisella tularensis. The setting in which infection is acquired is useful in differentiating among the various organisms causing infection. Sporotrichosis and leishmaniasis can have longer incubation periods than do the other common causes of nodular lymphangitis. A painful ulcer at the site of the initial lesion suggests tularemia; frankly purulent drainage often accompanies infections with Francisella and Nocardia species. Ulcerated or suppurating lymphangitic nodules occur commonly with Nocardia infections. Patients with nodular lymphangitis who fail to respond to empiric treatment for sporotrichosis should be evaluated for other organisms with appropriate biopsies and cultures. CONCLUSIONS: Nodular lymphangitis has distinctive clinical signs and symptoms, most commonly due to infection with a limited number of organisms. A detailed history, accompanied by information obtained from skin biopsy specimens using appropriate stains and cultures, should allow specific, effective therapy for most of these infections.

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14.) Cutaneous sporotrichosis in the period 1978-1992 in the province of Bari, Apulia, Southern Italy.

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SO - Mycoses 1993 May-Jun;36(5-6):181-5

AU - Barile F; Mastrolonardo M; Loconsole F; Rantuccio F

AD - Department of Dermatology, University of Bari, Italy.

PT - JOURNAL ARTICLE

AB - The authors report 16 cases of cutaneous sporotrichosis observed in the province of Bari, southern Italy, since 1978. While no more than 55 cases have been documented in other European countries in the last 30 years, in Italy 58 cases (present series included) have been recorded in the same time period. Furthermore, 42 of them (73.7%) originated from Apulia. This unexpectedly high incidence rate in Italy, and in Apulia in particular, provides evidence of the important role played by this area in the ecoepidemiology of sporotrichosis in Europe.

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15.) Zoonotic transmission of sporotrichosis: case report and review [see comments]

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CM - Comment in: Clin Infect Dis 1993 Dec; 17(6):1075

SO - Clin Infect Dis 1993 Mar;16(3):384-7

AU - Reed KD; Moore FM; Geiger GE; Stemper ME

AD - Microbiology Section, Marshfield Laboratories, Wisconsin 54449.

PT - JOURNAL ARTICLE; REVIEW (22 references); REVIEW OF REPORTED CASES

AB - We report a case of sporotrichosis in a veterinarian who acquired the infection from a cat. Transmission was confirmed at the genetic level by demonstration that the two clinical isolates of Sporothrix schenckii had identical restriction-fragment-length profiles of whole-cell DNA. Review of the literature indicates that zoonotic transmission of sporotrichosis is rare and is virtually always associated with direct contact with an infected cat. Exposure to the large number of fungal organisms present in skin lesions of cats with sporotrichosis can result in transmission of infection to humans even without an associated penetrating injury. Since veterinarians and their assistants are at greatest risk, awareness of this mode of transmission and proper use of gloves when caring for cats with cutaneous ulcers should prevent most cases.

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16.) Successful treatment of sporotrichosis with oral fluconazole: a report of three cases.

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SO - Br J Dermatol 1993 Mar;128(3):352-6

AU - Castro LG; Belda Junior W; Cuce LC; Sampaio SA; Stevens DA

AD - Department of Dermatology, University of Sao Paulo, Brazil.

PT - JOURNAL ARTICLE

AB - We report three cases of sporotrichosis successfully treated with oral fluconazole. A verrucous lesion on the toe was cured after 126 days, and a lesion on the left foot resolved after 91 days' treatment. A case of lymphangitic-type sporotrichosis required 174 days of treatment to achieve a cure, and a higher dose (400 mg daily) was necessary in this case. Any side-effects were insignificant. We conclude that this new bis-triazole compound can be successfully used as an alternative treatment for sporotrichosis when conventional drugs must be avoided.

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17.) Comparison between histochemical and immunohistochemical methods 

for diagnosis of sporotrichosis.

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SO - J Clin Pathol 1992 Dec;45(12):1089-93

AU - Marques ME; Coelho KI; Sotto MN; Bacchi CE

AD - Department of Pathology, Botucatu Medical School-UNESP, Botucatu, Sao Paulo, Brazil.

PT - JOURNAL ARTICLE

AB - AIMS: To compare the efficacy of histochemical and immunohistochemical methods in detecting forms of Sporothrix schenckii in tissue. METHODS: Thirty five cutaneous biopsy specimens from 27 patients with sporotrichosis were stained by histochemical haematoxylin and eosin, periodic acid Schiff, and Gomori's methenamine silver methods and an immunohistochemical (avidin-biotin complex immunoperoxidase) (ABC) technique associated with a newly produced rabbit polyclonal antibody anti-Sporothrix schenckii. RESULTS: A total of 29 (83%) cases were positive by the ABC method used in association with anti-Sporothrix schenckii rabbit polyclonal antibodies. Histochemical methods, using silver staining, periodic acid Schiff, and conventional haematoxylin and eosin detected 37%, 23%, and 23% of forms of S schenckii, respectively. The ABC technique was significantly more reliable than periodic acid Schiff and silver staining techniques. CONCLUSIONS: It is concluded that immunostaining is an easy and rapid method which can efficiently increase the accuracy of the diagnosis of sporotrichosis in human tissue.

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18.) Hyperthermic treatment of sporotrichosis: experimental use of infrared and far infrared rays. Japan

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SO - Mycoses 1992 Nov-Dec;35(11-12):293-9

AU - Hiruma M; Kawada A; Noguchi H; Ishibashi A; Conti Diaz IA

AD - Department of Dermatology, National Defense Medical College, Saitama, Japan.

PT - JOURNAL ARTICLE

AB - We used pocket warmers and infrared and far infrared rays to treat 14 cases of sporotrichosis, 7 in children and 7 in adults. There were 9 cases of the fixed cutaneous type and 5 of the lymphocutaneous type; 6 were located on the face and 8 on the limbs. Four cases were treated with pocket warmers, 5 with infrared rays, and 5 with far infrared rays. All lesions treated with pocket warmers were facial lesions in children; infrared and far infrared ray treatments were used in 3 children and 7 adults, 2 on facial lesions and 8 on lesions on the extremities. In treatments with infrared and far infrared rays, the amount of heat was greater than with the pocket warmers, and one 15-min treatment daily was sufficient to yield satisfactory results, but this method is difficult to use on children and on the face, and 40-min treatments two or three times a week proved unsatisfactory. Infrared and far infrared ray treatments allow the length of a single treatment to be reduced by three-quarters, in comparison with one pocket warmer treatment.

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19.) Role of cell-mediated immunity in the resistance to experimental sporotrichosis in mice.

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SO - Mycopathologia 1992 Oct;120(1):15-21

AU - Shiraishi A; Nakagaki K; Arai T

AD - Bioscience Research Laboratories, Sankyo Co., Ltd., Tokyo, Japan.

PT - JOURNAL ARTICLE

AB - Congenitally athymic nude (nu/nu) mice showed higher sensitivity to intratestical infection of Sporothrix schenckii than phenotypically normal littermates (nu/+). Active immunization with viable cells enhanced the resistance to intravenous (i.v.) infection of this fungus in BALB/c mice. Nu/nu mice transferred with immune spleen cells acquired the enhancement of resistance to the infection with S. schenckii, but not ones with normal spleen cells. Pre-treatment of OK-432 (Picibanil), one of the macrophage activating agents, enhanced resistance to i.v. infection of this fungus in BALB/c mice. On the other hand, pretreatment of carrageenan, one of the macrophage inhibitors, impaired the resistance. This fungus was intracellularly killed by peritoneal macrophage from OK-432 treated or immunized mice but not by those from normal mice in vitro. These results suggest that activated macrophage, that was mediated by T cells, play an important role in the resistance to S. schenckii in mice.

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20.) Saperconazole in the treatment of systemic and subcutaneous mycoses.

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SO - Int J Dermatol 1992 Oct;31(10):725-9

AU - Franco L; Gomez I; Restrepo A

AD - Corporacion para Investigaciones Biologicas (CIB), Hospital Pablo Tobon Uribe, Medellin, Colombia.

PT - JOURNAL ARTICLE

AB - In a 2-year period, 30 patients with culture-proven mycoses (chromoblastomycosis, sporotrichosis, and paracoccidioidomycosis) were treated with the new orally administered triazole, saperconazole (SPZ) (R66905). The daily dose varied from 100 to 200 mg. All patients responded to treatment; the mean time required to heal the lesions and convert the cultures to negative was 3.5 months for sporotrichosis, 4.6 for paracoccidioidomycosis, and 9.0 for chromoblastomycosis. Evaluation by a scoring system indicated that 36.6% of the patients achieved complete resolution of the pretherapy abnormalities, while the remaining (63.3%) experienced major improvement. No collateral effects were reported; there were no bone-marrow or liver toxicities. SPZ is an effective drug for the treatment of the above-mentioned mycoses and appears to be suitable for the control of chromoblastomycosis.

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21.) Treatment of human cutaneous sporotrichosis with itraconazole.

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SO - Mycoses 1992 May-Jun;35(5-6):153-6

AU - Conti Diaz IA; Civila E; Gezuele E; Lowinger M; Calegari L; Sanabria D; Fuentes L; Da Rosa D; Alzueta G

AD - Department of Parasitology, School of Medicine, University of the Republic, Montevideo, Uruguay.

PT - JOURNAL ARTICLE

AB - Eighteen adult white male patients with cutaneous sporotrichosis were treated with itraconazole following different daily dose schemes. Cure was obtained in all cases after periods of 15-75 days (median 44 days) with total doses between 3.1 and 14.8 g (median 8.4 g). No serious side effects were observed and no relapses occurred in the follow-up period of between 1 and 26 months (median 14.7). These results show that itraconazole represents a safe and effective drug for the treatment of sporotrichosis. Comparison with other studies leads us to consider a daily dose of 200 mg as the most appropriate. A concomitant warming of the affected limbs should be recommended.

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22.) Detection of cellular immunity with the soluble antigen of the fungus Sporothrix schenckii in the systemic form of the disease.

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SO - Mycopathologia 1992 Mar;117(3):139-44

AU - Carlos IZ; Sgarbi DB; Angluster J; Alviano CS; Silva CL

AD - Department of Clinical Analysis, School of Pharmaceutical Science of Araraquara, University Paulista Julio Mesquita Filho, SP, Brazil.

PT - JOURNAL ARTICLE

AB - Sporothrix schenckii is the etiologic agent of sporotrichosis, a mycosis of world-wide distribution more commonly occurring in tropical regions. The immunological mechanisms involved in the prevention and control of sporotrichosis are not fully understood but apparently include both the humoral and cellular responses. In the present investigation, cellular immunity was evaluated by in vivo and in vitro tests in mice infected with yeast-like forms of S. schenckii. The disease developed systemically and cellular immunity was evaluated for a period of 10 weeks. The soluble antigen utilized in the tests was prepared from yeast form of the fungus through the sonication (20 min: 10 sonications at 50 W at 2-min intervals). Delayed hypersensitivity and lymphocyte transformation tests showed that the cellular immune response was depressed between the 4th and 6th week of infection when the animals were challenged with the soluble fungal antigen. This depression frequently indicates worsening of the disease, with greater involvement of the host. This is a promising field of research for a better understanding of the pathogeny of this mycosis.

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23.) Treatment of cutaneous sporotrichosis with terbinafine.

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SO - Br J Dermatol 1992 Feb;126 Suppl 39:51-5

AU - Hull PR; Vismer HF

AD - Department of Dermatology, University of Pretoria, South Africa.

PT - JOURNAL ARTICLE

AB - Terbinafine, an allylamine antifungal agent, has been shown to have excellent in-vitro activity against dermatophytes. Several other fungi of importance also show in-vitro sensitivity. Because terbinafine is fungicidal rather than fungistatic in action, its efficacy in treating such fungal infections requires evaluation. Five patients with cutaneous sporotrichosis were treated with 250 mg of terbinafine twice daily. All of the patients were cured. Overall, the clinical response was rapid. In three patients, negative culture was achieved within 8 weeks; in the other two, negative culture was obtained at 12 and 32 weeks, respectively. Terbinafine was well tolerated, although one patient developed erectile dysfunction while receiving treatment. This was completely resolved on stopping the treatment. The treatment of sporotrichosis is also reviewed in this article.

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24.) Tissue response in sporotrichosis: light and electron microscopy studies.

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SO - Mycoses 1992 Jan-Feb;35(1-2):35-41

AU - Hiruma M; Kawada A; Noda T; Yamazaki M; Ishibashi A

AD - Department of Dermatology, National Defense Medical College, Japan.

PT - JOURNAL ARTICLE

AB - On the basis of electron microscopy examination of human tissue affected by sporotrichosis, we have proposed a classification, at the light microscopy level, of fungal cells in tissue. Light and electron microscopy observations clarified the following five points: (1) in sporotrichosis lesions in man, the fungal cells are frequently phagocytized by polymorphonuclear leucocytes (PMNs); (2) phagocytosis of phagocytes by other phagocytes was common, and giant cells phagocytized both fungal cells and PMNs; (3) fungal cells in the tissues of lesions were thought to be highly viable, and their budding was frequently observed within macrophages and giant cells; (4) it was highly probable that PMNs participated in asteroid body formation; (5) few free fungal cells were present in the tissues. We believe that the classification of fungal cells in sporotrichosis tissue into the five categories below is useful for correctly understanding the pathological condition in a sporotrichosis lesion: (1) fungal cells in PMNs, (2) fungal cells in PMNs within macrophages, (3) fungal cells in macrophages, (4) fungal cells in giant cells, and (5) free fungal cells.

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25.) Sporotrichosis presenting as pyoderma gangrenosum.

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SO - Mycopathologia 1991 Dec;116(3):165-8

AU - Liao WQ; Zang YL; Shao JZ

AD - Dermatology Department of Chang Zheng Hospital, Shanghai, The People's Republic of China.

PT - JOURNAL ARTICLE

AB - A 56-year-old female with an eight-year history of corticosteroid therapy for rheumatoid arthritis presented with large, deep, painful ulcers on the left buttock and thigh. The lesions appeared typical of pyoderma gangrenosum. Nine separate cultures of the exudate grew Sporothrix schenckii. During the course of iodide therapy, the patient expired due to Escherichia coli pneumonia. This is the third case report of sporotrichosis presenting as pyoderma gangrenosum and the first report from China. Sporotrichosis presenting as pyoderma gangrenosum is a special form of this disease. It develops quickly and must be treated promptly. Only two cases have been reported in the world literature. This is the first case reported from China.

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26.) An unusual presentation of fixed cutaneous sporotrichosis: a case report and review of the literature.

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SO - J Am Acad Dermatol 1991 Nov;25(5 Pt 2):928-32

AU - Rafal ES; Rasmussen JE

AD - Department of Dermatology, University of Michigan Medical Center, Ann Arbor 48109-0314.

PT - JOURNAL ARTICLE; REVIEW (38 references); REVIEW, TUTORIAL

AB - Sporotrichosis is extremely rare in infants. This report describes an 84-day-old girl with fixed cutaneous sporotrichosis, presumably transmitted by a cat. A rapid, complete response to a low dose of oral potassium iodide therapy was attained. To our knowledge, this is the youngest reported patient with sporotrichosis, as well as the lowest effective daily dose of potassium iodide.

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27.) Disseminated sporotrichosis in patients with AIDS: case report and review of the literature.

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SO - AIDS 1991 Oct;5(10):1243-6

AU - Heller HM; Fuhrer J

AD - Infectious Disease Unit, Massachusetts General Hospital, Boston 02114.

PT - JOURNAL ARTICLE; REVIEW (13 references); REVIEW LITERATURE

AB - Sporotrichosis is the disease caused by the dimorphic fungus Sporothrix schenkii. Disseminated sporotrichosis is an uncommon infection which usually occurs in alcoholics or patients receiving immunosuppressive medication. We report a case of a patient with AIDS who had disseminated sporotrichosis which was progressive and fatal despite antifungal therapy. Four previously reported cases of disseminated sporotrichosis in patients with AIDS are reviewed. Disseminated sporotrichosis occurs in patients with HIV-1 infection and severe CD4 lymphocyte depletion. It usually presents with diffuse cutaneous lesions and is associated with polyarticular arthritis. Response to treatment is variable and chronic suppressive therapy is probably needed to prevent relapse.

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28.) Sporotrichosis following a rodent bite. A case report.

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SO - Mycopathologia 1991 Oct;116(1):5-8

AU - Frean JA; Isaacson M; Miller GB; Mistry BD; Heney C

AD - Department of Tropical Diseases, School of Pathology, South African Institute for Medical Research, Johannesburg.

PT - JOURNAL ARTICLE

AB - A ten year old boy developed lymphocutaneous sporotrichosis following a wild rodent bite. The infection was successfully treated with potassium iodide. Sporotrichosis in humans has followed bites, pecks and stings inflicted by a variety of animals, birds and insects. Many species of animals are susceptible to infection by Sporothrix schenkii, but transmission from infected animals to man is uncommon.

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29.) Concurrent infection with sporotrichosis and blastomycosis: an unusual case.

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SO - Cutis 1991 Sep;48(3):193-6

AU - Hoy SE; Chuang TY

AD - Department of Medicine, University of Wisconsin, Madison.

PT - JOURNAL ARTICLE

AB - Two facial nodules and a pulmonary infiltrate occurred in a twenty-one-year-old man. Tissue cultures from one of the facial lesions showed both Sporothrix schenckii and Blastomyces dermatitidis. Cultures from lung biopsy tissue grew B. dermatitidis. This is the first known reported case of sporotrichosis and blastomycosis occurring concurrently in the same cutaneous lesion.

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30.) Ultrastructure of asteroid bodies in sporotrichosis.

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SO - Mycoses 1991 Mar-Apr;34(3-4):103-7

AU - Hiruma M; Kawada A; Ishibashi A

AD - Department of Dermatology, National Defense Medical College, Saitama, Japan.

PT - JOURNAL ARTICLE

AB - Ultrathin sections were prepared from a paraffin-embedded tissue specimen which had been obtained from a sporotrichosis patient and in which large numbers of asteroid bodies had been observed. Electronmicroscopic examination of the ultrastructure of the asteroid bodies revealed a central fungal cell with peripheral rays. These cells were almost structurally identical with fungal elements found elsewhere than in asteroid bodies; and in the rays, electron-dense granular substance was arranged in layers marked by fissures and material resembling remnants of destroyed host cells. The outermost layer was formed of a granular substance of rather low electron density, surrounded by adherent cell membrane fragments. These findings suggest that an asteroid body might be composed of crystalline products of disintegrated host cells deposited around a fungal cell.

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31.) Sporotrichosis in Nepal.

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SO - Int J Dermatol 1990 Dec;29(10):716-8

AU - Rajendran C; Ramesh V; Misra RS; Kandhari S

AD - Medical Mycology Laboratory, National Institute of Communicable Diseases, Delhi, India.

PT - JOURNAL ARTICLE

AB - The first case of sporotrichosis from Nepal is reported in a 25-year-old man from a village about 60 km east of Kathmandu. He never travelled outside of Nepal before and had acquired the lymphocutaneous form of the disease after an accidental injury to the right foot while cutting wood. The diagnosis of the case was made by culturing Sporothrix schenckii from the lesions, proving the dimorphic character of the fungus in vitro, its pathogenicity in mice, and its serology. Oral potassium iodide therapy resulted in complete cure.

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32.) Cutaneous sporotrichosis in Thailand: first reported case.

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SO - Mycoses 1990 Nov-Dec;33(11-12):513-7

AU - Kwangsukstith C; Vanittanakom N; Khanjanasthiti P; Uthammachai C

AD - Department of Medicine, Faculty of Medicine, Chiang Mai University, Thailand.

PT - JOURNAL ARTICLE

AB - A case of cutaneous sporotrichosis is reported for the first time in Thailand. The infection occurred in a 33-year-old Thai female who has been in good health and had no history of previous trauma or contact with any animals. Histopathology revealed pseudoepitheliomatous hyperplasia of the epidermis and a combination of granulomatous and pyogenic reactions in the dermis and subcutaneous tissue. Typical asteroid bodies (Splendore-Hoeppli phenomenon) with central yeast cells were seen. Sporothrix schenckii was recovered from skin biopsy specimens. The patient responded well to the treatment with saturated solutions of potassium iodide within three months. No recurrence was seen after more than six months follow-up.

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33.) A case of sporotrichosis caused by two genetically different Sporothrix schenckii strains.

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SO - Mycopathologia 1990 Oct;112(1):19-22

AU - Kobayashi H; Kawasaki M; Ishizaki H; Fukushiro R; Matsumoto R

AD - Department of Dermatology, Medical University Uchinada, Ishikawa, Japan.

PT - JOURNAL ARTICLE

AB - Two Sporothrix schenckii strains of different mitochondrial DNA restriction profiles were isolated from different cutaneous lesions in a 53 year-old woman with sporotrichosis. These results suggest that sporotrichosis can be simultaneously caused by two or more genetically different S. schenckii strains.

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34.) Sporotrichosis with bilateral lesions. A case report.

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SO - Mycoses 1990 Jul-Aug;33(7-8):325-34

AU - Takase T; Uyeno K

AD - Department of Dermatology, University of Tsukuba, Japan.

PT - JOURNAL ARTICLE

AB - We report on a case of sporotrichosis in which lesions occurred bilaterally on upper limbs at different periods. The patient was an 84-year-old farmer living in Tsukuba City, Japan. The first lesion appeared on the left upper arm and remained untreated. The second lesion appeared on the back of the right hand 5 years later. Findings suggesting internal metastasis could not be confirmed in various examinations. We judged that the lesion of the left upper arm was primary and the lesion at the back of the right hand was caused by autoinoculation.

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35.) Sporotrichosis in the metropolitan area of Cusco, Peru, and in its region.

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SO - Mycoses 1990 May;33(5):231-40

AU - Cuadros RG; Vidotto V; Bruatto M

AD - Departamento de Dermatologia, Universidad Nacional San Antonio Abad del Cusco, Peru.

PT - JOURNAL ARTICLE

AB - Eight cases of sporotrichosis originating from the metropolitan area of Cusco, Peru, and its region are described, including the circumstances of infection and the isolation of Sporothrix schenckii from the lesions. This finding classifies this particular area with high altitude, low temperature and dry weather as an endemic zone of interest in the epidemiological and ecological study of Andean sporotrichosis. Among the eight cases observed, five were of the fixed cutaneous type and three were lymphocutaneous. Six patients were male and two female. Two paediatric cases were also observed. Therapy with potassium iodide was very satisfactory, whereas poor results were obtained with ketoconazole.

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36.) A familial occurrence of sporotrichosis.

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SO - J Dermatol 1990 Apr;17(4):255-9

AU - Yamada Y; Dekio S; Jidoi J; Ozasa S; Tohgi K

AD - Department of Dermatology, Shimane Medical University, Izumo, Japan.

PT - JOURNAL ARTICLE

AB - A grandfather and granddaughter suffering from sporotrichosis were reported. It is thought that they might have been infected from the same source of Sporothrix schenckii (S. schenckii).

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37.) Mother-and-child cases of sporotrichosis infection.

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SO - Mycoses 1990 Jan;33(1):33-6

AU - Jin XZ; Zhang HD; Hiruma M; Yamamoto I

AD - Department of Dermatology, Second Teaching Hospital, Norman Bethune University of Medical Sciences, Jilin, China.

PT - JOURNAL ARTICLE

AB - We report the appearance of lymphocutaneous sporotrichosis on the left arm of a 28-year-old farmer's wife, followed two months later by the same type of lesion on the right upper eyelid of this patient's three-year-old child. According to the mother, the child was accustomed to sleeping with the right side of her face applied to the lesion on the mother's arm, and so it was presumed that the infection had been transmitted by direct contact from mother to child. Cases of person-to-person contagion of this disorder are thought to be extremely rare, but where there has been close contact on a daily basis, such contagion is likely to occur.

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38.) Feline sporotrichosis: a case report.

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SO - Mycopathologia 1989 Dec;108(3):149-54

AU - Gonzalez Cabo JF; de las Heras Guillamon M; Latre Cequiel MV; Garcia de Jalon Ciercoles JA

AD - Departamento de Patología Animal, Facultad de Veterinaria, Universidad de Zaragoza, España.

PT - JOURNAL ARTICLE

AB - The isolation of Sporothrix schenckii from a female European cat it is described. The cat showed lengthened alopecic areas, with prominent nodules in the external surface of the thighs and abdomen. A mycological and histopathological studies of the lesions were carried out. The lesions resolved under treatment with 20% potassium iodide in doses of 0'1 ml/kg oral route in a 8 weeks period.

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39.) Epidemiology of sporotrichosis in Latin America.

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SO - Mycopathologia 1989 Nov;108(2):113-6

AU - Conti Díaz IA

AD - Departamento de Parasitología, Instituto de Higiene, Montevideo, Uruguay.

PT - JOURNAL ARTICLE; REVIEW (25 references); REVIEW, MULTICASE

AB - Applying the concept of 'epidemiological chain', it is successively analyzed: the etiologic agent, Sporothrix schenckii and its natural reservoirs (sources of infection); the different ways that infecting particles may reach man (mechanisms of infection); the susceptible population and the population at risk; the incidence and distribution by sex and age in countries of Latin America; the prevalence of the disease according to clinical cases in dermatological clinics and the variation of incidence rates in some countries with time; the influence of the environment mainly climatic conditions on the geographic distribution of the disease. Finally, according to Mackinnon's hypothesis, the climate could have a determining role on the predominance of a certain clinical form on another in different countries.

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40.) Sporotrichosis in the acquired immunodeficiency syndrome.

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SO - J Am Acad Dermatol 1989 Nov;21(5 Pt 2):1145-7

AU - Shaw JC; Levinson W; Montanaro A

AD - Oregon Health Sciences University.

PT - JOURNAL ARTICLE

AB - Kaposi's sarcoma and disseminated sporotrichosis of the skin and joints developed simultaneously in a homosexual man with antibodies to human immunodeficiency virus. There was no identified source of exposure to Sporothrix organisms. Sporotrichosis may be a presenting opportunistic infection associated with acquired immunodeficiency syndrome and tends to be disseminated at the time of diagnosis.

EM - 9002

IS - 0190-9622

LA - English

UI - 90037821

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DATA-MÉDICOS/DERMAGIC-EXPRESS No (20) 27/11/98 DR. JOSE LAPENTA R. DERMATÓLOGO

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Produced by Dr. José Lapenta R. Dermatologist
Venezuela 1.998-2.024

Producido por Dr. José Lapenta R. Dermatólogo Venezuela 1.998-2.0024

Tlf: 0414-2976087 - 04127766810