Sucesso terapêutico da terbinafina em um caso de esporotricose

Abstract

A esporotricose e uma infeccao subaguda ou cronica, causada por fungos pertencentes ao Complexo Sporothrix. Relato do caso: esporotricose de localizacao nasal foi tratada com iodeto de potassio e como nao se obteve sucesso, reiniciou-se o tratamento com associacao de iodeto de potassio e itraconazol. Porem, ocorreu nova recidiva. As culturas dos exames micologicos foram submetidas a ensaios de atividade antifungica in vitro para auxiliar no tratamento. A terbinafina foi o antifungico que apresentou melhores resultados, por isso, o tratamento foi reiniciado com este antifungico e, apos dois anos do termino do mesmo, nao recidivou. Adicionalmente, ambas as culturas foram comparadas por RAPD, obtendo padroes de fragmentos distintos, indicando que os isolados sao diferentes ou demonstrando um processo microevolutivo do microrganismo.

Sporotrichosis is a chronic subacute infection caused by fungi belonging to the Sporothrix Complex. In the present clinical case, nasal sporotrichosis was treated with potassium iodide. This was unsuccessful, and the treatment was restarted with a combination of potassium iodide and itraconazole. This however resulted in a further recurrence of the infection. The mycological cultures were tested in vitro for antifungal activity to assist in treatment. Terbinafine, an antifungal drug, produced the best results and was therefore used for the rest of the treatment course, with no recurrence after two years of its completion. In addition, both cultures were compared using RAPD and different fragment patterns were observed. This indicated that the isolates were either different or indicated a microevolutionary process of this microorganism.