3/28/2017. Disclosure of Relevant Financial Relationships FUNGUS IN FORMALIN. CASE 1 ADIASPIROMYCOSIS ADIASPIROMYCOSIS

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1 FUNGUS IN FORMALIN. Alejandro Velez Hoyos, M.D Professor Universidad Pontificia Bolivariana Consultor Medico Cientifico Dinamica Patologo Hospital Pablo Tobon Uribe Disclosure of Relevant Financial Relationships USCAP requires that all planners (Education Committee) in a position to influence or control the content of CME disclose any relevant financial relationship WITH COMMERCIAL INTERESTS which they or their spouse/partner have, or have had, within the past 12 months, which relates to the content of this educational activity and creates a conflict of interest. Dr. Velez Hoyos has nothing to disclose. CASE 1 ADIASPIROMYCOSIS Dr jaime Furhman ADIASPIROMYCOSIS 1

2 ADIASPIROMYCOSIS CASE 2 2

3 , GMS STAIN S 1995 Fungus 2010 Aquatic parasite (Mesomyceozoea). Figura 3. Distribución geográfica de los casos de rinosporidiosis en Colombia Ubicación Número de casos Ubicación Número de casos Tolima 17 Bogotá 3 Purificación 5 Bogotá D.C 3 Lérida 2 Cundinamarca 3 Ortega 2 Soacha 1 Venadillo 1 Tabio 1 Saldaña 1 Subachoque 1 Guamo 1 Santander 4 Armero 1 Barrancabermeja 2 Dolores 1 Lebrija 1 Espinal 1 Bucaramanga 1 Ambalema 1 Boyacá 1 Chaparral 1 Tuta 1 Antioquia 11 Arauca 1 Caucasia 2 Saravena 1 El Bagre 2 Atlántico 1 Apartadó 1 Barranquilla 1 Nechí 1 Bolívar 1 Sopetrán 1 Sin dato 1 Map of Colombia Medellin Geographic distribution of Rhinosporidiosis in Colombia. Fifty eight reported cases. Turbo 1 Casanare 1 Puerto Berrío 1 Sin dato 1 Sin dato 2 Chocó 1. Magdalena 11 Quibdó 1 El Retén 4 Vaupés 1 Zona bananera 3 Mitú 1 Banco 1 Sin dato 2 Ciénaga 1 TOTAL 58 Aracataca 1 Santa Marta 1 3

4 CASE 3. Fine needle aspiration in skin lesion F.N.A IN SKIN Chromoblastomycosis Medlard Cell Chromoblastomycosis PARACOCCIDIOIDOMYCOSIS CASE 4. Men 46 years old with adrenal tumor and oral ulcer. 4

5 SYSTEMIC DISEASE More common in men. Lung infection and skin lesión. Lymphadenopathy. Mucosal involvement in 50% of cases. CNS, colon and adrenal involvement. PARACOCCIDIOIDOMYCOSIS (PCM). TAMI EPIDEMIOLOGY. JUVENIL FORM ACUTE/SUBACUTE DISTRIBUTION BY CHILD GENDER Total cases: 95 Boys: 51 Girls : 44 Relation M/W= 1.1:1 In women Estradiol may be protective. In ADULT Total patient studied: Men Women Relation M:W :1 Skin lesions, ulcers and verrucous lesions. Face and lower limbs. In children affects bone marrow and bones. JUVENIL FORM ( ACUTE/ SUBACUTE) Accounts 10% of all cases. Affects lymph nodes,liver and spleen. CHRONIC FORM ADULT Lung involvement Mucosal lesions (50%) Lymphadenopathy Skin lesions Larynx 5

6 PARACOCCIDIOIDOMYCOSIS (PCM). PARACOCCIDIOIDOMYCOSIS (PCM). PCM brasiliensis. EPIDEMIOLOGY DIAGNOSIS. Brazil: 80% of cases Venezuela Colombia Ecuador Bolivia Argentina In a range of 21 years, 1950 deaths reported. PARACOCCIDIOIDOMYCOSIS Large, round yeast cells (ship wheel). Methenamine silver stain-pas. Granulomatous inflammation with multinucleated giant cells. 6

7 PARACOCCIDIODOMYCOSIS PARACOCCIDIODOMYCOSIS 7

8 Dr. Angela Restrepo M.D. Case 5 Man 52 years old from Magdalena (state), Colombia. Fever, lung nodules and erythema nodosum.. COCCIDIODOMYCOSIS 8

9 Papers published in Colombia. 1.Salas. E Revista Medica Quirurgica del Atlantico Godoy J. Acta Medica Colombiana Robledo M. Antioquia Medica Anonimo. Antioquia Medica COCCIDIODOMYCOSIS IMMITIS VS COCCIODIODOMYCOSIS POSADAI First native case reported in Colombia. Magdalena River Pinto Magdalena, Colombia Pinto Magdalena, Colombia First native case reported in Colombia 9

10 Desert in the Magdalena state, Colombia. Desert in the Magdalena state, Colombia. Traveling from Medellin to Pinto Magdalena. Coccidiodin skin test. Fifty percent of the tested population was positive. Magdalena River, Colombia 10

11 Immunohistochemical stain showing positive stain for Coccidioides Previous publications failed to show cases of Coccidioides Immitis in South America First reported case of Coccidiodes Immitis in South America Provável Comprovada C IMMITIS IN COLOMBIA, S.A MOLECULAR IDENTIFICATION OF THE FUNGUS IN A PARAFFIN-EMBEDDED BIOPSY TISSUE. MEDICAL MYCOLOGY. A RESTREPO, C CANTEROS, A VELEZ, A TOBON Second case of C. Immitis Immitis. This cases is from the same geographic area that the first case reported previously. Future publications should indicate that Coccidiodes immitis cases also occur in Colombia, as demonstrated by this first case. Until now reports only included cases of Coccidiomycosis Posadai in South America 11

12 Please join us in Cartagena Colombia for the Latin American Pathology conference on August Cartagena, Colombia Cartagena, Colombia Cartagena, Colombia Also join us for the Colombian Pathology Congress on Medellin August 2018 Sculptures by Fernando Botero Medellin, Colombia 12

13 Sculptures by Fernando Botero Medellin, Colombia GRACIAS 13