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Journal of Clinical Microbiology, June 1999, p. 2031-2033, Vol. 37, No. 6
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Lacazia loboi gen. nov., comb. nov., the
Etiologic Agent of Lobomycosis
Paulo R.
Taborda,1
Valeria A.
Taborda,1 and
Michael R.
McGinnis2,*
Instituto L. S. Lima, São Paulo,
Brazil 17001-970,1 and Medical Mycology
Research Center, University of Texas Medical Branch, Galveston,
Texas 77555-06092
Received 14 October 1998/Returned for modification 26 December
1998/Accepted 4 March 1999
 |
ABSTRACT |
The new genus Lacazia P. Taborda, V. Taborda, et
McGinnis is proposed to accommodate Lacazia loboi (O. M. Fonseca et Lacaz) P. Taborda, V. Taborda, et McGinnis, the obligate
pathogen that causes lobomycosis in mammals. The continued placement of
that fungus in the genus Paracoccidioides Almeida as
Paracoccidioides loboi is taxonomically inappropriate.
Loboa loboi Ciferri et al. is a synonym of
Paracoccidioides brasiliensis.
| |
TEXT |
In 1930, Jorge Lobo (14)
described a previously unknown infection in human cutaneous and
subcutaneous tissue. He believed that the etiologic agent
(15) was a fungus similar to Paracoccidioides brasiliensis (Splendore) Almeida, in that the fungus consisted of
solitary, budding yeast cells and pseudohyphae in tissue. It was
reported that tissue taken from the original patient's lesion was
placed upon Sabouraud glucose agar and a fungus was isolated. This
isolate was described as Glenosporella loboi O. Fonseca f. et Leão 1940 (9) but was, in fact, P. brasiliensis (3). The current consensus is that this
etiologic agent of mycotic infection is an obligate pathogen of humans
and other mammals which has not been cultivated in vitro.
In 1971, Fonseca and Lacaz (10) proposed the new species
name Paracoccidioides loboi for the etiologic agent of
lobomycosis. The proposal included the designation of neotype material
in the form of human tissue sections that were distributed to several culture collections and herbaria throughout the world. No single slide
was designated as a holotype. The proposed name of the agent was
invalidly published, because a Latin description was not included (article 36.1 of reference 11). To validate the name
(article 45 of reference 11), in 1996, Lacaz
provided the required Latin description (12), restated the
facilities to which the "neotypus" (actually syntype) had been
distributed, and gave the reference to the proposed new species name.
Lacaz informed us that the syntype tissue section that had been
maintained at the Instituto de Medicina Tropical de São Paulo (IMTSP) has been lost. Based upon our study of the lectotype (BPI 792295, U.S. National Fungus Collections) and tissue sections from 35 patients living in the Amazon region of Brazil, we conclude that no
existing genus can accommodate this taxon. We propose a new genus and
binomial for the obligate pathogen that causes lobomycosis.
Taxonomy of Lacazia P. Taborda, V. Taborda, et McGinnis
gen. nov. (i) Type species.
Paracoccidioides loboi O. M. Fonseca et Lacaz (12) (synonymous with L. loboi [O. M. Fonseca et Lacaz] comb. nov.).
(ii) English description.
In vivo, globose to subglobose cells
producing blastoconidia connected by a narrow tubular connector,
solitary, catenulate, or both, with the latter variable in branching.
(iii) Latin description.
In vivo, globosae et subglobosae
cellulae producentes blastoconidia coniuncta ab angustaligatione in
specie tubi, solae, catenulatae vel ambo sed his variabilibus pro summa ramorum.
(iv) Etymology.
The generic name Lacazia has been
selected to acknowledge the major contributions to our understanding of
lobomycosis made by Carlos da Silva Lacaz.
Taxonomy of Lacazia loboi.
(O. M. Fonseca et
Lacaz), comb. nov.
(i) Basionym.
Paracoccidioides loboi O. M. Fonseca
et Lacaz (12), illustrated in Fig. 9 of reference
10.
(ii) Lectotypus.
Slide BPI 792295 in the U.S. National Fungus
Collections, human cutaneous-subcutaneous lesion, IMTSP.
(iii) Syntypes.
Deposited by Lacaz in 1971 at the Mycological
Herbarium (DAOM), Agriculture Canada, Ottawa, Canada; the Commonwealth
Mycological Institute (CMI), Surrey, United Kingdom; the Laboratory of
Cryptogamy (LCP), National Museum of Natural History, Paris, France;
and the University of Uppsala (UPS), Uppsala, Sweden.
(iv) English description.
In vivo, globose to subglobose cells
producing blastoconidia connected by narrow connectors, cells 7.6 to
7.9 µm (range 5 to 11 µm). Catenulate, chains of various lengths
and degrees of branching. Constitutive melanin present in yeast cell
walls. Cell walls of older cells increase in thickness, resulting in
the separation of adjacent cells.
(v) Etymology.
The specific epithet loboi was
proposed by Fonseca and Leão (9) and validly published
by Lacaz in 1996 (12) to honor the Brazilian dermatologist
Jorge O. Lobo because of his discovery of this mycosis.
(vi) Disease nomenclature.
We support the disease name
lobomycosis accepted by the Nomenclature Committee of the International
Society for Human and Animal Mycology (17).
(vii) Materials examined.
Materials containing L. loboi included lectotypus BPI 792295 from the U.S. National Fungus
Collections and samples from 35 cases from Instituto L.S. Lima (ILSL):
ILSL B95-1480 and B96-1071, patient 1, 76-year-old male, diffuse
lesions, Acre (AC), Brazil (BR); ILSL B95-1423, patient 2, 55-year-old
male, left ear, AC, BR; ILSL B95-1484, patient 3, 54-year-old male,
right ear, AC, BR; ILSL B95-1485, patient 4, 52-year-old male, diffuse,
AC, BR; ILSL B95-1488, patient 5, 29-year-old female, right leg, AC,
BR; ILSL B95-1575 and B96-263, patient 6, 34-year-old male, left ear, AC, BR; ILSL B95-1490, patient 7, 72-year-old male, diffuse, AC, BR;
ILSL B95-1491, patient 8, 29-year-old female, right leg, AC, BR; ILSL
B96-1082, patient 9, 77-year-old male, right cheek, AC, BR; ILSL
B95-1492 and B95-1493, patient 10, 74-year-old male, face, AC, BR; ILSL
B95-1494, patient 11, 70-year-old male, left ear, AC, BR; ILSL B95-1495
and B96-1080, patient 12, 72-year-old male, right ear, AC, BR; ILSL
B95-1496 and B96-1072, patient 13, 72-year-old male, left ear, AC, BR;
ILSL B95-1497 and B96-1078, patient 14, 64-year-old male, right ear,
AC, BR; ILSL B95-1498 and B96-914, patient 15, 20-year-old male, right
ear, AC, BR; ILSL B95-2088, patient 16, 48-year-old male, right foot
and leg, AC, BR; ILSL B95-2089, patient 17, 35-year-old male, right
elbow, AC, BR; ILSL B95-2090, patient 18, 35-year-old male, right ear, AC, BR; ILSL B95-2025 and B96-1079, patient 19, 59-year-old male, left
leg, AC, BR; ILSL B95-2091, patient 20, 53-year-old male, left leg, AC,
BR; ILSL B95-2092 and B96-1077, patient 21, 51-year-old male, left
thigh, AC, BR; ILSL B95-2093 and B96-1083, patient 22, 46-year-old
male, right ear, AC, BR; ILSL B95-2024, patient 23, 43-year-old male,
right ear, AC, BR; ILSL B95-2094 and B96-1073, patient 24, 65-year-old
male, legs, AC, BR; ILSL B96-264, patient 25, 56-year-old male, right
elbow, AC, BR; ILSL B95-2096, patient 26, 29-year-old male, left ear,
AC, BR; ILSL B95-2040, patient 27, 40-year-old male, chest, AC, BR;
ILSL B95-2553, patient 28, 48-year-old female, diffuse, AC, BR; ILSL
B95-2098, patient 29, 53-year-old male, right thigh, AC, BR; ILSL
B95-2099 and B96-1074, patient 30, 78-year-old male, left ear, AC, BR;
ILSL B95-2100 and B96-1081, patient 31, 62-year-old male, left ear, AC,
BR; ILSL B96-1075, patient 32, 52-year-old male, right ear, AC, BR; ILSL B96-1471, patient 33, 42-year-old male, right ear, AC, BR; ILSL
B86-755 and B87-1025, patient 34, 78-year-old male, ears, BR; and ILSL
B95-2097, patient 35, 44-year-old male, right arm, AC, BR. Materials
yielding P. brasiliensis were from five culture-proven human
cases from the ILSL: ILSL 95-042, patient 36, 56-year-old female,
cervical lymph node, São Paulo (SP), BR; ILSL B95-170, patient
37, 42-year-old male, right foot, SP, BR; ILSL B95-940, patient 38, 40-year-old male, mouth, SP, BR; ILSL B95-1762, patient 39, 36-year-old
female, cervical lymph node, SP, BR; and ILSL B96-2772, patient 40, 49-year-old male, face, SP, BR.
Discussion.
It is clearly recognized that P. brasiliensis is a fungus that can be isolated from human tissue,
as well as from animals inoculated with environmental material. The
isolate that was originally thought to be the agent of lobomycosis
probably represents a laboratory isolate from a different patient,
because the original patient's condition did not have the features of
an infection caused by P. brasiliensis (2, 15).
The binomial Glenosporella loboi O. Fonseca f. et Leão
1940 was based upon an isolate now known to be P. brasiliensis (3, 10). Another isolate believed to be
the etiologic agent of lobomycosis was described as
Glenosporopsis amazonica O. Fonseca f. 1943 (8).
This fungus (18) was most likely an environmental
contaminant that is identifiable as Aspergillus penicillioides Spegazzini.
Fonseca and Lacaz (10) proposed the new species name
P. loboi, without the required Latin description, based upon
the fungus in human tissue sections that they studied and designated as
"neotypus." In actuality, the tissue sections are not a neotype,
because these authors were specifically establishing a new species for
the agent of lobomycosis independent of the use of cultures. Lacaz has
informed us that the original slide maintained at IMTSP has been lost. Therefore, we designate BPI 792295 as lectotypus (article 9.2 of
reference 11) for this taxon and designate the other
tissue sections they sent to various collections throughout the world as syntypes (article 9.4 of reference 11).
Validation of the new species name
P. loboi was completed in
1996 when the required Latin description was provided (article
45.1 of
reference
11). According to recommendation 32C.1 of
reference
11, adoption of a binomial previously but
not validly
published for a different taxon should be avoided. Such
recommendation
did not invalidate the specific epithet
loboi
as suggested by
Borelli (
4).
Additional confusion resulted when the new generic name and combination
Loboa loboi Ciferri, Azevedo, et Carneiro 1956 (
5)
was proposed. This proposal was based upon the culture
identified
as
Glenosporella loboi, a fungus known to be
identical with
P. brasiliensis. Even though this name is
popular,
L. loboi Ciferri,
Azevedo, et Carneiro is a synonym
of
P. brasiliensis and taxonomically
not related to the
agent of
lobomycosis.
In 1952, Langeron and Vanbreuseghem (
13) used the name
Blastomyces loboi, which is an invalidly described binomial
(article
32 of reference
11), as their
recommendation for the appropriate
name to be used for the causal agent
of lobomycosis. In 1968,
Borelli (
4) proposed the generic
name
Lobomyces for the fungus
in the tissue. This proposal
was made as a suggestion in passing
and is therefore invalid (article
34 of reference
11).
The genus
Paracoccidioides Almeida 1930 (
1)
is characterized in part by the formation of a globose to
subglobose solitary
yeast cell that forms a nucleus from which multiple
daughter blastoconidia
are formed. The central cells become extremely
large with thickened
cell walls (Fig.
1).
In contrast,
L. loboi forms yeast cells that
remain
consistent in diameter, giving rise to branching chains
of
blastoconidia (Fig.
2). In addition, the
cell wall of
L. loboi contains constitutive melanin that is
readily detectable by the
use of the Fontana-Masson histologic stain
(
21). An apparent
difference in temperature tolerance in
vivo exists between these
two species.
P. brasiliensis is a
pulmonary pathogen that can
disseminate by hematogenous means,
including associating with
tegumentary surfaces, whereas
L. loboi is known to be associated
only with cutaneous-subcutaneous
tissue, especially tissue with
a lower temperature, such as the skin of
ears, elbows, the anterior
aspect of legs, and ankles.
In essence, owing to the fact that
L. loboi has not been
cultured in vitro, the generic name
Lacazia circumscribes a
fungus
known only from mammalian tissue where it causes lobomycosis.
Lesions of the skin and subcutaneous tissue of humans, marine
dolphins
(
Tursiops truncatus Montagu 1821) (
6,
20), and
marine-freshwater
dolphins (
Sotalia fluviatilis Gervais
1853) (
7) are predominantly
localized and keloid-like
(solitary or multiple) but can be extensive
and either multifocal or
diffuse and can combine keloid-like lesions
with macular, gummatous,
ulcerative, or verrucous
surfaces.
Human cases in most Latin American countries have been reported as well
as isolated cases in Holland (
20) and Bangladesh
(
19), although in our opinion, the Bangladesh case may not
have
been lobomycosis. Dolphins with lobomycosis have been found along
the Florida and Texas coasts (
6), the Spanish-French coast
(
20), the South Brazilian coast (
16), and the
Suriname river
estuary (
7).
| |
ACKNOWLEDGMENTS |
We thank Carlos da Silva Lacaz, Libero Ajello, and Richard
Korf for reviewing the mycological aspects of the manuscript and Diltor
A. Opromolla and Raul N. Fleury from the ILSL for their encouragement
to conduct this research. Lester L. Pasarell is owed special
appreciation for his technical help and stimulating discussions.
| |
FOOTNOTES |
*
Corresponding author. Mailing address: 301 University
Blvd., Keiller Building 1.116, Galveston, TX 77555-0609. Phone: (409) 747-0604. Fax: (409) 747-0605. E-mail:
michael.mcginnis{at}utmb.edu.
| |
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|
Journal of Clinical Microbiology, June 1999, p. 2031-2033, Vol. 37, No. 6
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
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