Suppression of cellular immune responses following transfer factor: report of a case.
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No significant increases in antibody levels (IgG, IgM) were detected when serum specimens obtained from individuals exhibiting a positive skin test to the Histoplasma capsulatum yeast phase reagent, Histolyn-CYL, were assayed by the indirect enzyme-linked immunosorbent assay (ELISA) using yeast and mycelial phase antigens.
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The natural habitat of Paracoccidioides brasiliensis, the aetiologic agent of paracoccidioidomycosis, has not been determined. Consequently, the events leading to the acquisition of infection remain controversial. To identify factors associated with infection in endemic areas we conducted a survey in three rural communities in Colombia where we had previously diagnosed paracoccidioidomycosis in children. Permanent residents were surveyed taking into consideration environmental and occupational variables. Skin tests were used to classify subjects as infected or non-infected. Variables found associated with infection were: (i) community A: previous residence around Porce river and agriculture in vegetable gardens; (ii) community C: frequent use of specific water sources; (iii) community V: housekeeping activities, and (iv) total group: age > 25 years and contact with bats. Residents in communities with higher prevalence of infection were older, had more complex residence history, and referred more contact with armadillos than residents of communities with lower infection.
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The authors describe seven patients presenting with ophthalmoscopic findings typical of "presumed ocular histoplasmosis syndrome." However, no humoral antibodies could be demonstrated. Moreover, the results of skin tests were all negative even after "boostering." Hence, the diagnosis of ocular histoplasmosis had to be ruled out. Tests for listeriosis, lues, leptospirosis, ornithosis, Toxocara canis, toxoplasmosis, Larva migrans, and Candida albicans were also negative. There are evidently other, so far unknown, agents which lead to an ophthalmoscopic picture that mimics ocular histoplasmosis with its typical "punched-out lesions" and central hemorrhagic chorioretinopathy. One of these agents may be Epstein-Barr virus, because two of six patients had increased antibody levels of Epstein-Barr nuclear antigen and early antigen, indicating an active or persistent state of viral infection.
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Five uncommon cases of skin sporotrichosis are presented, including a small family outbreak with interesting epidemiological findings and two patients treated with corticosteroids; we attributed the severity of the lesions to the steroids. Mice were used to confirm our hypothesis on the pathogenesis. The pathological findings in case of sporotrichosis in a dog are presented. A group of 359 pulmonary patients was tested with two different antigens of Sporotrichum schenkii.
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