Lobomycosis in Soldiers, Colombia

Emerg Infect Dis. 2019 Apr;25(4):654-660. doi: 10.3201/eid2504.181403.

Abstract

Lobomycosis is a disease that is endemic to the Amazon rainforest and is caused by the still uncultured fungus Lacazia loboi. This disease occurs in loggers, farmers, miners, fishermen, and persons living near coastal rivers of this region. We report 6 soldiers in Colombia in whom lobomycosis developed after military service in the Amazon area. The patients had nodular and keloid-like lesions on the face, neck, trunk, and limbs. The duration of illness ranged from 2 years to 15 years. The initial diagnosis was leishmaniasis on the basis of clinical manifestations and direct smear results, but biopsies confirmed the final diagnosis of lobomycosis. Treatment with surgical excision, itraconazole and clofazimine was satisfactory. However, the follow-up time was short. Healthcare professionals responsible for the diagnosis and treatment of skin diseases need to be able to recognize the clinical signs of lobomycosis and differentiate them from those of cutaneous leishmaniasis.

Keywords: Colombia; Jorge Lobo disease; Lacazia loboi; cutaneous disease; dermatologic analysis; fungal infections; fungi; lacaziosis; leishmaniasis; lobomycosis; military activities; soldiers.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Biopsy
  • Humans
  • Lacazia*
  • Lobomycosis / diagnosis*
  • Lobomycosis / drug therapy
  • Lobomycosis / epidemiology
  • Lobomycosis / microbiology*
  • Male
  • Military Personnel*
  • Skin / microbiology
  • Skin / pathology
  • Treatment Outcome

Substances

  • Antifungal Agents