Lobomycosis in Amazon Region, Bolivia, 2022

Abstract

We report a patient with lobomycosis caused by Paracoccidioides loboi fungi in the Andes-Amazon region of Bolivia. We examined clinical, epidemiologic, and phylogenetic data and describe potential transmission/environmental aspects of infection. Continued surveillance and identification of lobomycosis cases in South America are crucial to prevent the spread of this disease.

Keywords: Amazon; Andes; Bolivia; Lacazia loboi; Paraccocidiodes loboi; fungi; lobomycosis.

Figure 1

Clinical manifestations of lesions in patient with lobomycosis in Amazon Region, Bolivia, 2022. A) Multiple hyperpigmented, confluent keloid-like nodular lesions with overriding telangiectasias and patchy crusted and eroded squamous areas were noted on the helix and lobule of the left ear. B, C) Histologic examination of lesion specimens showed oval-to-round shaped cells that had connecting tubular projections organized in a string-of-pearls pattern, in pairs and individually. B) Fontana-Masson stain; original magnification ×1,000. C) Gömöri methenamine silver stain; original magnification ×400.

Figure 2

Phylogenetic analysis of genes from different Paracoccidioides spp. in study of lobomycosis in Amazon Region, Bolivia, 2022. Phylogenetic trees were inferred by using the maximum-likelihood method for ADP-rf (A), GP43 (B), and ITS1/ITS2 (C) genes. Sequences obtained from GenBank were compared with sequences from the patient sample (sequences deposited in European Nucleotide Archive [https://www.ebi.ac.uk/ena] under Bioproject no. PRJEB77911). Scale bars indicate nucleotide substitutions per site.