Chromoblastomycosis and Chagas' disease: a case study in the Brazilian Northeast

Background: Chromoblastomycosis is a disease caused by melanized fungi that have a slow evolution, and the disease may be chronic due to a lack of treatment at the onset of the disease. Besides chromoblastomycosis, other neglected diseases primarily affect people of low-income living in rural areas. The objective of this study was to analyze a case of coinfection with Trypanosoma cruzi and Fonsecaea pedrosoi in a patient with these agents. Methods: For the diagnosis of chromoblastomycosis, a biopsy of the lesion site was performed, and fungal tests were performed with KOH, cultured on Sabouraud Dextrose and Mycobiotic Agar. A microculture on the Potato Agar Dextrose was performed, followed by histopathology stained with hematoxylin-eosin. The diagnosis of Chagas disease, with the examination of gout on a slide, and staining using the Walker method. Results: The thick drop blood test was positive for Trypanosoma cruzi. Additionally, muriform brown corpuscles were visualized in the direct mycological biopsy, and also Fonsecaea pedrosoi was identified through the culture and microcultivation and sequencing, being thus diagnosed the chromoblastomycosis. Conclusions: Chromoblastomycosis and Chagas disease are neglected diseases in Brazil, especially in the states of the Northeast and North regions, where the prevalence of cases is still high.