Rev Iberoam Micol. 39 (2022) 59–60 Revista Iberoamericana de Micología www.elsevier.es/reviberoammicol Mycologic Forum Lobomycosis and paracoccidioidomycosis meet again夽 La lobomicosis y la paracoccidioidomicosis se vuelven a encontrar F. Javier Cabañes Veterinary Mycology Group, Department of Animal Health and Anatomy, Veterinary School, Universitat Autònoma de Barcelona, Bellaterra, Spain The relationship between lobomycosis and paracoccidioidomy- cosis goes back a long way. Jorge Lobo reported in 1931 the observation of an unusual yeast-like fungal pathogen in a human patient with skin lesions, and described this disease as a mild variety of paracoccidioidomycosis. Over the years, the disease has received various names, such as Lobos’ disease, lobomycosis and, more recently, lacaziosis. Attempts to isolate the fungus from the skin lesions failed. Many years later, a similar skin disease was reported in dolphins, and based on its phenotypic features in the infected tissues and its non-culturable condition, the etiological agent was thought to be the same as that described in humans. Thereafter, this mycosis in humans was found restricted to Latin Fig. 1. Dermal lesions in a bottlenose dolphin with lobomycosis. Note the typical American countries, mainly in the Amazon basin. In dolphins, it verrucous appearance with ulcerations and crusts. Photo courtesy of Dr. Gregory D. has been described in specimens from several oceans, mostly in Bossart, Georgia Aquarium, Atlanta, Georgia, USA. coastal areas of the Americas and Japan. As it is a non-culturable fungus, its nomenclature has always been controversial and this causative agent has been known under through photo-identification. In general, lesions are verrucous and various names, such as Paracocciodioides loboi or Loboa loboi, and, form crusty plaques with ulcerations that are limited to the skin more recently, Lacazia loboi. After 90 years of taxonomic uncer- (Fig. 1). tainties, using phenotypic, phylogenetic, and population genetics However, this disease has also been diagnosed in dolphins in analyses, the two non-culturable fungi which cause this skin dis- captivity far from the coastal areas where lobomycosis is dis- ease in humans and dolphins are now, once again, placed as tributed. This is the case of a bottlenose dolphin born in the wild separate species within the genus Paracoccidioides.3 These authors who was brought from Cuba to an aquarium in Spain.1 This ani- have proposed the names Paracoccidioides cetii for the species that mal arrived with two localized, slightly prominent, whitish dermal causes the disease in dolphins and P. loboi for the one that causes lesions on the left flipper. Cytology and histopathology analyses the disease in human beings. of the skin lesions showed the presence of yeast-like structures in Most lobomycosis-like cases in cetaceans have been described chains, characteristic of lobomycosis (Figs. 2 and 3). Interestingly, in free-ranging bottlenose dolphins (Tursiops truncatus) and in the animal was treated along several phases using mainly itracona- very few specimens among other species such as Tursiops aduncus, zole and terbinafine and, after four weeks, the lesions were reduced Lagenorhynchus obliquidens, Sotalia guianensis, Sousa plumbea and to single, small, cicatricial nodules. Usually, these animals are not Stenella frontalis. A Pubmed search using the descriptors “lobomy- treated so there is little information about the treatment of this cosis” AND “dolphins” (December 15th, 2021) yielded a total of mycosis. 33 case reports regarding lobomycosis in different dolphin species. Paracoccidioidomycosis is a systemic fungal infection occurring Bottlenose dolphins appeared in 76 percent of these papers. How- in Latin America caused by culturable fungi of the genus Paracoc- ever, in several cases, the diagnosis of lobomycosis was made only cidioides, whose major known hosts are humans and armadillos. Paracoccidioides brasiliensis has been considered for many years the only species causing this disease. Nowadays it is known that, 夽 These Mycology Forum articles can be consulted in Spanish on the Ani- at least, five phylogenetic species may cause this disease: Para- mal Mycology section on the website of the Spanish Mycology Association coccidioides americana, P. brasiliensis sensu stricto, Paracoccidioides (https://aemicol.com/micologia-animal/). lutzii, Paracoccidioides restrepiensis and Paracoccidioides venezue- E-mail address: javier.cabanes@uab.es lensis. Although Paracoccidioides spp. ecological niche has not yet https://doi.org/10.1016/j.riam.2022.01.002 1130-1406/© 2022 The Author. Published by Elsevier España, S.L.U. on behalf of Asociación Española de Micologı́a. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). F.J. Cabañes Revista Iberoamericana de Micología 39 (2022) 59–60 disease may develop acutely, which is rare but, usually, more severe, and chronically, after a long latency period, years or even decades. Wild animals infected with P. brasiliensis can be important sentinels regarding the presence of this fungus in the environment. The detection of this pathogen in road-killed wild animals has been proven a key strategy for eco-epidemiological surveillance of para- coccidioidomycosis, helping to map hot spots for human infection. Recently, following this approach, two new hosts for this fungal pathogen have been cited, the crab-eating fox (Cerdocyon thous) and the paca (Cuniculus paca).2 As far as the lobomycosis is concerned, although a possible zoonotic transmission has been raised due to the similarity of both lesions and disease agents in humans and dolphins, there are no Fig. 2. Detail of a KOH wet mount preparation of a dermal specimen from a bot- conclusive data pointing out that these cetaceans infected with P. tlenose dolphin with lobomycosis, showing the characteristic yeast cells in chains. cetii can transmit the disease to humans. Photo courtesy of Professor Leonel Mendoza, Michigan State University, USA. Conflict of interest Author has no conflict of interest. Acknowledgements Financial support came from Servei Veterinari de Bacteriologia i Micologia of the Universitat Autònoma de Barcelona. References 1. Esperón F, García-Párraga D, Bellière EN, Sánchez-Vizcaíno JM. Molecular diagno- sis of lobomycosis-like disease in a bottlenose dolphin in captivity. Med Mycol. 2012;50:106–9. 2. de Souza Scramignon-Costa B, Almeida-Silva F, Wanke B, Weksler M, Moratelli R, do Valle ACF, et al. Molecular eco-epidemiology of Paracoccidioides brasiliensis Fig. 3. Histological section of a cutaneous lesion from a bottlenose dolphin with in road-killed mammals reveals Cerdocyon thous and Cuniculus paca as new hosts harboring this fungal pathogen. PLOS ONE. 2021;16:e0256668. lobomycosis showing the characteristic yeast cells in chains. Grocott stain. Photo 3. Vilela R, Huebner M, Vilela C, Vilela G, Pettersen B, Oliveira C, et al. The taxonomy courtesy of Professor Leonel Mendoza, Michigan State University, USA. of two uncultivated fungal mammalian pathogens is revealed through phylogeny and population genetic analyses. Sci Rep. 2021;11:18119. been precisely identified, this pathogen has been mainly asso- ciated with nine-banded armadillos (Dasypus novemcinctus) and their burrows. The infection occurs by inhaling fungal propag- ules dispersed in the air after soil disturbing activities. The human 60