A Study on Rare Dermatological Infections Conducted at Three Major Reference Hospitals in Costa Rica.

Retrospective Descriptive Observational Study of the Epidemiological, Clinical and Therapeutic Profile of Patients With Rare Infections of Dermatological Interest at Three Major Reference Hospitals in Costa Rica From 2019-2023

In Costa Rica there are some descriptive studies of some of these rare infectious diseases (sporotrichosis, chromomycosis and mycetomas); however, there are no recent published reports. Most of the publications on the subject date back to the previous century; from 2000 to the present year there are only publications of small series of cases, so the current behavior of these skin infections is unknown. The primary objective is to analyze the epidemiological, clinical, and therapeutic profile and determine the risk factors in patients with a diagnosis of rare infections of dermatological interest treated at Hospital México, Hospital Rafael Calderón Guardia, and Hospital San Juan de Dios during the period 2019-2023.

Study Overview

• Status: Completed
• Conditions: Coccidioidomycosis; Sporotrichosis; Blastomycosis; Mycetoma; Actinomycosis; Chromomycosis; Nocardiosis; Mycobacterial Cutaneous Infection; Paracoccidioidomycosis; Phaeomycosis

• Study Type: Observational
• Enrollment (Actual): 95

Contacts and Locations

Study Locations

• Costa Rica
  • San José, Costa Rica, 10101
    • Hospital Rafael Ángel Calderón Guardia
  • San José, Costa Rica, 10103
    • Hospital San Juan de Dios
  • San José, Costa Rica, 10107
    • Hospital México

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients over 18 years with confirmed microbiological, histological and/or molecular diagnosis of sporotrichosis, chromomycosis, actinomycosis, nocardiosis, mycetoma, mycobacterial infection, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, cutaneous nocardiosis and pheomycotic abscess diagnosed and/or treated at Hospital México, Hospital Rafael Calderón Guardia, and Hospital San Juan de Dios during the period 2019-2023.

Description

Inclusion Criteria:

1. Age over 18 years, regardless of gender and ethnic group.
2. Patients who during the period from January 1, 2019 to December 31, 2023 received medical care at the Hospital Rafael Ángel Calderón Guardia, Hospital México and Hospital San Juan de Dios.
3. Subjects who meet a confirmed microbiological, histological and/or molecular diagnosis of sporotrichosis, chromomycosis, actinomycosis, nocardiosis, mycetoma, mycobacterial infection, coccidioidomycosis, blastomycosis, paracoccidioidomycosis, cutaneous nocardiosis and pheomycotic abscess (either through the unique digital health record, pathology registries, clinical laboratory service database of each hospital, clinical laboratory of the University of Costa Rica and Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud).
4. Subjects diagnosed at a private level and referred to continue medical care at Hospital Rafael Ángel Calderón Guardia, Hospital México and Hospital San Juan de Dios.

Exclusion Criteria:

1. The research team may exclude patients who have an unconfirmed diagnosis, an erroneous diagnosis, or have participated in the study before, as they may hinder the ability to obtain satisfactory data to achieve the study's objectives.
2. Patients who have more than 30% of the variables required for analysis missing will also be excluded from the study.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Analyze epidemiological, clinical, and therapeutic profile	Analyze the epidemiological, clinical, and therapeutic profile and determine the risk factors in patients with a diagnosis of rare infections of dermatological interest treated at Hospital México, Hospital Rafael Calderón Guardia, and Hospital San Juan de Dios during the period 2019-2023.	5 year
Determine the risk factors	Analyze the epidemiological, clinical, and therapeutic profile and determine the risk factors in patients with a diagnosis of rare infections of dermatological interest treated at Hospital México, Hospital Rafael Calderón Guardia, and Hospital San Juan de Dios during the period 2019-2023.	5 year
Determine the diagnostic methods	Determine the diagnostic methods utilized for each case, including culture, histological techniques, and molecular testing.	5 year

Collaborators and Investigators

• Sponsor: Caja Costarricense de Seguro Social
• Investigators: Principal Investigator: Daniel E Barquero Orias, MD, Caja Costarricense de Seguro Social

Publications and helpful links

General Publications

• Bolognia JL, Schaffer JV, Cerroni L, Callen JP. Dermatología. 4th ed. Barcelona: Elsevier; 2019.
• Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, et al. Fitzpatrick's Dermatology. 9th ed. New York: McGraw-Hill Education; 2019.
• Trejos A. La cromoblastomicosis como problema micológico [Tesis de grado para optar por el título de licenciatura en Microbiología]. San José, Costa Rica: Universidad de Costa Rica, 1954.
• Trejos A. Cladosporium carrionii n. sp. and the problem of Cladosporia isolated from chromoblastomycosis. Rev Biol Trop. 1954, 2(1):75-112.
• Mora M, Molina B, Moya A. Cromoblastomicosis por Cladophialophora Carrionnii: Primer caso descrito en literatura costarricense. Rev. méd. Costa Rica Centroam. 2010;67(594):373-6.
• Romero A, Trejos A. La cromomicosis en Costa Rica. Rev Biol Trop. 1953;1(2):95-115.
• Soto L, Jaikel D. Cromoblastomicosis: Situación en Costa Rica. Rev. méd. Costa Rica Centroam. 2014;71(613):737-44.
• Salazar K. Esporotricosis y cromoblastomicosis en San Ramón de Costa Rica. Acta Med Costarr. 2022;64(3):1-5. Disponible en https://doi.org/10.51481/amc.v64i3.1224
• Solano E. Cromomicosis. Acta Med Costarr. 1966;9(2):77-85.
• Astorga E, Bonilla E, Martínez C, Mora W. Cromomicosis (Nuevos casos de Cromomicosis tratados con Anfotericina B y 5·Fluorcitosina en forma simultánea). Rev. Méd. de Costa Rica. 1980;47(479):17-22.
• Sáenz L, Morera P. Sobre un caso de blastomicosis suramericana asociada a cromomicosis. Acta Med Costarr. 1963;6(1):55-71.
• Alice E. Ecología de Sporothrix schenkii. Rev Méd de Costa Rica. 1982;49(479):81-6.
• Rodríguez J. Aspectos clínicos, epidemiológicos y ecológicos sobre 100 casos de Esporotricosis en Costa Rica. Revista costarricense de Ciencias Médicas. 1992;12:29-36.
• González J, Rodríguez J. Tres casos de Esporotricosis. Revista costarricense de Ciencias Médicas. 1990;12:57-9.
• Jaramillo O. Esporotricosis en Costa Rica: Estudio clínico epidemiológico y terapéutico de cien casos. Boletín Médico del Seguro Social de Costa Rica. 1972;1(4):27-37.
• Rodríguez J, Gamboa A, Alvarado F. Etiología y epidemiología de los micetomas en Costa Rica. Rev. iberoamer. micol. 1988;5:144-8.
• Trejos A, Romero A. Contribución al estudio de las blastomicosis en Costa Rica. Rev Biol Trop. 1953;1(1):63-81.
• Astorga E, Mora W, Rodríguez A. Tratamiento de la Paracoccidioidomicosis con Ketoconazol (Primer caso en Costa Rica). Rev. Méd. de Costa Rica. 1986;53(494):1-3.
• Fernández K, Quirós JL. Paracoccidiodomicosis: (Reporte de siete casos). Rev. méd. Costa Rica Centroam. 2008;65(582):41-7.
• Kawer A, Madrigal L, Mata F. Paracoccidioidomicosis en lengua. Rev. méd. Costa Rica Centroam. 2011;68(599):505-8.
• Bonilla E, Miranda M, Mata L. Reporte del primer caso de Nocardiasis en Costa Rica. Acta Med Costarr. 1960;3(1):51-5.
• Cueva A. Nocardiosis. Acta Med Costarr. 1968;11(1):45-51. 23.
• Castro A, Trejos A. Constatación del primer caso centroamericano de Coccidioidomicosis. Rev Biol Trop. 1953;83-93.
• Hidalgo W, Xinirachs H, Cappella E, Solano E. Un caso de actinomicosis cervicofacial por Actinomyces bovis. Rev Biol Trop. 1960;8(2):155-63.
• Hidalgo W, Morera P, Hernández VM, Suárez A, Céspedes R. Criptococosis Estudio del primer caso confirmado en Costa Rica. Acta Med Costarr. 1960;3(5):221-35.
• Brizuela S, Montero N. Criptococosis asociado a VIH/SIDA (A propósito de un paciente). Rev. méd. Costa Rica Centroam. 2013;70(605):43-7.
• Mora J, Salazar J, Calderón C, García R. Rinosporidiosis en Costa Rica. (Revisión del tema e informe del primer caso en nuestro país). Acta Med Costarr. 1985;28(2):122-5.
• Riggioni S, Díaz S. Lacaziosis: Micosis cutánea profunda, Reporte de un caso. Rev. clín. esc. med. UCR-HSJD. 2015 Jun 29;5(3). https://doi.org/10.15517/rc_ucr-hsjd.v5i3.19916

Study record dates

Study Major Dates

• Study Start (Actual): December 11, 2023
• Primary Completion (Actual): May 24, 2024
• Study Completion (Actual): May 24, 2024

Study Registration Dates

• First Submitted: July 23, 2024
• First Submitted That Met QC Criteria: July 26, 2024
• First Posted (Actual): July 29, 2024

Study Record Updates

• Last Update Posted (Actual): July 29, 2024
• Last Update Submitted That Met QC Criteria: July 26, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Non-tuberculous mycobacteria; Infectious Skin Diseases; Bacterial Infections and Mycoses; Sporotrichosis; Mycetoma; Chromoblastomycosis
• Additional Relevant MeSH Terms: Pathologic Processes; Skin Diseases; Respiratory Tract Infections; Respiratory Tract Diseases; Lung Diseases; Disease Attributes; Bacterial Infections; Bacterial Infections and Mycoses; Gram-Positive Bacterial Infections; Actinomycetales Infections; Parasitic Diseases; Protozoan Infections; Skin Diseases, Infectious; Mycoses; Skin Diseases, Bacterial; Dermatomycoses; Lung Diseases, Fungal; Nocardia Infections; Infections; Communicable Diseases; Blastomycosis; Sporotrichosis; Coccidioidomycosis; Coccidiosis; Mycetoma; Paracoccidioidomycosis; Actinomycosis
• Other Study ID Numbers: R023-SABI-00344

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No