Inmunoanálisis enzimático (ELISA) en la evolución terapéutica de la cromoblastomicosis por Cladophialophora carrionii en el área endémica del Estado Falcón, Venezuela

The purpose of this research was to evaluate an ELISA indirect method in patients with chromoblastomycosis caused by Cladophialophora carrionii. Samples collected before, during and postreatment with ajoene or itraconazole, and those from apparently healthy people from the endemic area were evaluated with the ELISA test. 94 individuals were studied, 10 with chromoblastomycosis, and 84 apparently healthy subjects. All of them were evaluated by clinical-dermatological examinations. On those with lesions suggestive of chromoblastomycosis, mycological studies were carried out to confirm the disease. This approach was repeated during and at the end of therapy. Five patients with lesions ≤ 5 cms were treated with ajoene and five with lesions ≤ 5 cms, received itraconazole. Mycological cure (60%) was similar in both groups of patients and persisted three months after therapy. One hundred and fourteen sera were analyzed by ELISA, 30 from 10 patients with chromoblastomycosis, before, during and postreatment and 84 from apparently healthy people, using a somatic antigen of C. carrionii (AgSPP). All patients with chromoblastomycosis were positive before-treatment, two became negative on day 45 of treatment and a total of six patients were negative three months post-treatment. All sera from apparently healthy individuals were negative. The sensitivity and specificity was 100% and 98.9%, respectively. The relationship between clinical-mycological studies and the ELISA assay was 100% before and after treatment. In summary, ELISA could be a valuable tool for the diagnosis and evolution of the therapeutic efficacy in patients with chromomycosis (C. carrionii). The use of an ELISA test is therefore highly recommended to establish remission criteria in chromoblastomycosis caused by C. carrionii.