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Papers by Daniel Wagner Santos

Emerging Infectious Diseases, 2020

We describe cases of donor-derived transmission of Cryptococcus deuterogattii in 2 kidney transpl... more We describe cases of donor-derived transmission of Cryptococcus deuterogattii in 2 kidney transplant recipients in Brazil and published information on other cases. Prompt reduction of immunosuppression and initiation of antifungal therapy was required to successfully control the fungal infections and preserve engraftment.

FEMS Yeast Research, 2007

The antifungal susceptibility profiles and the genetic variability of 83 sequential clinical isol... more The antifungal susceptibility profiles and the genetic variability of 83 sequential clinical isolates of Cryptococcus neoformans, including four Cryptococcus gattii isolates, obtained from 38 Sao Paulo AIDS patients with cryptococcal meningitis were assessed by electrophoretic karyotyping and random amplified polymorphic DNA (RAPD) analysis. The majority of the Cryptococcus neoformans isolates were highly susceptible to amphotericin B and fluconazole. Twenty percent of the minimum inhibitory concentration values for amphotericin B varied from 0.5 to 1 mg mL À1. For fluconazole, 22% occurred in the range 8-16 mg mL À1. Sequential isolates from nine patients showed a trend towards lower susceptibility to fluconazole, flucytosine, itraconazole and amphotericin B. The results of molecular typing by electrophoretic karyotyping and RAPD analysis showed the presence of 22 electrophoretic karyotypes (EK) and 15 RAPD profiles that were highly correlated. Our results provided evidence for the occurrence of genetic changes in some strains associated with microevolution during the course of infection. We also observed both microevolution and simultaneous coinfection with two distinct Cryptococcus neoformans strains in one patient. In some patients, we found changed EK-and RAPD patterns in association with increased MIC values.

Medical Mycology

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Introduction Paracoccidioidomycosis is... more Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Introduction Paracoccidioidomycosis is a systemic mycosis caused by the dimorphic fungus Paracoccidioides brasiliensis. The disease is restricted to Latin America. It is the principal systemic mycosis in Brazil, with higher incidences in the southern, southeastern and central regions. Objectives It's to report a case of paracoccioidomycosis with a bizarre presentation on the face. Case Report A 54-year-old male farmer from Açailândia, Maranhão, with a history of an extensive ulcerated lesion that started in the right wing of the nose. After 6 months of evolution, the lesion had already spread reaching the nasal and oral mucosa, evolving with acute respiratory failure, requiring tracheostomy (Fig.1). He was referred to the Cancer Hospital for a biopsy, which was referred for pathological examination, showing an intense inflammatory infiltrate consisting of lymphocytes, histiocytes, neutrophilis with giant, multinucleated ...

Brazilian Journal of Transplantation, 2022

Resumen: El Covid-19 impactó fuertemente los trasplantes de órganos sólidos (TOS). Los pacientes ... more Resumen: El Covid-19 impactó fuertemente los trasplantes de órganos sólidos (TOS). Los pacientes en lista de TOS y aquellos ya trasplantados pertenecen a la población prioritaria para la vacunación contra el Covid-19, que tiene por objetivo reducir a morbilidad y mortalidad del Covid-19. Todas las vacunas hoy en día utilizadas contra el Covid-19 pueden ser administradas en el escenario de TOS. El esquema de vacunas (plataforma de fabricación, edad, número de dosis, indicación de dosis de refuerzo) varía según el país.

Brazilian Journal of Transplantation, 2022

Your article is protected by copyright and all rights are held exclusively by Springer Science +B... more Your article is protected by copyright and all rights are held exclusively by Springer Science +Business Media Dordrecht. This e-offprint is for personal use only and shall not be selfarchived in electronic repositories. If you wish to self-archive your article, please use the accepted manuscript version for posting on your own website. You may further deposit the accepted manuscript version in any repository, provided it is only made publicly available 12 months after official publication or later and provided acknowledgement is given to the original source of publication and a link is inserted to the published article on Springer's website. The link must be accompanied by the following text: "The final publication is available at link.springer.com".

Transplant Infectious Disease

Journal of Fungi

There is worldwide concern with the increasing rates of infections due to multiresistant Candida ... more There is worldwide concern with the increasing rates of infections due to multiresistant Candida isolates reported in tertiary medical centers. We checked for historical trends in terms of prevalence rates and antifungal susceptibility of the Candida haemulonii species complex in our yeast stock culture collected during the last 11 years. The isolates were identified by sequencing the rDNA internal transcribed spacer (ITS) region, and antifungal susceptibility tests for amphotericin B, voriconazole, fluconazole, anidulafungin, and 5-fluorocytosine were performed by the Clinical and Laboratory Standards Institute (CLSI) microbroth method. A total of 49 isolates were identified as Candida haemulonii sensu stricto (n = 21), followed by C. haemulonii var. vulnera (n = 15) and C. duobushaemulonii (n = 13), including 38 isolates cultured from patients with deep-seated Candida infections. The prevalence of the C. haemulonii species complex increased from 0.9% (18 isolates among 1931) in th...

Journal of Neurology

The association between coronaviruses and central nervous system (CNS) demyelinating lesions has ... more The association between coronaviruses and central nervous system (CNS) demyelinating lesions has been previously shown. However, no case has been described of an association between the novel coronavirus (SARS-COV-2) and CNS demyelinating disease so far. SARS-COV-2 was previously detected in cerebrospinal fluid (CSF) sample of a patient with encephalitis. However, the virus identity was not confirmed by deep sequencing of SARS-COV-2 detected in the CSF. Here, we report a case of a patient with mild respiratory symptoms and neurological manifestations compatible with clinically isolated syndrome. The viral genome of SARS-COV-2 was detected and sequenced in CSF with 99.74-100% similarity between the patient virus and worldwide sequences. This report suggests a possible association of SARS-COV-2 infection with neurological symptoms of demyelinating disease, even in the absence of relevant upper respiratory tract infection signs.

Journal of Fungi

Chromoblastomycosis (CBM) is a neglected implantation mycosis prevalent in tropical climate zones... more Chromoblastomycosis (CBM) is a neglected implantation mycosis prevalent in tropical climate zones, considered an occupational disease that affects impoverished rural populations. This retrospective study described clinical aspects of CBM in a hyperendemic area in Brazil and constructed a worldwide haplotype network of Fonsecaea spp. strains. The variables were collected from medical records using a standard report form, reporting 191 patients with CBM from Maranhão, Brazil. The mean age was 56.1 years, 168 (88%) patients were male and predominantly farmers (85.8%). The mean time of evolution of the disease until diagnosis was 9.4 years. Lower limbs (81.2%) and upper limbs (14.2%) were the main sites affected. Most patients exhibited verrucous (55%) and infiltrative plaque (48.2%). Fonsecaea spp. were identified in 136 cases and a haplotype network constructed with ITS sequences of 185 global strains revealed a total of 59 haplotypes exhibiting high haplotypic and low nucleotide dive...

The association between coronaviruses and central nervous system (CNS) demyelinating lesions has ... more The association between coronaviruses and central nervous system (CNS) demyelinating lesions has been previously shown. However, no case has been described of an association between the novel coronavirus (SARS-COV-2) and CNS demyelinating disease so far. SARS-COV-2 was previously detected in cerebrospinal fluid (CSF) sample of a patient with encephalitis. However, the virus identity was not confirmed by deep sequencing of SARS-COV-2 detected in the CSF. Here, we report a case of a patient with mild respiratory symptoms and neurological manifestations compatible with Clinically Isolated Syndrome. The viral genome of SARS-COV-2 was detected and sequenced in CSF with 99.74 to 100% similarity between the patient virus and worldwide sequences. This report suggests a possible association of SARS COV-2 infection with neurological symptoms of demyelinating disease, even in the absence of relevant upper respiratory tract infection signs.

Current Fungal Infection Reports

Brazilian Journal of Nephrology

In 2004, a global spread of Chikungunya fever affected most tropical and subtropical regions of t... more In 2004, a global spread of Chikungunya fever affected most tropical and subtropical regions of the world. In 2016, an outbreak occurred in Northeast Brazil with hundreds of cases documented. Solid organ transplant recipients have a modified immune response to infection and the clinical course is usually different from immunocompetent patients. The diagnosis can be challenging in this population. Most reports describe patients residing in endemic areas, although we must emphasize the importance of differential diagnosis in kidney transplanted travelers who visit endemic regions, such as Northeast Brazil. Here, we reported a case of a kidney transplant recipient that acquired Chikungunya fever after a trip to an endemic region at Northeast Brazil during the outbreak in 2016, with a good clinical evolution. We also present warning recommendations for travelers to endemic areas as additional measures to prevent disease outbreaks.

The Brazilian Journal of Infectious Diseases

American Journal of Transplantation

Tuberculosis (TB) mortality is high among kidney-transplant (KT) recipients. Although local epide... more Tuberculosis (TB) mortality is high among kidney-transplant (KT) recipients. Although local epidemiology is an important factor, diagnostic/therapeutic challenges and immunosuppressive therapy (ISS) may influence outcomes. We analyzed the cumulative incidence (CumI) of TB in KT recipients receiving a variety of ISS with long-term follow-up. Our retrospective single-center cohort study included all KTs performed between 01/01/1998- 08/31/2014, followed-up until 08/31/2015. Induction therapy was based on perceived immunological risk; maintenance ISS included prednisone and calcineurin-inhibitor (CNI) plus azathioprine (AZA), and mycophenolic-acid (MPA) or mTOR-inhibitor (mTORi). Thirty-four patients received belatacept/MPA. KT was performed on 11,453 patients, and followed for 1989 (IQR 932-3632) days. Among these, 152 patients were diagnosed with TB (CumI 1.32%). Median time from KT to TB was 18.8 (IQR 7.2-60) months, with 59% of patients diagnosed after the first year. Unadjusted analysis revealed an increasing CI of TB (0.94%CNI/AZA, vs. 1.6%CNI/MPA [HR 1.62,95%CI 1.13-2.34, p=0.009] vs. 2.85%CNI/mTORi [HR 2.45,95%CI 1.49-4.32, p<0.001] vs. 14.7% Belatacept/MPA [HR 13.14, 95%CI 5.27-32.79, p<0.001]). Thirty-seven (24%) patients died, 39 (25.6%) experienced graft loss. Cytomegalovirus-infection (p=0.02) and definitive ISS-discontinuation (p<0.001) were associated with death. Rejection (p=0.018) and ISS-discontinuation (p=0.005) with graft loss. Tuberculosis occurred at any time after KT, and was influenced by immunosuppressive regimen. This article is protected by copyright. All rights reserved.

The Brazilian Journal of Infectious Diseases

Emerging Infectious Diseases, 2020

FEMS Yeast Research, 2007

Medical Mycology

Brazilian Journal of Transplantation, 2022

Transplant Infectious Disease

Journal of Fungi

Journal of Neurology

Journal of Fungi

The association between coronaviruses and central nervous system (CNS) demyelinating lesions has ... more The association between coronaviruses and central nervous system (CNS) demyelinating lesions has been previously shown. However, no case has been described of an association between the novel coronavirus (SARS-COV-2) and CNS demyelinating disease so far. SARS-COV-2 was previously detected in cerebrospinal fluid (CSF) sample of a patient with encephalitis. However, the virus identity was not confirmed by deep sequencing of SARS-COV-2 detected in the CSF. Here, we report a case of a patient with mild respiratory symptoms and neurological manifestations compatible with Clinically Isolated Syndrome. The viral genome of SARS-COV-2 was detected and sequenced in CSF with 99.74 to 100% similarity between the patient virus and worldwide sequences. This report suggests a possible association of SARS COV-2 infection with neurological symptoms of demyelinating disease, even in the absence of relevant upper respiratory tract infection signs.

Current Fungal Infection Reports

Brazilian Journal of Nephrology

The Brazilian Journal of Infectious Diseases

American Journal of Transplantation

The Brazilian Journal of Infectious Diseases