Scientific letter
Necrotising otitis externa due to Scopulariopsis brevicaulis in a patient without predisposing factors
Otitis externa necrosante causada por Scopulariopsis brevicaulis en un paciente sin factores predisponentes
Isabel de Miguel-Martineza,
, Pilar Michelle Hernandez-Cabrerab, María Aser Armesto-Fernándezc, Antonio Manuel Martín-Sáncheza
Corresponding author
a Servicio de Microbiología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
b Unidad de Enfermedades Infecciosas, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
c Servicio de Otorrinolaringología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Gran Canaria, Las Palmas de Gran Canaria, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Otitis externa necrosante causada por <span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span> en un paciente sin factores predisponentes" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 727 "Ancho" => 1700 "Tamanyo" => 228360 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Main diagnostic signs of otitis externa due to <span class="elsevierStyleItalic">Scopulariopsis brevicaulis.</span> (A) Head CT showing opacification of the mastoid cells and chondritis of the EAC, on the left side. (B) Lactophenol blue staining (40×) after 7 days of incubation: spherical conidia with truncate base in chains.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">This article studies the case of a 38-year-old male patient with no history of interest. He reported regular contact with farm animals and takes part in water sports. He came to the clinic with purulent otorrhoea and oedema of the left external auditory canal (EAC). He received topical empirical treatment with gentamicin and dexamethasone. After 10 months, he returned to the clinic due to still having painless otorrhoea. Examination with an otoscope revealed dermal and cartilaginous necrosis and non-marginal perforation of the eardrum, associated with indurated dermatitis of the auricle. He had non-tender lymphadenopathy in the left posterior triangle of the neck. He had no fever, dysphonia or weight loss. Human immunodeficiency virus screening and tests for autoimmune disorders were negative. Biopsies were taken from the EAC for microbiological and anatomical pathology testing and a computed axial tomography (CT scan) of the ear was ordered. The patient was treated with linezolid and oral ciprofloxacin. The CT scan showed opacification of the left epitympanic region, with a soft tissue mass in the internal and lateral portion, with opacification of the mastoid cells and tympanic cavity, secondary to the concomitant inflammatory process due to perforation of the eardrum which is consistent with the diagnosis of outer ear infection with integrity of the ossicular chain (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Anatomical pathology revealed hyperkeratosis and chronic inflammation of the soft tissue along with necrotic lesions with thrombotic phenomena. Periodic acid-Schiff and Grocott methenamine silver stains were negative as were microbiological cultures.</p><p id="par0015" class="elsevierStylePara elsevierViewall">At a check-up performed one month later, no improvement was observed and areas of necrosis within the EAC had continued to spread; new specimens were sent for microbiological analysis.</p><p id="par0020" class="elsevierStylePara elsevierViewall">A KOH test showed irregular hyphae and oval conidia in chains. Gram staining showed abundant hyphae. Yeast only grew in cultures after incubation for 48 hours at 37<span class="elsevierStyleHsp" style=""></span>°C. Colonies on Sabouraud agar plates were white, velvety and turned a brown colour at day five. Lactophenol blue staining (×40) of colonies showed septate hyphae, swollen conidiophores and spherical conidia with wide truncate base in chains, which are characteristic of the genus <span class="elsevierStyleItalic">Scopulariopsis</span> (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). Yeast were identified using MALDI-TOF (Bruker<span class="elsevierStyleSup">®</span>) mass spectrometry, <span class="elsevierStyleItalic">via</span> total extraction of the isolate, revealing <span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span> in the first 7 patterns reported. Although the score was 1.759, the result was deemed to be correct as it was consistent with the morphological identification.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The National Centre for Microbiology confirmed this identification by morphological analysis. Likewise, antifungal susceptibility tests were conducted based on recommendations of the <span class="elsevierStyleItalic">Subcommittee on Antifungal Susceptibility Testing</span> of the <span class="elsevierStyleItalic">European Committee for Antimicrobial Susceptibility Testing</span>, obtaining the following results, expressed in mg/l: amphotericin B, MIC >16; itraconazole, MIC >8; voriconazole, MIC >8; posaconazole, MIC >8; terbinafine, MIC >16, and caspofungin, MIC<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8. Although no antifungal susceptibility testing breakpoints have been defined for this microorganism, observed and expected <span class="elsevierStyleItalic">in vitro</span> activity was limited.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2–6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The patient's ear was cleaned surgically and voriconazole (300<span class="elsevierStyleHsp" style=""></span>mg/12<span class="elsevierStyleHsp" style=""></span>h) was administered. A major improvement with re-epithelialisation of the EAC was observed at 6 weeks and control cultures were negative. The same treatment was prescribed for another month without the patient visiting the clinic for a check-up or experiencing any recurrence.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Hennequin et al.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> and Besbes et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> reported two patients with otomycosis due to <span class="elsevierStyleItalic">S. brevicaulis</span> who had previously undergone tympanoplasty and cholesteatoma surgery, respectively. Issakainen et al.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> studied 13 cases of otitis externa due to <span class="elsevierStyleItalic">Scopulariopsis</span> spp. and only 7 had underlying diseases.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The patient whose case we are presenting had no predisposing factors and the infection was considered to possibly be due to unperceived microtrauma to the EAC. The patient also showed no onychomycosis, an infection often caused by <span class="elsevierStyleItalic">S. brevicaulis</span>.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The presence of <span class="elsevierStyleItalic">S. brevicaulis</span> in pure cultures and the patient's clinical outcome and response to treatment, with no other confirmed aetiology, affirmed that this microorganism was the causal agent.</p><p id="par0045" class="elsevierStylePara elsevierViewall">A differential diagnosis of malignant otitis externa was performed, but the absence of osteolytic lesions and granulomas in the EAC ruled out this condition.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Invasive infection due to <span class="elsevierStyleItalic">S. brevicaulis</span> is uncommon and has been described mainly in immunocompromised patients, but may occur in immunocompetent individuals and tends to have a good prognosis.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3–6</span></a> There is no established therapy, although some authors indicate voriconazole to be the most effective antifungal <span class="elsevierStyleItalic">in vivo</span> and it is a good therapeutic option in association with surgical debridement of the lesion.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: de Miguel-Martinez I, Hernandez-Cabrera PM, Armesto-Fernández MA, Martín-Sánchez AM. Otitis externa necrosante causada por <span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span> en un paciente sin factores predisponentes. Enferm Infecc Microbiol Clin. 2018;36:62–64.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 727 "Ancho" => 1700 "Tamanyo" => 228360 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Main diagnostic signs of otitis externa due to <span class="elsevierStyleItalic">Scopulariopsis brevicaulis.</span> (A) Head CT showing opacification of the mastoid cells and chondritis of the EAC, on the left side. (B) Lactophenol blue staining (40×) after 7 days of incubation: spherical conidia with truncate base in chains.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aplicación de la espectrometría de masas en micología" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I. Quiles-Melero" 1 => "T. Peláez" 2 => "A. Rezusta-López" 3 => "J. Garcia-Rodríguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0213-005X(16)30187-2" "Revista" => array:7 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2016" "volumen" => "34" "numero" => "Supl 2" "paginaInicial" => "26" "paginaFinal" => "30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27389289" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span>, a fungal pathogen resistant to broad-spectrum antifungal agents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Cuenca-Estrella" 1 => "A. Gomez-Lopez" 2 => "E. Mellado" 3 => "M.J. Buitrago" 4 => "A. Monzón" 5 => "J.L. Rodriguez Tudela" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Antimicrob Agents Chemother" "fecha" => "2003" "volumen" => "47" "paginaInicial" => "2339" "paginaFinal" => "2341" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12821493" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fatal bronchial invasion of <span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span> in an acute monocytic leukemia patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Q. Yang" 1 => "J. Wei" 2 => "Z. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.diagmicrobio.2012.04.010" "Revista" => array:6 [ "tituloSerie" => "Diagn Microbiol Infect Dis" "fecha" => "2012" "volumen" => "73" "paginaInicial" => "369" "paginaFinal" => "377" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22633337" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fatal <span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span> infection in paediatric stem-cell transplant patient treated with voriconazole and caspofungin and review of <span class="elsevierStyleItalic">Scopulariopsis</span> infections in immunocompromised patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W.J. Steinbach" 1 => "W.A. Schell" 2 => "J.L. Miller" 3 => "J.R. Perfect" 4 => "P.L. Martin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Infect" "fecha" => "2004" "volumen" => "48" "paginaInicial" => "112" "paginaFinal" => "116" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14667801" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Disseminated <span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span> infection in an allogeneic stem cell recipient: case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Salmon" 1 => "A. Debourgogne" 2 => "M. Vasbien" 3 => "L. Clement" 4 => "J. Collomb" 5 => "F. Plénat" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1198-743X.2009.02878.x" "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Infect" "fecha" => "2010" "volumen" => "16" "paginaInicial" => "508" "paginaFinal" => "512" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19624505" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sinusitis caused by <span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span>: case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Sattler" 1 => "M. Sabou" 2 => "A. Ganeval-Stoll" 3 => "C. Dissaux" 4 => "E. Candolfi" 5 => "V. Letscher-Bru" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.mmcr.2014.05.003" "Revista" => array:6 [ "tituloSerie" => "Med Mycol Case Rep" "fecha" => "2014" "volumen" => "5" "paginaInicial" => "24" "paginaFinal" => "27" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25003024" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Otomycose à <span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span> après tympanoplastie" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Hennequin" 1 => "M. El-Bez" 2 => "J. Trotoux" 3 => "M. Simonet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Otolaryngol Chir Cervicofac" "fecha" => "1994" "volumen" => "111" "paginaInicial" => "353" "paginaFinal" => "354" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7785936" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Otomycose à <span class="elsevierStyleItalic">Scopulariopsis brevicaulis</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Besbes" 1 => "F. Makni" 2 => "F. Cheikh-Rouhou" 3 => "H. Sellami" 4 => "K. Kharrat" 5 => "A. Ayadi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Laryngol Otol Rhinol" "fecha" => "2002" "volumen" => "123" "paginaInicial" => "77" "paginaFinal" => "78" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deep, respiratory tract and ear infections caused by <span class="elsevierStyleItalic">Pseudallescheria (Scedosporium)</span> and <span class="elsevierStyleItalic">Microascus (Scopulariopsis)</span> in Finland. A 10-year retrospective multi-center study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Issakainen" 1 => "J.H. Salonen" 2 => "V.J. Anttila" 3 => "P. Koukila-Kähkölä" 4 => "M. Castrén" 5 => "O. Liimatainen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/13693780903161208" "Revista" => array:6 [ "tituloSerie" => "Med Mycol" "fecha" => "2010" "volumen" => "48" "paginaInicial" => "458" "paginaFinal" => "465" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19672782" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Onychomycosis by molds. Report of 78 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Bonifaz" 1 => "P. Cruz-Aguilar" 2 => "R.M. Ponce" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1684/ejd.2007.0092" "Revista" => array:6 [ "tituloSerie" => "Eur J Dermatol" "fecha" => "2007" "volumen" => "17" "paginaInicial" => "70" "paginaFinal" => "72" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17324832" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/2529993X/0000003600000001/v2_201801220600/S2529993X17302939/v2_201801220600/en/main.assets" "Apartado" => array:4 [ "identificador" => "63562" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000003600000001/v2_201801220600/S2529993X17302939/v2_201801220600/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X17302939?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 11 | 5 | 16 |
| 2024 September | 31 | 5 | 36 |
| 2024 August | 28 | 3 | 31 |
| 2024 July | 21 | 2 | 23 |
| 2024 June | 33 | 4 | 37 |
| 2024 May | 19 | 2 | 21 |
| 2024 April | 44 | 8 | 52 |
| 2024 March | 37 | 5 | 42 |
| 2024 February | 30 | 1 | 31 |
| 2024 January | 34 | 4 | 38 |
| 2023 December | 64 | 3 | 67 |
| 2023 November | 50 | 4 | 54 |
| 2023 October | 46 | 4 | 50 |
| 2023 September | 53 | 6 | 59 |
| 2023 August | 38 | 1 | 39 |
| 2023 July | 50 | 6 | 56 |
| 2023 June | 55 | 5 | 60 |
| 2023 May | 90 | 1 | 91 |
| 2023 April | 68 | 1 | 69 |
| 2023 March | 99 | 3 | 102 |
| 2023 February | 70 | 7 | 77 |
| 2023 January | 52 | 3 | 55 |
| 2022 December | 46 | 5 | 51 |
| 2022 November | 40 | 9 | 49 |
| 2022 October | 75 | 11 | 86 |
| 2022 September | 29 | 32 | 61 |
| 2022 August | 51 | 23 | 74 |
| 2022 July | 22 | 8 | 30 |
| 2022 June | 31 | 8 | 39 |
| 2022 May | 36 | 5 | 41 |
| 2022 April | 25 | 12 | 37 |
| 2022 March | 36 | 10 | 46 |
| 2022 February | 47 | 4 | 51 |
| 2022 January | 68 | 8 | 76 |
| 2021 December | 47 | 10 | 57 |
| 2021 November | 61 | 11 | 72 |
| 2021 October | 43 | 10 | 53 |
| 2021 September | 25 | 8 | 33 |
| 2021 August | 57 | 10 | 67 |
| 2021 July | 21 | 14 | 35 |
| 2021 June | 32 | 7 | 39 |
| 2021 May | 57 | 7 | 64 |
| 2021 April | 76 | 10 | 86 |
| 2021 March | 39 | 10 | 49 |
| 2021 February | 30 | 10 | 40 |
| 2021 January | 27 | 10 | 37 |
| 2020 December | 41 | 12 | 53 |
| 2020 November | 45 | 7 | 52 |
| 2020 October | 24 | 8 | 32 |
| 2020 September | 25 | 9 | 34 |
| 2020 August | 18 | 7 | 25 |
| 2020 July | 17 | 9 | 26 |
| 2020 June | 30 | 7 | 37 |
| 2020 May | 29 | 6 | 35 |
| 2020 April | 18 | 6 | 24 |
| 2020 March | 43 | 2 | 45 |
| 2020 February | 33 | 4 | 37 |
| 2020 January | 39 | 6 | 45 |
| 2019 December | 30 | 5 | 35 |
| 2019 November | 25 | 1 | 26 |
| 2019 October | 29 | 9 | 38 |
| 2019 September | 20 | 3 | 23 |
| 2019 August | 19 | 1 | 20 |
| 2019 July | 61 | 5 | 66 |
| 2019 June | 93 | 19 | 112 |
| 2019 May | 190 | 65 | 255 |
| 2019 April | 87 | 30 | 117 |
| 2019 March | 12 | 4 | 16 |
| 2019 February | 21 | 6 | 27 |
| 2019 January | 14 | 3 | 17 |
| 2018 December | 9 | 2 | 11 |
| 2018 November | 16 | 7 | 23 |
| 2018 October | 16 | 9 | 25 |
| 2018 September | 7 | 2 | 9 |
| 2018 August | 6 | 0 | 6 |
| 2018 July | 8 | 0 | 8 |
| 2018 January | 22 | 4 | 26 |
| 2017 December | 1 | 2 | 3 |
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