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    Subcutaneous Mycoses

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    sarguss14
    1. The document discusses several subcutaneous mycoses including sporotrichosis, chromoblastomycosis, and mycetoma. 2. Sporotrichosis is caused by Sporothrix schenkii and presents as nodules or ulcers along lymphatics from inoculation. Diagnosis involves identifying the yeast or mold form microscopically or in culture. 3. Chromoblastomycosis is caused by several fungi and presents as warty nodules on the legs that become cauliflower-like. Diagnosis involves finding the pathogen's sclerotic bodies microscopically.

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    Subcutaneous Mycoses

    Uploaded by

    sarguss14
    2K views23 pages
    1. The document discusses several subcutaneous mycoses including sporotrichosis, chromoblastomycosis, and mycetoma. 2. Sporotrichosis is caused by Sporothrix schenkii and presents as nodules or ulcers along lymphatics from inoculation. Diagnosis involves identifying the yeast or mold form microscopically or in culture. 3. Chromoblastomycosis is caused by several fungi and presents as warty nodules on the legs that become cauliflower-like. Diagnosis involves finding the pathogen's sclerotic bodies microscopically.

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    1. The document discusses several subcutaneous mycoses including sporotrichosis, chromoblastomycosis, and mycetoma. 2. Sporotrichosis is caused by Sporothrix schenkii and presents as nodules or ulcers along lymphatics from inoculation. Diagnosis involves identifying the yeast or mold form microscopically or in culture. 3. Chromoblastomycosis is caused by several fungi and presents as warty nodules on the legs that become cauliflower-like. Diagnosis involves finding the pathogen's sclerotic bodies microscopically.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    2K views23 pages

    Subcutaneous Mycoses

    Uploaded by

    sarguss14
    1. The document discusses several subcutaneous mycoses including sporotrichosis, chromoblastomycosis, and mycetoma. 2. Sporotrichosis is caused by Sporothrix schenkii and presents as nodules or ulcers along lymphatics from inoculation. Diagnosis involves identifying the yeast or mold form microscopically or in culture. 3. Chromoblastomycosis is caused by several fungi and presents as warty nodules on the legs that become cauliflower-like. Diagnosis involves finding the pathogen's sclerotic bodies microscopically.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 23
    At a glance
    Powered by AI
    The key takeaways are that subcutaneous mycoses are fungal infections that reside in soil or on vegetation and are introduced via trauma to the skin or subcutaneous tissue. They typically present as granulomatous lesions confined to the subcutaneous tissue.

    The main clinical presentations of subcutaneous mycoses include painless nodules or papules that can ulcerate and drain pus. Lesions are usually located on extremities and are generally localized.

    The main diagnostic tests used for subcutaneous mycoses include microscopic examination of tissue samples using fungal stains, histopathological examination, and fungal culture.

    SUBCUTANEOUS

    MYCOSES

    Mary Ann C. Bunyi, MD


    • Fungi reside in soil or on vegetation

    • Traumatic inoculation of the skin or


    subcutaneous tissue

    • In general, lesions become


    granulomatous

    • Lesions usually confined to the


    subcutaneous tissue
    Sporothrix schenkii
    • Dimorphic

    • Associated with grass,


    trees,rose bushes and
    other
    plants

    • Grows as a mold, have


    branches, septate
    hyphae and conidia

    • Agent of
    SPOROTRICHOSIS:
    chronic granulomatous
    infection with seondary
    Sporothrix schenkii
    (Morphology and Identification)
    • Grows well on
    routine agar media

    • Young colonies –
    blackish , shiny then
    wrinkles with age

    • Produces branches,
    septate
    hyphae and small
    conidia clustered at
    the ends
    Sporothrix schenkii
    (Clinical Findings)
    • Conidia introduced into
    the skin by trauma

    • Initial location of lesion


    is the extremity

    • Initial lesion is a
    granulomatous nodule,
    eventually necroses or
    ulcerates

    • Little systemic illness


    associated in
    immunocompetent hosts
    Sporothrix schenkii
    (Diagnostic Tests)

    A. Microscopic Examination of Specimen


    - histopathologic examination of tissue
    using routine fungal stain (Gomori’s or
    PAS)

    D. Culture
    - most reliable method
    - Saboraud’s agar
    Sporothrix schenkii
    (Treatment)

    • Oral itraconazole – treatment of choice

    • Amphotericin B – systemic disease

    • Other cases, self-limited


    Sporothrix schenkii
    (Epidemiology)

    • Occurs worldwide closely associated


    with plants

    • Predominant in males

    • Higher incidence in agricultural


    workers
    CHROMOBLASTOMYCOSIS
    (Chromomycosis)
    • Traumatic inoculation of any of the 5
    recognized agents that reside in soil
    and vegetation

    • Phialophora verrucosa, Fonsecaea pedrosoi,


    Rhinocladiella aquaspersa, Fonsecaea
    compacta, Cladosporium carrionii

    • Progressive granulomatous infection –


    hyperplasia of the epidermal tissue
    Morphology

    • Similar in pigmentation and morphology

    • Colonies – compact, deep brown to black,


    develop velvety wrinkled surface

    • Identified by their modes of conidiation

    • Produce spherical brown cells termed as


    muriform or sclerotic or “Medlar” bodies
    Phialophora verrucosa
    (Morphology)

    • Conidia produced
    from flask-shaped
    phialides with cup-
    shaped collarettes

    • Mature conidia
    accumulate around
    the phialide
    Cladosporium carrionii
    (Morphology)

    • Produce
    branching chains
    of conidia by
    distal budding
    Rhinociadiella aquaspersa
    Morphology

    • Produces lateral
    or terminal
    conidia from a
    lengthening
    conidiogenous
    cell

    • Elliptical shaped
    conidia
    Fonsecaea pedrosoi
    Morphology

    • Polymorphic
    - phialides
    - chains of
    blastoconidia
    similar to
    cladosporium
    - similar to
    rhinocladiella ,
    sympodial
    CHROMOBLASTOMYCOSIS
    (Clinical findings)
    • Introduced into the
    skin by trauma

    • Usual site of lesion:


    lower extremities
    (feet or legs)

    • lesion becomes
    wartlike ;
    cauliflower-like
    nodules with
    abscesses cover the
    area; “ black dots”
    cover the warty
    CHROMOBLASTOMYCOSIS
    (Diagnostic tests)

    1. Microscopy
    - scrapings placed
    in 10% KOH
    - detection of the
    sclerotic bodies is
    diagnostic
    4. Culture
    - Saboraud’s agar
    with antibiotics
    CHROMOBLASTOMYCOSIS
    (Treatment)

    • surgical excision – therapy of choice


    for
    small lesions

    • Flucytosine or itraconazole – larger


    lesions

    • Relapse - common
    MYCETOMA

    • Chronic infection induced by traumatic


    inoculation with any of the saprophytic
    species of fungi or actinomycetous
    bacteria

    • Actinomycetoma – caused by
    actinomycetes

    • Eumycetoma (Madura foot) – caused by


    a fungus
    EUMYCETOMA

    • Pseudoallescheria boydii – most


    common etiologic agent in US

    • Madurella mycetomatis – agent which


    accounts for most cases worldwide
    EUMYCETOMA
    (Clinical Findings)
    • Traumatic inoculation
    with soil contaminated
    with the agent

    • Lower extremities, hands


    and exposed areas are
    often involved

    • Characterized by
    suppuration and abscess
    formation

    • May spread to
    contiguous muscles
    EUMYCETOMA
    (Diagnostic tests

    • Identification of the etiologic


    agent is based on direct
    microscopis examination of the
    granules, culture of isolates of the
    agent, colonial morphology
    EUMYCETOMA
    ( Treatment)

    • combined surgical and medical


    treatment
    - management option of choice

    Antifungal therapy has varied results


    Agent S/Sx Identificat
    Disease ion

    Sporotrichosi Sporothrix Nodules & Yeast in


    s 2. Yeast ulcers tissue,
    along mold at rm
    3. mold
    lymphatics temp with
    & at site of “rosette
    chromoblasto Fonsecaea inoculation
    Warty pattern”
    Copper
    mycosis nodules colored
    that spherical
    become yeasts
    “cauliflowe called
    Mycetoma Madurella rDraining
    like “Medlar”
    White,
    appearance
    sinus or sclerotic
    brown,
    (Eumycetoma at bodies in
    ) tracts at yellow or
    inoculation
    the site of tissue
    black
    inoculation granules in
    exudates
    that are in

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