0106100930 - Mfm Ii - Subcutaneous Mycoses (Alley)

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Sporotrichosis transmission/infection and demographic

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cuts or lesions on hands or arms is most common from soil, tree bark, garden plants and frequent in male gardeners, farmers in Mexico, Brazil, Uruguary, S. Africa

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Sporotrichosis post infection presentation

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papules as site of infection, spreads through lymphatics, will eventually manifest as (lymphocutaneous) lesions on the skin that follow lymphatics pattern

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Sporotrichosis causative agent

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Sporothrix schenkii, thermally dimorphic w/ 37C - round yeast, 25C septate hyphae, rosette shaped clusters of conidia at tips of conidiophores

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Sporotrichosis Dx

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Microscopy of pus or sputum, *Asteroid bodies in histo biopsy within yeast cells and Splendore-Hoeppli, culture, serology

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Sporotrichosis Tx

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spontaneous, topical/oral (potassium iodide)

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Sporotrichosis rare presentation

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pulmonary, osteoarticular, disseminated

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Chromoblastomycosis transmission/infection and demographic

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Caused by trauma (splinters, thorns), in men in tropical/subtropical regions, affecting extremities

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Chromoblastomycosis rare presentation

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systemic

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Chromoblastomycosis post infection presentation

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1)cauliflower nodular lesions
2)plaques, central healiing with atrophic yellow scar tissue

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Chromoblastomycosis causative agent

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Fonsecaea (F. pedrosoi), Cladosporium (C. carrionii)

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Chromoblastomycosis Dx

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KOH microscopy with sclerotic cells/bodies, velvety culture

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Chromoblastomycosis Tx

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antifungal tx, surgery, cryosurgery

Front 13

Mycetoma transmission/infection and demographic

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trauma infection of trunk, feet usually from walking barefoot, mainly in men of subcutaneous tissue and bone, more frequent in tropical and subtropical climates

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Mycetoma post infection presentation

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painless swelling, thickening of skin -> enlarge to become tumorous -> discharge viscous fluid containing GRAINS

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Mycetoma causative agents

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40% Eumycetoma (Pseudodallescheria boydii (US), Madurella mycetomatis (WW)), Actinomyces

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Mycetoma Dx

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Clinical triad: tumefaction, draining sinuses, granules. Granules are the most significant

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Mycetoma Tx

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Surgical antifungal combo, 80% recurrance with surgery

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Mycetoma rare presentation

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can spread to bone, muscle, blood vessels

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Phaeohypomycosis transmission/infection and demographic

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saprophytes cause infection, presents on hands and feet, sometimes looks like a synovial cyst, firm or fluctuant to touch, painless

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Phaeohypomycosis post infection presentation

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cyst, can spread to face and trunk, hyperpigmented demarcated plaques

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Phaeohypomycosis causative agent

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over 20 saprophytes, but remember Exophilia jeanselmei and Wangiella dermtitidis

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Phaeohypomycosis Dx

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Microscopy w/ brown pigmented, branching septate hyphae and dark walled yeast, histo with hyphae with giant cells

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Phaeohypomycosis Tx

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surgical, antifungal

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Zygomycosis transmission/infection and demographic

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traumatic implantation

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Zygomycosis causative agent

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C. coronatus in males' nasal submucosa; B. ranarum in male children's limbs, trunk

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Zygomycosis Dx

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Biopsy, so histo necessary: focal clusters of inflammation eosinophils and zygomycotic hyphae - Splendore-Hoeppli phenomenon

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Zygomycosis Tx

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Surgery, anti-fungal (itraconazole, oral potassium iodide)