Subcutaneous mycoses

grow on soil or on decaying vegetation

must be introduced into subcutaneous tissue in order to produce disease

GENERALLY : lesions spread slowly from the area of implantation

extension via lymphatics draining the lesion is slow (except in sporotrichosis)

SUBCUTANEOUS MYCOSES

Thursday, January 19, 2012

SPOROTHRIX SCHENCKII

dimorphic

live on plants or wood

causes sporotrichosis

chronic granulomatous infection



DIAGNOSTICS:

pus or biopsy from lesions as specimens

culture on Saboraud’s with clusters of conidia = diagnostic

converts to yeast form at 37C

agglutination of yeast cell from sera = not diagnostic



TREATMENT:

self-limited though chronic

potassium iodide administered orally for weeks

ampothericin B intravenously

oral ketoconazole


CHROMOBLASTOMYCOSIS (Chomomycosis)

slowly progressive granulomatous infection of skin

caused by black molds

Phialophora verrucosa, Fonsecaea pedrosoi, Rhinocladiella aquaspersa, Cladosporium carrionii


Phialophora verrucosa


Fonsecaea pedrosoi


Rhinocladiella aquaspersa


Cladosporium carrionii


DIAGNOSTICS:

specimen: scrapings or biopsy from lesions

microscopy: scrapings in 10% potassium hydroxide (dark, round fungus cells = sclerotic bodies diagnostic)

culture in Saboraud’s and digests gelatin



TREATMENT:

surgical excision with wide margins for small lesions

chemotherapy with flucytosine or itraconazole for larger lesions

locally applied heat may be beneficial

relapse common



Subcutaneous mycoses

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