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Subcutaneous Mycoses

Mod 2 Lec 2

Subcutaneous mycoses 4 major infections Mycetoma, Chromoblastomycosis, Phaeohyphomycosis, Sporotrichosis
Common to all subcutaneous mycoses Lesion develops at site of inoculation (localized); soil saprophytes that are moderately slow growers; most are dematiaceous fungi
Types of conidiation seen in dematiaceous fungi Cladosporium type, Phialophora type, Rhinocladiella type
Cladosporium type conidiation Resembles a tree, conidiophore is trunk and branched chains of conidia form branches
Phialophora type conidiation Short conidiophores + phialide, vase shaped, conidia extrude from phialide and then cluster
Rhinocladiella type conidiation Stalked conidiophores that become knobby as conidia are produced, conidia produced sequentially until a cladosporium type conidiation is reached
Media used for identification of subcutaneous fungi SAB with and without antibiotics; PDA for subculture
Mycetoma Chronic granulomatous disease of feet; enlarges nodules, sinus drainage, bone destruction; granules in exudate; no lymphatic system involvement
Two types of granules in mycetoma Actinomycotic(narrow hyphae) and Eumycotic(wide hyphae, ending in chlamydoconidia)
Chromoblastomycosis Localized disease of skin and subcutaneous tissue; wart-like (verrucoid) lesions on feet, legs, hands, buttocks; soil saphrophytes introduced by trauma; dematiacious
Chromoblastomycosis - what is seen microscopically Single celled or clusters of single cells, dark pigment
Chromoblastomycosis - setting up for culture SAB at room temp, hold for 6 weeks
What are you looking for in chromoblastomycosis 3 types of conidiation: cladosporium type, rhionocladiella type, phialophora type
Phaeohyphomycosis Infection of subcutaneous tissue, caused by misc. dematiaceous fungi, introduced through trauma
Phaeohyphomycosis - KOH shows Pigmented hyphae
Cause of chromoblastomycosis Cladophialophora carrioinii
Cladophialophora carrioinii macro Slow grower - up to 30 days; grey-green to black surface and reverse, cottony
Cladophialophora carrioinii micro Pigmented, septate hyphae; cladosporium type conidiation
Causes chromoblastomycosis and phaeohyphomycosis Fonsecaea pedrosoi and Phialophora verrucosa
Fonsecaea pedrosoi macro Grey-green to black, cottony; slow grower, w/in 21 days
Fonsecaea pedrosoi micro Pigmented, spetate hyphae; all 3 types of conidiation: phialophora, cladosporium, rhinocladiella
Phialophora verrucosa macro Olive-green to black, velvety
Phialophora verrucosa micro Pigmented, septate hyphae; only phialophora type conidiation
Major etiologic agent of mycetoma in US and Europe Pseudallescheria boydii
Pseudallescheria boydii macro Grows rapidly; white to brownish-grey, fluffy
Pseudallescheria boydii micro Hyaline, septate hyphae; single anelloconidia produced on an anellophore (conidiophore)
How is Pseudallescheria boydii different from other subcutaneous mycoses Grows rapidly, hyaline, has a sexual form
Cause of Mycetoma and phaehyphomycosis by minor trauma and contaminated fomites Exophiala jeanselmei
Exophiala jeanselmei macro Young cultures: appear as black yeast; Mature cultures: velvety colonies
Exophiala jeanselmei micro Stick-like conidiophores with clustered conidia
Wangiella dermatitidis causes phaeohyphomycosis
Wangiella dermatitidis macro Initially resembles black yeast; > 10days, olive-grey to black, velvety or glabrous; grows better at 40-42C
Wangiella dermatitidis micro Pigmented, septate hyphae; conidiophores are indistinguishable from vegetative hyphae except conidia are clustered at ends
Acremonium spp cause Etiologic agent of mycetomas, corneal infections, and nail infections
Madurella grisea macro Folded in center with radial grooves, dark grey to olive-brown, reverse dark
Madurella grisea micro Dark, thick hyphae; other structures may be absent
Madurella mycetomatis macro Slow growing, fluffy white, grows best at 37C, reverse dark
Madurella mycetomatis micro Dark, thick hyphae, other structures may be absent, some have tiny flask-shaped phialides
Created by: blackicecreamcat