Mod 2 Lec 2
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| Subcutaneous mycoses 4 major infections | Mycetoma, Chromoblastomycosis, Phaeohyphomycosis, Sporotrichosis
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| Common to all subcutaneous mycoses | Lesion develops at site of inoculation (localized); soil saprophytes that are moderately slow growers; most are dematiaceous fungi
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| Types of conidiation seen in dematiaceous fungi | Cladosporium type, Phialophora type, Rhinocladiella type
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| Cladosporium type conidiation | Resembles a tree, conidiophore is trunk and branched chains of conidia form branches
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| Phialophora type conidiation | Short conidiophores + phialide, vase shaped, conidia extrude from phialide and then cluster
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| Rhinocladiella type conidiation | Stalked conidiophores that become knobby as conidia are produced, conidia produced sequentially until a cladosporium type conidiation is reached
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| Media used for identification of subcutaneous fungi | SAB with and without antibiotics; PDA for subculture
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| Mycetoma | Chronic granulomatous disease of feet; enlarges nodules, sinus drainage, bone destruction; granules in exudate; no lymphatic system involvement
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| Two types of granules in mycetoma | Actinomycotic(narrow hyphae) and Eumycotic(wide hyphae, ending in chlamydoconidia)
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| Chromoblastomycosis | Localized disease of skin and subcutaneous tissue; wart-like (verrucoid) lesions on feet, legs, hands, buttocks; soil saphrophytes introduced by trauma; dematiacious
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| Chromoblastomycosis - what is seen microscopically | Single celled or clusters of single cells, dark pigment
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| Chromoblastomycosis - setting up for culture | SAB at room temp, hold for 6 weeks
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| What are you looking for in chromoblastomycosis | 3 types of conidiation: cladosporium type, rhionocladiella type, phialophora type
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| Phaeohyphomycosis | Infection of subcutaneous tissue, caused by misc. dematiaceous fungi, introduced through trauma
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| Phaeohyphomycosis - KOH shows | Pigmented hyphae
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| Cause of chromoblastomycosis | Cladophialophora carrioinii
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| Cladophialophora carrioinii macro | Slow grower - up to 30 days; grey-green to black surface and reverse, cottony
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| Cladophialophora carrioinii micro | Pigmented, septate hyphae; cladosporium type conidiation
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| Causes chromoblastomycosis and phaeohyphomycosis | Fonsecaea pedrosoi and Phialophora verrucosa
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| Fonsecaea pedrosoi macro | Grey-green to black, cottony; slow grower, w/in 21 days
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| Fonsecaea pedrosoi micro | Pigmented, spetate hyphae; all 3 types of conidiation: phialophora, cladosporium, rhinocladiella
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| Phialophora verrucosa macro | Olive-green to black, velvety
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| Phialophora verrucosa micro | Pigmented, septate hyphae; only phialophora type conidiation
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| Major etiologic agent of mycetoma in US and Europe | Pseudallescheria boydii
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| Pseudallescheria boydii macro | Grows rapidly; white to brownish-grey, fluffy
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| Pseudallescheria boydii micro | Hyaline, septate hyphae; single anelloconidia produced on an anellophore (conidiophore)
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| How is Pseudallescheria boydii different from other subcutaneous mycoses | Grows rapidly, hyaline, has a sexual form
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| Cause of Mycetoma and phaehyphomycosis by minor trauma and contaminated fomites | Exophiala jeanselmei
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| Exophiala jeanselmei macro | Young cultures: appear as black yeast; Mature cultures: velvety colonies
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| Exophiala jeanselmei micro | Stick-like conidiophores with clustered conidia
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| Wangiella dermatitidis causes | phaeohyphomycosis
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| Wangiella dermatitidis macro | Initially resembles black yeast; > 10days, olive-grey to black, velvety or glabrous; grows better at 40-42C
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| Wangiella dermatitidis micro | Pigmented, septate hyphae; conidiophores are indistinguishable from vegetative hyphae except conidia are clustered at ends
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| Acremonium spp cause | Etiologic agent of mycetomas, corneal infections, and nail infections
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| Madurella grisea macro | Folded in center with radial grooves, dark grey to olive-brown, reverse dark
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| Madurella grisea micro | Dark, thick hyphae; other structures may be absent
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| Madurella mycetomatis macro | Slow growing, fluffy white, grows best at 37C, reverse dark
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| Madurella mycetomatis micro | Dark, thick hyphae, other structures may be absent, some have tiny flask-shaped phialides
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