Phaeohyphomycosis caused by Alternaria infectoria in a renal transplant recipient.
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We report on a case of phaeohyphomycosis caused by Alternaria infectoria in a renal transplant recipient with pulmonary infiltrates and multiple skin lesions. Diagnosis was based on microscopy and culture of the skin lesions. Treatment consisted of a combination of surgical excision and systemic antifungal therapy, first with itraconazole and subsequently with liposomal amphotericin B, for 39 days. At a 20-month follow-up visit, no recurrence of the skin lesions or the pulmonary infiltrates had occurred. (+info)
Dermatophytoses in children: study of 137 cases.
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Dermatophytoses are common fungal infections caused by dermatophytes but there are few data about this condition in the childhood. 137 children below the age of 12 and clinically diagnosed as tineas were investigated prospectively at Instituto de Puericultura e Pediatria, Rio de Janeiro, from 1994 to 1999. Hair, skin/nails scraping and pus swabs were collected from lesions and processed for fungus. Male children from 2 to 12 years were mostly affected; tinea capitis (78 cases) mainly caused by Microsporum canis (46 cases) was the most common clinical form. Tinea corporis (43 cases) mainly caused by Trichophyton rubrum (17 cases) accounted for the second most frequent clinical form. Tinea cruris (10 cases) with Trichophyton rubrum (5 cases) as the most common etiologic agent accounted for the third most frequent clinical form. Tinea pedis and tinea unguium were much less frequent (3 cases each). Trichophyton rubrum was the most common etiologic agent isolated in these cases (3 cases). (+info)
Phaeohyphomycotic cyst caused by Colletotrichum crassipes.
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A case of phaeohyphomycosis is reported in a male renal transplant recipient with a nodular lesion in the right leg who was treated with immunosuppressing drugs. The lesion consisted of a purulent cyst with thick walls. The cyst was excised surgically, and the patient did not receive any antifungal therapy. One year later he remains well. Histological study of the lesion showed a granulomatous reaction of epithelioid and multinucleate giant cells, with a central area of necrosis and pus. Fontana-Masson staining demonstrated the presence of pigmented hyphal elements. The fungus Colletotrichum crassipes was grown in different cultures from the cyst. The in vitro inhibitory activities of eight antifungal drugs against the isolate were tested. Clotrimazole and UR-9825 were the most active drugs. This case represents the first known reported infection caused by this rare species. (+info)
Phialemonium curvatum infection after bone marrow transplantation.
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We report a case of cutaneous infection caused by Phialemonium curvatum GAMS et COOKE, 1983, after bone marrow transplantation. The genus Phialemonium was created by GAMS & MCGINNIS in 1983 including three new species: Ph. obovatum, Ph. curvatum and Ph. dimorphosporum, and represents an intermediate genus between Acremonium and Phialophora. Nowadays, the genus Phialemonium is considered to be a pheoid fungus which may cause the eventual lesions observed in pheo- and hyalohyphomycosis. Species of this genus have been described as opportunistic agents in humans and animals, mainly as a result of immunosuppression. In the present case, the patient had multiple myeloma and received an allogenic bone marrow transplant from his HLA-compatible brother. Two months after transplantation, he developed purplish and painful nodular lesions on the right ankle. Some of these lesions drained spontaneously and apparently hyaline mycelial filaments were observed, whose culture was initially identified as Acremonium sp. Subsequent studies showed that the fungus was Phialemonium curvatum. The infection was treated with amphotericin B, followed by ketoconazole. The patient was submitted to surgical debridement followed by two skin grafts to repair the bloody area. The duration of the treatment was 4 months and secondary prophylaxis with ketoconazole alone was maintained for one additional month. No recurrence was observed after discontinuation of treatment. The authors comment on the pathogenicity of the genus Phialemonium. (+info)
Attachment of Malassezia pachydermatis to the ear dermal cells in canine otitis externa.
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To investigate the predominance of Malassezia pachydermatis (M. pachydermatis) as a causative agent of canine otitis externa, ear cerumen samples were observed for adhesion of M. pachydermatis to the cornified epithelial cells by light and electron microscopes. The yeasts appeared not to adhere to the cornified epithelial cells directly, but they seemed to exist in the proximity of the epithelial cells with an electron opaque halo-like space around them. Polysaccharide and lipid staining techniques were conducted to identify the substances existing in that space. Lipid substances, not saccharides, were observed around the yeasts and the cornified epithelial cells. These results suggested that in the canine ear canal malassezia yeast attachment to the cornified epithelial cells is mediated by lipids. (+info)
Invasive phaeohyphomycosis caused by Curvularia species in a dog.
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A 2-year-old female Boxer dog was presented with a history of skin lesions that started 1 month after being given oral glucocorticoids for a neurologic problem. Clinically, the animal had focal areas of alopecia with papules and nodules often with ulceration overlain by crusts. Lesions were most common on the dorsum and the lateral aspects of the trunk and extremities. Histologic evaluation revealed pigmented fungal organisms within the lumina of hair follicles and throughout the dermis and subcutis. These organisms were associated with a multinodular, pyogranulomatous luminal folliculitis/furunculosis, dermatitis, and panniculitis. Curvularia sp. was isolated from the cutaneous lesions. The histologic identification of dematiaceous fungal organisms in the hair follicles may explain how phaeohyphomycosis can occur without history of a penetrating injury. (+info)
Differential diagnosis of annular lesions.
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Although most annular lesions will be typical of a dermatophytosis, physicians must consider other possible diagnoses. Tinea corporis can often be diagnosed on the basis of a positive potassium hydroxide examination. Topical and systemic antifungals are usually curative. Pityriasis rosea is characterized by small, fawn-colored lesions distributed along skin cleavage lines. Treatment is symptomatic. Granuloma annulare is characterized by nonscaly, annular plaques with indurated borders, typically on the extremities. One half of cases resolve spontaneously within two years. Sarcoidosis can present as annular, indurated plaques similar in appearance to the lesions of granuloma annulare. Diagnosis is based on histopathology and the involvement of other organ systems. Hansen's disease can mimic tinea corporis by presenting as one or more annular, sometimes scaly, plaques. Urticaria may affect 10 to 20 percent of the population. The annular plaques lack scale and are evanescent. Subacute cutaneous lupus erythematosus can present in an annular form on sun-exposed surfaces or in a papulosquamous form. Erythema annulare centrifugum typically presents as annular patches with trailing scale inside erythematous borders. (+info)
Application of PCR to distinguish common species of dermatophytes.
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This report describes the application of PCR fingerprinting for the identification of species and varieties of common dermatophytes and related fungi utilizing as a single primer the simple repetitive oligonucleotide (GACA)(4). The primer was able to amplify all the strains, producing species-specific profiles for Microsporum canis, Microsporum gypseum, Trichophyton rubrum, Trichophyton ajelloi, and Epidermophyton floccosum. Intraspecific variability was not observed for these species. Instead, three different profiles were observed in the Trichophyton mentagrophytes group. (+info)