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Subcutaneous Mycosis 06-07

1. Subcutaneous mycosis refers to chronic fungal or bacterial infections of the subcutaneous tissues that cause swelling, sinus formation, and suppuration. 2. Mycetoma (Madura foot) is caused by fungi like Madurella mycetomatis or bacteria like Actinomyces and presents as abscesses and draining sinuses in the feet and lower extremities. 3. Sporotrichosis is caused by the dimorphic fungus Sporothrix schenckii and presents as chronic ulcers and nodules along lymphatic drainage from an initial puncture wound.

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263 views16 pages

Subcutaneous Mycosis 06-07

1. Subcutaneous mycosis refers to chronic fungal or bacterial infections of the subcutaneous tissues that cause swelling, sinus formation, and suppuration. 2. Mycetoma (Madura foot) is caused by fungi like Madurella mycetomatis or bacteria like Actinomyces and presents as abscesses and draining sinuses in the feet and lower extremities. 3. Sporotrichosis is caused by the dimorphic fungus Sporothrix schenckii and presents as chronic ulcers and nodules along lymphatic drainage from an initial puncture wound.

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Subcutaneous Mycosis

Subcutaneous Mycosis

Mycetoma (Maduromycosis = Madura Foot)

• Chronic granulomatous lesion of


subcutaneous tissues characterized by
swelling, sinus formation & suppuration.
• Post-traumatic chronic infection
• Common in tropical climates
Mycetoma
Causes

• Bacterial (Actinomycotic Mycetoma)

o Actinomyces, Nocardia & Streptomyces

o The granules contain very fine delicate


filaments

o Usually has one sinus tract


Mycetoma

• Fungal (Eumycotic Mycetoma)

• Saprophytic fungi like Madurella (soil organism)

• Granules contain large coarse septate hyphae

• Usually the lesion has many sinus openings

• Causative agents
• Madurella mycetomatis
• Pseudallescheria boydii
• Acremonium
• Aspergillus
Mycetoma

Clinical findings

Site(s)
• Feet, lower extremities, hands

Findings
• Abscess formation
• Draining sinuses containing granules
• Deformities
Mycetoma

Lab Diagnosis
• Characteristics of the granule & colony
morphology are used for identification

KOH Preparation
• Bacterial : Fine branching filaments
• Fungal : Coarse septated hyphae
Mycetoma
Treatment
• Bacterial
o Antibiotics usually penicillin
• Fungal
o Itraconazole or
o Amphotericin B
 Amputation of the affected part may
be needed
Subcutaneous Mycosis
Sporotrichosis
• Chronic infection involving cutaneous,
subcutaneous and lymphatic tissues
• Frequently encountered in gardeners
Causative Agent
Sporothrix schenckii
• A dimorphic fungus living in soil & on
vegetation
• Spores introduced into puncture wounds
(thorn pricks)
Sporotrichosis

Symptoms
o A chronic ulcer at wound site
o Ulcerating nodules along the lymphatic
drainage
o Enlarged draining LN
o Systemic dissemination to:
o Bones, joints, meninges
Sporotrichosis

• Treatment
• Cutaneous infection
 Topical potassium iodide

• Disseminated infection
 Amphotericin B
 Itraconazole
CHROMOBLASTOMYCOSIS
• Posttraumatic chronic infection of
subcutaneous tissue
• Papules  cauliflower-like lesions on
lower extremities
• Causative agents
1. Fonsecaea
2. Phialophora
3. Cladosporium
LOBOMYCOSIS
Causative Agent
• Loboa loboi
• Multiple budding yeast cells forming short chains

• Chronic, subcutaneous, progressive infection


• Traumatic inoculation of the fungus
• Hard, painless nodules on extremities
• Ulcerative lesions
• Lesions resemble those of chromoblastomycosis
mycetoma and carcinoma
RHINOSPOROIDOSIS

Causative agent
Rhinosporidium seeberi
• Has not been cultured in vitro on artificial media

• Chronic infection in divers


• Polypoid masses at nasal mucosa, conjunctiva,
genitalia and rectum
• Seropurulent discharge from nasal lesions

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