P5: Subcutaneous Mycoses

Question 1

Chronic localized infections of the skin as well as
the subcutaneous tissue

Answer 1

SUBCUTANEOUS MYCOSES

Question 2

● Chronic infection of the subcutaneous tissues and
lymphatics
● A fungal infection of the skin caused by a fungus
found on the decaying vegetation, rose bushes or
any plants with thorns, twigs, hays, z
● a.k.a. Rose Gardener’s Disease

Answer 2

SPOROTRICHOSIS

Question 2

grows well at 35ºC but not at 37ºC

Answer 2

Fixed Cutaneous

Question 2

causative agent of sporotrichosis

Answer 2

sporothrix schenckii

Question 3

grows well at 35ºC and 37ºC

Answer 3

Lymphocutaneous

Question 3

a virulence factor present in lymphocutaneous types

Answer 3

Neuraminidase

Question 4

○ primary lesion begins as a small,
non-healing ulcer
○ common on index finger or back of the
hand
○ most common form

Answer 4

FIXED CUTANEOUS SPOROTRICHOSIS

Question 4

infections spreads along the lymph nodes
and a chain of lymphatic nodules develop
in a line

Answer 4

LYMPHOCUTANEOUS SPOROTRICHOSIS

Question 5

○ with cutaneous lesions on long bones
near affected joints
○ often seen in patients with a history of
alcohol abuse or immunosuppression

Answer 5

OSTEOARTICULAR SPOROTRICHOSIS

Question 5

○ Rare but can happen when someone
inhales fungal spores from the
environment
■ inhalation of conidia

Answer 5

PULMONARY SPOROTRICHOSIS

Question 5

clinical manifestations depend on the
organs involved
○ usually affects immunocompromised
individuals

Answer 5

DISSEMINATED SPOROTRICHOSIS

Question 6

direct examination of subcutaneous mycoses

Answer 6

potassium hydroxide
calcoflour

Question 7

2 forms of scm

Answer 7

mycelia form (RT)
yeast form (37ºC)

Question 8

stains used in tissue biopsy

Answer 8

Gomori’s Methenamine Silver
Periodic Acid Schiff
Fluorescent Antibody Testing
H&E

Question 9

inside are the antigen; outside are the structures covering the antibodies

Answer 9

Splendore-Hoeppli phenomenon

Question 10

a titer of 1:160 or greater is diagnostic of sporotrichosis

Answer 10

Yeast Cell Agglutination Test

Question 11

2 types of mycetoma

Answer 11

eumycetoma
actinomycetoma

Question 11

elicits delayed skin test reactions in sensitive persons
■ major usefulness is in epidemiological investigation

Answer 11

Sporotrichin

Question 11

most common treatment

Answer 11

amphotericin b

Question 11

● Chronic infection of the (1) skin including (2)
subcutaneous tissue, and sometimes (3) muscles,
(4) bones, and (5) joint
● Characterized by the presence of nodules
● Usually in lower extremities

Answer 11

MYCETOMA

Question 12

○ caused by fungal organism
○ fungal mycetoma

Answer 12

EUMYCETOMA

Question 12

tend to be more aggressive and destructive invading bones; because bacterial agents are able to grow twice or thrice or four times faster than fungal elements

Answer 12

actinomycetoma

Question 13

○ caused by filamentous bacteria coming
from the order of Actinomycetes
○ bacterial mycetoma

Answer 13

ACTINOMYCETOMA

Question 14

● Most common cause of eumycetoma WORLDWIDE

Answer 14

Madurella mycetomatis

Question 15

● Most common agent of mycetoma in US

Answer 15

Scedosporium boydii

Question 16

(asexual form)

Answer 16

Anamorph

Question 17

(sexual form)

Answer 17

Teleomorph

Question 17

● Traumatic inoculation ● Warty, verrucous or cauliflower-like lesions

Answer 17

CHROMOBLASTOMYCOSIS

Question 17

short flask-shaped phialides with collarette

Answer 17

Phialophora

Question 17

chains of blastoconidia borne from branching conidiophores

Answer 17

Cladosporium

Question 17

■ polymorphic; phialides; chains of blastoconidia ■ sympodial: conidia can grow at any part of the phialide or conidiophore

Answer 17

Fonsecaea pedrosoi

Question 17

○ Produces lateral or terminal conidia from conidiogenous cell ○ elliptical to clavate conidi

Answer 17

Rhinocladiella

Question 18

■ spherical with broad base connecting the conidia − smaller, more compact (single base only)

Answer 18

Fonsecaea compacta

Question 18

○ characteristic histologic findings in tissues with chromoblastomycosis ⇒ hallmark ○ copper-colored, septate cells that appear to be dividing (copper pennies)

Answer 18

SCLEROTIC BODIES

Question 18

A term used to describe subcutaneous and systemic diseases caused by dematiaceous fungi other than those causing chromomycosis

Answer 18

PHAEOHYPHOMYCOSIS

Question 19

● Chronic infection ● Polypoid masses of nasal mucosa

Answer 19

RHINOSPORIDIOSIS

Question 20

Causative agent of RHINOSPORIDIOSIS

Answer 20

Rhinosporidium seeberi

Question 21

● Chronic & progressive subcutaneous infection of humans and dolphins

Answer 21

LOBOMYCOSIS

Question 22

Causative agent of LOBOMYCOSIS

Answer 22

Loboa loboi

Question 23

● Initial swelling in the nasal area ● Hard, subcutaneous nodules develop, and an acute or chronic inflammatory response may ensue ● Severe edema of the nose may block passage of air

Answer 23

RHINOENTOMOPHTHOROMYCOSIS

Question 24

● Chronic self-limiting infection ● Initial small, firm, movable nodule on the torso or limb ● Skin is generally intact but may become very rough

Answer 24

SUBCUTANEOUS PHYCOMYCOSIS

Question 24

Causative agent of RHINOENTOMOPHTHOROMYCOSIS

Answer 24

Entomophthora coronata

Question 25

causative agent of SUBCUTANEOUS PHYCOMYCOSIS

Answer 25

Basidiobolus haptosporus