Subcutaneous mycoses ➢1-Mycetoma ➢2-Sporotrichosis ➢3-Chromoblastomycosis ➢4-Rhinosporidiosis ➢5- Lobomycosis ➢6- Entomophthoramycosis Sporotrichosis
Rose gardener’s disease Chronic desease Agent Sporothrix schenckii: ➢ Thermal dimorphic
➢ In soil ➢ On decaying vegetation,plants,plant products (hay, straw, sphagnum moss), and a variety of animals (cats) ➢ less than 37° C (hyphal) ➢ 37° C (yeast)
➢ Sporothrix brasiliensis
➢ Sporothrix globosa Epidemiology ➢Worldwide ➢Tropical regions ➢Mexico ➢Brazile ➢France ➢USA Occupational disease:
➢Farmers ➢ ➢Workers
➢Gardeners
➢Florists Predisposing factors:
➢Trauma ➢Inhalation (very rarely) ➢HIV Clinical Syndromes
1-lymphocutaneous 2-Fixed cutaneous 3- Osteoarticular involvement 4-Pulmonary 5-Systemic Primary infection 1-Lymphocutaneous sporotrichosis
2-Fixed cutaneous sporotrichosis: Fixed cutaneous sporotrichosis verrucous-type sporotrichosis localized cutaneous type Paronychia sporotrichosis Osteoarticular involvement Pulmonary sporotrichosis:
➢Alcoholic
➢Pulmonary tuberculosis, diabetes mellitus and steroid ➢A productive cough ➢Low-grade fever ➢Weight loss Systemic sporotrichosis Transmission: ➢Dog bite
➢parrot bite
➢Insects bite
➢Cases of animal-to-human transmission Laboratory Diagnosis: 1-Collection of samples: ➢Drainage from skin lesions ➢Exudates ➢Pus ➢Blood ➢Pulmonary secretions ➢Tissue biopsy specimens 2-Direct examination ➢Gram
➢PAS
➢GMS
➢H & E
❖Yeast Cells ❖Asteroid body: Elongated Buds (“Cigar Body”)
Wet Mount BHI Blood 37˚C Yeast with Elongated Daughter Cell
Biopsy of subcutaneous tissue H & E Stain Asteroid body Culture: Media: ➢SCC. S…22 ➢BHI.BA…37
Serology:
❖In extracutaneous and systemic forms:
✓LA ✓Enzyme immunoassay (EIA) Treatment: ❖lymphocutaneous: ❖Itraconazole; 100-200 mg/day, 3-6 months ❖Terbinafine
➢Saturated solution of potassium iodine (SSKI); 6-12 weeks
Definition: Chronic granulomatous mucosal infection. polyps
➢Human ➢Animals
➢Nose ➢Eyes ➢Other (rare) Agent: ❖Rhinosporidium seeberi
➢Protozoan: (Seeberi G,1900) ➢Fungus: (Ashworth JH,1923) ➢Hydrophilic pathogen ➢Cosmopolitan organism
➢Endemic in all of the continents
➢Except Australia
➢Ground water in ponds and lakes
➢Soil Predisposing factors: ➢Trauma
➢Bath in pools of stagnant water
➢Labour in river
➢Dust storms 1-Rhinosporidiosis (nose): 72%
2-Oculosporidiosis (eyes): 15%
3-Others: 13%
Nasal and oropharyngeal Rhinosporidiosis ➢Nasal obstruction Involvement of palpebral conjunctiva and nose Lesions developing far up in the turbinates Oculosporidiosis (eyes):
➢USA ➢Iran (22%) ➢India (15%) ➢South Africa Lesion on the hard palate Cutaneous: ➢Rare ➢Primary infection ➢Small papules ➢Verrucous ➢Painless Disseminated cutaneous rhinosporidiosis
➢Lesion on the tip of nose
➢Hyperpigmented verrucous on the back ➢Discoid verrucous plaque over the forearm Epidemiology: ➢Worldwide ➢Southern India ➢Sri Lanka ➢Brazil ➢Argentina ➢Tropical ➢Subtropical ➢Muslims • Male • 20-40 years old • Sporadic ➢Ardabil ➢Tabriz ➢Zanjan animal ➢Domestic bovines ➢Dog ➢Horse ➢Pink river dolphin Laboratory Diagnosis: ➢Nasal discharge ➢Nasal biopsy ➢KOH ➢Spherules = Sporangium ➢Geimsa ➢10 to 200-400 µm ➢H & E ➢PAS ➢Spore: 7-9 µm ➢GMS ➢Culture – ➢White dots ➢Serology - Nasal polyp Young sporangia. H & E Mature sporangium Coccidioidomycosis:
❖ Coccidioides immitis
➢Spherule: 80 µm ➢ (10 to 200-400 µm)
➢Spore: 2.5µm (in c. immitis) (Spore: 7-9 µm) Cocci…: Lung tissue. PAS Treatment: ➢Surgery
➢Cryosurgery
➢Wide excision
➢Cauterization
➢Amp.B in prokaen solution (local) Complications: ➢Excessive bleeding ➢Secondary bacterial infection ➢Fatal sepsis
***