ABSTRACT
Abstract Pseudomycetoma is an extremely rare deep mycosis, caused by dermatophytic fungi that penetrate the tissue from infected follicles of tinea capitis. Both clinically and histopathology are similar to eumycetoma, being distinguished through the isolation of the fungus, which in the case of pseudomycetoma can be Microsporum spp. or Trichophyton spp. genre. We present a 24-year-old man with an exuberant tumor in the occipital region with fistula, whose histopathological examination evidenced grains composed of hyaline hyphae and the culture for fungi isolated the agent Microsporum canis. Combined treatment of surgical excision followed by oral griseofulvin for two years was performed, with resolution of the condition.
Subject(s)
Humans , Male , Young Adult , Scalp Dermatoses/microbiology , Dermatomycoses/microbiology , Mycetoma/microbiology , Microsporum/isolation & purification , Scalp Dermatoses/surgery , Scalp Dermatoses/pathology , Treatment Outcome , Dermatomycoses/surgery , Dermatomycoses/pathology , Immunocompetence , Mycetoma/surgery , Mycetoma/pathologyABSTRACT
Resumen Se presenta un caso clínico de un actinomicetoma plantar en un paciente sin factores de riesgo, cuyo diagnóstico fue realizado mediante una biopsia de tejido plantar por sospecha de una neoplasia. Dado que el paciente no respondió satisfactoriamente a la terapia de primera línea, debió completar 24 semanas de tratamiento con doxiciclina, a lo cual evolucionó favorablemente. Finalmente, se desarrolla una breve discusión sobre los micetomas plantares.
A case of plantar actinomycetoma without risk factors is presented, which was diagnosed by hystopatological analysis of a foot biopsy because of the suspicion of neoplasia. Since the patient did not fully respond to the first-line therapy antibiotics, a 24-weeks doxycycline regime was started, achieving a satisfactory response. Finally, a brief discussion on plantar mycetomas is presented.
Subject(s)
Humans , Male , Middle Aged , Actinomyces/isolation & purification , Foot Diseases/diagnosis , Mycetoma/diagnosis , Biopsy , Diagnosis, Differential , Foot Diseases/microbiology , Foot Diseases/pathology , Mycetoma/microbiology , Mycetoma/pathologyABSTRACT
Mycetomas are a chronic skin infection characterized by perilesional edema, formation of sinus tracts, and discharge of purulent or seropurulent exudate containing grains. This report aims to demonstrate the clinical diagnosis (by dermoscopy) of a skin lesion that initially bared no clinical features of a mycetoma.
Subject(s)
Female , Humans , Middle Aged , Dermoscopy/methods , Mycetoma/pathology , Skin/pathologyABSTRACT
We report a case of eumycetoma by Madurella mycetomatis on the buttocks and thighs in an adult immunocompetent patient, diagnosed after 30 years of clinical development. He was treated over four years with fluconazol and itraconazol associated with five times surgical excisions of subcutaneous nodules. At the eighth year of follow-up, one nodule recurred on the right infragluteal region, which was excised surgically and has remained asymptomatic ever since.
Relatamos o caso de um paciente adulto, imunocompetente, com eumicetoma por Madurella mycetomatis, localizado nos glúteos e coxas, diagnosticado após 30 anos de evolução clínica. Tratado no decorrer de quatro anos com fluconazol e itraconazol, associado a cinco tempos cirúrgicos de exérese dos nódulos subcutâneos. No oitavo ano de follow-up ocorreu recidiva de apenas um nódulo na região infraglútea, o qual foi excisado cirurgicamente, mantendo-se assintomático desde então.
Subject(s)
Humans , Male , Middle Aged , Madurella , Mycetoma/therapy , Antifungal Agents/therapeutic use , Biopsy , Disease Progression , Fluconazole/therapeutic use , Immunocompetence , Itraconazole/therapeutic use , Mycetoma/pathology , Recurrence , Time Factors , Treatment OutcomeSubject(s)
Humans , Male , Adult , Female , Young Adult , Aged , Mycetoma , Mycetoma/diagnosis , Mycetoma/pathology , Mycetoma/therapy , PeruABSTRACT
Mycetoma is a chronic, granulomatous, subcutaneous, inflammatory lesion caused by true fungi (eumycetoma) or filamentous bacteria (actinomycetoma). Mycetoma commonly affects young people between 20 and 40 years old. The most common affected site is the foot. The characteristic clinical triad is tumefaction, draining sinuses and discharging grains. We report a healthy 31-year-old male, with a 6-year history of a progressive inflammatory tumor associated with sinus tracts and granules on his left sole. Actinomycetoma was suspected. The clinical diagnosis was confirmed by microbiological and histopathological study. Polymerase chain reaction and DNA sequencing identified Actinomadura madurae. To our knowledge, this is the second case of mycetoma reported in Chile. Our report emphasizes the need to consider this diagnosis in patients with chronic granulomatous disease associated with sinus tracts, fistulas and grains.
El micetoma es una lesión subcutánea inflamatoria granulomatosa crónica causada por hongos (eumiceto-ma) o bacterias filamentosas (actinomicetoma). Afecta a adultos entre los 20-40 años y el sitio más comúnmente afectado es el pie. La tríada característica es un aumento de volumen del tejido afectado, con trayectos sinuosos y gránulos excretados. Comunicamos el caso de un hombre de 31 años, sano, con una historia de 6 años de un tumor asociado a trayectos sinuosos y gránulos en la región plantar izquierda. El diagnóstico clínico de micetoma fue confirmado mediante estudio microbiológico e histológico. La amplificación y secuenciación del AlDN bacteriano identificó Actinomadura madurae. Es el segundo caso de actinomicetoma reportado en Chile. Consideramos importante considerar este diagnóstico en pacientes con enfermedad granulomatosa crónica asociado a trayectos sinuosos, fístulas y gránulos.
Subject(s)
Adult , Humans , Male , Actinomycetales Infections/pathology , Foot Dermatoses/microbiology , Mycetoma/pathology , Actinomycetales Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Biopsy , Foot Dermatoses/pathology , Mycetoma/drug therapy , Treatment Outcome , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic useABSTRACT
O gênero Exophiala é composto por fungos melanizados dimórficos, responsáveis por um espectro de doenças, incluindo feohifomicoses, micetomas, cromoblastomicoses e fungemia. A espécie E. jeanselmei é a predominante nestas infecções, seguida de E. dermatitidis. Este trabalho tem como objetivo relatar quatro casos e discutir aspectos clínicos, histológicos, micológicos e epidemiológicos para o seu diagnóstico.
The Exophiala genus comprises dimorphic melanized fungi responsible for a spectrum of diseases including phaeohyphomycosis, mycetoma, chromoblastomycosis and fungemia. The E. jeanselmei species is predominant in such infections, followed by E. dermatitidis. This paper aims at reporting four cases and at discussing clinical, histologycal, mycologycal and epidemiologycal aspects for its diagnosis.
Subject(s)
Adult , Humans , Male , Middle Aged , Exophiala , Mycetoma/pathology , Biopsy , Erythema/pathology , Erythema/therapy , Mycetoma/microbiology , Mycetoma/therapyABSTRACT
Aspergilloma refers to a fungal ball formed by saprophytic overgrowth of Aspergillus species and is seen secondary to cavitatory/cystic respiratory diseases. Paucity of clinical and pathological data of aspergilloma in India prompted us to analyze cases of aspergilloma over 15 years. The clinical features were recorded in all and correlated with detailed pathological examination. Aspergillomas were identified in 41 surgical excisions or at autopsy. There was male predominance; half the patients were in their fourth decade. Episodic hemoptysis was the commonest mode of presentation (85.4%). Forty aspergillomas were complex, occurring in cavitatory lesions (82.9%) or in bronchiectasis (14.6%). Simple aspergilloma was seen as an incidental finding in only one. Tuberculosis was the etiological factor in 31 patients, producing cavitatory or bronchiectatic lesions; other causes were chronic lung abscess and bronchiectasis (unrelated to tuberculosis). Surgical resections are endorsed in view of high risk of unpredictable, life-threatening hemoptysis.
Subject(s)
Adolescent , Adult , Age Factors , Aged , Female , Hemoptysis/etiology , Humans , India , Male , Middle Aged , Mycetoma/pathology , Pulmonary Aspergillosis/pathology , Sex FactorsABSTRACT
We describe a patient with mycetoma or Madura foot, in which histopathological stains of the bone and surface cultures suggested three different organisms including Nocardia species as the cause. Criteria for the diagnosis of the organisms, differentiation between colonizer and pathogen, and significance of mixed infections are discussed.
Descrevemos um paciente com micetoma ou maduromicose de pé, no que colorações histopatológicos de osso e de culturas superficiais sugeriram três organismos diferentes, incluindo espécies de Nocardia como causador. Os critérios de diagnóstico dos organismos, a diferenciação entre colonizador e patógeno, e a significância das infecções mistas são discutidos.
Subject(s)
Humans , Male , Middle Aged , Foot Dermatoses/microbiology , Leg Dermatoses/microbiology , Mycetoma/microbiology , Anti-Infective Agents/therapeutic use , Chronic Disease , Doxycycline/therapeutic use , Foot Dermatoses/drug therapy , Foot Dermatoses/pathology , Leg Dermatoses/drug therapy , Leg Dermatoses/pathology , Mycetoma/drug therapy , Mycetoma/pathology , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic useSubject(s)
Male , Humans , Aged , Dermis/pathology , Mycetoma/diagnosis , Mycetoma/pathology , Wounds and Injuries/complications , Mycetoma/therapy , Nocardia/pathogenicity , Knee/pathologyABSTRACT
Mycetoma due to Madurella grisea has not been previously reported from Gujarat. We report a case in whom identification of the strain was made through the structure and texture of grains, morphology in Sabouraud's dextrose agar and histopathology.
Subject(s)
Adult , Amputation, Surgical , Female , Foot , Humans , India , Madurella/isolation & purification , Mycetoma/pathologyABSTRACT
Although oportunistic fungal infections occur commonly in immunocompromised hosts, mycetoma has never been reported in association with HIV infection. The authors present a case that to their knowledge is the first reported case of mycetoma associated with HIV infection. Diagnosis was confirmed by direct examination of grains and histologic examination. Precise identification of the agent, an actinomycete, was not possible. The unusual site of infection may probably be related to the use of contaminated needless and sirynges for HIV drug injection
Subject(s)
Humans , Male , Adult , AIDS-Related Opportunistic Infections/microbiology , HIV Infections/complications , Mycetoma/microbiology , Mycetoma/pathologyABSTRACT
Resumo: Neste trabalho é apresentado um caso de pé Madura. Os aspectos clínicos e imagenológicos säo discutidos, juntamente com uma revisäo da literatura.
Subject(s)
Humans , Male , Adult , Mycetoma , Mycetoma/diagnosis , Mycetoma/pathology , Foot , FootABSTRACT
El micetoma es una enfermedad crónica producida por hongos falsos actinomicetos aeróbicos (10 especies) y hongos verdaderos eumicetos (23 especies), su cuadro clínico es muy semejante, sin importar el agente etiológico. El examen histopatológico de rutina con hematoxilina y eosina de los micetomas es muy útil, ya que se puede diagnosticar más del 90 por ciento de los casos. Es más preciso que el estudio en fresco y más rápido que el cultivo, para el estudio histopatológico hay que tomar en cuenta la forma y silueta de los granos, tamaño y su apetito tintorial
Subject(s)
Humans , Biopsy , Hematoxylin , Mycetoma/diagnosis , Mycetoma/etiology , Mycetoma/pathology , PathologyABSTRACT
Se realiza una descripción histopatológica de las micosis profundas de mayor frecuencia en el Noroeste Argentino, con una pequeña referencia clínica y del medio ambiente en que se desarrollan las mismas