Rapid Resolution of Subcutaneous Phycomycosis in a Child: A Case Report.

Subcutaneous phycomycosis is a rare saprophytic fungal infection. We herein report a case of subcutaneous phycomycosis with stony hard swelling on the chest wall as an unusual site of infection. Diagnosis was made based on the clinical, histopathological, and culture studies. Oral treatment with itraconazole resulted in rapid resolution of lesion.

An old confusion: Entomophthoromycosis versus mucormycosis and their main differences.

Fungal diseases were underestimated for many years. And the global burden of fungal infections is substantial and has increased in recent years. Invasive fungal infections have been linked to several risk factors in humans which basically depend on the individual homeostasis of the patients. However, many fungi can infect even apparently healthy people. Knowledge of these pathogens is critical in reducing or stopping morbidity and/or mortality statistics due to fungal pathogens. Successful therapeutic strategies rely on rapid diagnosis of the causative fungal agent and the underlying disease. However, the terminology of the diseases was updated to existing phylogenetic classifications and led to confusion in the definition of mucormycosis, conidiobolomycosis, and basidiobolomycosis, which were previously grouped under the now-uncommon term zygomycosis. Therefore, the ecological, taxonomic, clinical, and diagnostic differences are addressed to optimize the understanding and definition of these diseases. The term "coenocytic hyphomycosis" is proposed to summarize all fungal infections caused by Mucorales and species of Basidiobolus and Conidiobolus.

Adverse effects of Lugol's iodine: Heart failure in a patient with subcutaneous phycomycosis from a resource-limited setting.

Subcutaneous phycomycosis becomes a chronic, debilitating condition if left untreated. Treatment includes oral antifungal therapy, though oral potassium iodide has been used in resource-limited settings. Lugol's iodine has been an effective substitute, but little is known about its safety. We report a case of subcutaneous phycomycosis complicated by heart failure during treatment with Lugol's iodine. We review subcutaneous phycomycosis, iodine-mediated cardiotoxicity, as well as social determinants of health relevant to our case, suggesting that Lugol's iodine may only be an effective treatment with proper dosing and long-term monitoring.

A Very Rare Basidiobolomycosis Case Presented with Cecal Perforation and Concomitant Hepatic Involvement in an Elderly Male Patient: A Case Study.

This is a case report of Basidiobolomycosis in a 65-year-old male patient from Jizan presenting with colonic perforation and concomitant liver involvement from February 2021 to July 2021. To control the infection, the patient underwent colonic resection and segmental liver resection, as well as three antifungal drugs. The treatment was successful, and the condition was completely resolved.

COVID-19 associated mucormycosis: A case report in Pakistan and a review of 144 cases.

Mucormycosis is the third most common mycosis in order of its importance as a human pathogen, occurrence of which has become more frequent around the world. Although not proven as a causal association, the increased number of cases has been attributed to Covid-19, the rampant use of corticosteroids, and diabetes. We report the case of a 53-year-old male with mucormycosis related to a Covid-19 infection as the novel case from Pakistan and discuss its epidemiology, diagnostic principles, and management. In our literature review, this is the 145th case being reported with most cases occurring in India, mostly in males, of rhino-orbital form and about a third of them leading to the death of the patient.

Gastric mucormycosis with splenic invasion a rare abdominal complication of COVID-19 pneumonia.

Mucormycosis (previously called zygomycosis or phycomycosis) is an uncommon opportunistic infection with the gastrointestinal form being the rarest occurrence and one of the most lethal infections known to humanity. The most common risk factors predisposing to develop gastric mucormycosis are uncontrolled diabetes mellitus, stem cell transplantation, or underlying any hematologic malignancy and major trauma. Pain abdomen, hematemesis, and melena are common symptoms which the patient presents. The exact diagnosis of gastric mucormycosis can be missed due rarity of the disease. A high level of suspicion is required in the early diagnosis and management of disease, particularly in immunocompromised patients. The radiological imaging modalities such as CT scan or MRI of the abdomen initially usually reveal non-specific findings such as mucosal wall thickening, mass, and reactive lymphadenopathy and prompt additional investigation with endoscopic or surgical biopsy of the lesions. The disease outcome and mortality are very high with gastrointestinal mucormycosis.

Basidiobolomycosis: Case Report and Literature Overview.

Basidiobolomycosis or subcutaneous zygomycosis or subcutaneous phycomycosis is a chronic granulomatous infection of skin and subcutaneous tissue, caused by a saprophytic filamentous fungus, Basidiobolus ranarum, clinically characterized by firm, painless subcutaneous swelling with smooth and rounded edges. Histopathological features include the peculiar Splendore-Hoeppli phenomenon. Culture on Sabouraud dextrose agar shows creamy white, heaped up, and furrowed colonies. This entity has been reported from tropical and subtropical regions of the world and the southern part of India. We report a case of Basidiobolomycosis in a seven-year-old girl from Eastern India, which was excised twice before presenting to us. We diagnosed the case as Basidiobolomycosis based on clinical features, histopathology, and culture findings, and treated it with itraconazole.

Subcutaneous entomophthoromycosis mimicking soft-tissue sarcoma in children.

AIM: Subcutaneous entomophthoromycosis (EM) is an uncommon fungal infection of childhood. This article is intended to draw the attention of pediatric surgeons to the fact that EM can mimic soft-tissue tumor. METHODS: It is a retrospective review of 16 children treated for subcutaneous EM between 2000 and 2013. RESULTS: The median age of patients was 3.5 years. The typical lesion was a discoid subcutaneous mass that can be easily lifted from deeper tissues (the doughnut lifting sign). Lesions were mostly distributed in the lower half of body. All the patients were immunocompetent. Correct clinical diagnosis was made only in 4 cases while others were mistaken for a tumor. All the 8 children who underwent wide excision of the pseudotumor had local recurrence. Supersaturated solution of potassium iodide was curative in 11 cases while addition of itraconazole was needed in one case. One child died of multi-drug resistant infection. The mean treatment duration was 4.7 months (range 2-8 months). CONCLUSION: Subcutaneous EM can mimic soft-tissue tumor. High index of suspicion is essential to avoid misdiagnosis and inappropriate treatment. A newly described "doughnut-lifting sign' may be helpful in clinical diagnosis. Emergence of multi-drug resistant infection is a source of concern.

Cutaneous manifestations of deep mycosis: an experience in a tropical pathology laboratory.

BACKGROUND: Cutaneous manifestations of deep mycotic infection are fraught with delayed or misdiagnosis from mainly cutaneous neoplastic lesions. AIM: This study is designed to present our experience of these mycoses in a pathology laboratory in the tropics. MATERIALS AND METHODS: A clinicopathologic analysis of deep mycotic infections was conducted over a 15 years period Formalin fixed and paraffin wax processed biopsies were stained with hematoxylin and eosin, periodic acid Schiff (PAS), and Grocott's methenamine silver (GMS) for the identification of fungus specie. Patients' bio-data and clinical information were obtained from records. RESULTS: Twenty males and seven females presented with 6 months to 6 years histories of varying symptoms of slow growing facial swellings, nodules, subcutaneous frontal skull swelling, proptosis, nasal blockage, epistaxis, discharging leg sinuses, flank mass, convulsion and pain. Of the 27 patients, four gave antecedent history of trauma, two had recurrent lesions which necessitated maxilectomy, two presented with convulsion without motor dysfunction while one had associated erosion of the small bones of the foot. None of the patients had debilitating illnesses such as diabetes mellitus, tuberculosis, and HIV infection. Tissue histology revealed histoplasmosis (10), mycetoma (9), subcutaneous phycomycosis (6), and phaeohyphomycosis (2). CONCLUSION: Deep mycoses may present primarily as cutaneous lesions in immunocompetent persons and often elicit distinct histologic inflammatory response characterized by granuloma formation. Diagnosis in resource constraint setting can be achieved with tissue stained with PAS and GMS which identifies implicated fungus. Clinical recognition and adequate knowledge of the pathology of these mycoses may reduce attendant patient morbidity.

Rhinomaxillary mucormycosis with cerebral extension.

Mucormycosis is a rare opportunistic infection caused by fungus belonging to the order Mucorales. A case of a controlled diabetic male with rhino maxillary mucormycosis, with cerebral extension, is described. The patient presented with hemifacial swelling, a nasal twang in his voice, fever, ocular signs, gross tissue destruction, and was sluggish. Early recognition of mucormycosis is necessary to limit the spread of infection, which can lead to high morbidity and mortality. Therefore, health practitioners should be familiar with the signs and symptoms of the disease.

Rare complications for aortitis syndrome / 日本心臓血管外科学会雑誌

Rare complications-1) Sarcoidosis, 2) Amyloidosis, 3) Phycomycosis-following surgical therapy for aortitis syndrome are reported. Sarcoidosis occurred in 39 y.o. female following Bentall operation for AAE and AR was diagnosed by biopsy and was controlled with drug completely 1 year after the onset. Amyloidosis found in 56 y. o. male after AVR and AAo plication for AAE and AR started with severe diarrhea and the diagnosis was made by autopsy. Phycomycosis was diagnosed by necropsy in 49 y. o. female after CABG and thoraco-abdominal bypass operation. Poor control of inflammation and administration of gluco-corticoid are the common problems for the 3 cases. Aortitis syndrome is autoimmune disease and some immunological factor has a role for the cause of the three complications. We must be very strict about the administration of the gludo-corticoid and the control of the inflammation.

Phycomycosis Involving Ankle Joint: Report of a case

Phycomycosis is an uncommon opportunistic fungal infection, involving several organs, such as brain, lungs, gastrointestinal tract and skin. Invasion of joint cavity by phycomycetes, however, has never been reported. We report a case of 33-year-old male who had had prehallux with congenital equinovarus and underwent correction operation on the right ankle joint. There after, joint pain and edema had developed on that site. He received reoperation and underwent excisional biopsy from there. Operation showed hypertrophied yellowish synovium. On microscopic examination, the tissue showed several foci of fibrinoid necrosis and suppurative and granulomatuous inflammation. Periodic acid Schiff stain demonstrated broad. Aseptate hyphae that were wrinkled and folded.