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Subcutaneous Pp t

Subcutaneous Pp t

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Published by Vinod. Jyothikumar
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Published by: Vinod. Jyothikumar on Apr 29, 2013
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CLS 419 Clinical Microbiology IIMycologySubcutaneous Molds1
MycologySubcutaneous Fungi
Division of Medical TechnologyCarol Larson MSEd, MT(ASCP)
Please click audio iconto hear Carol’s narration
General Characteristics
Growth rate: 1-4 weeksIdentification
Colony morphologyMicroscopic morphology
Dematiaceous septate hyphaeHyaline septate hyphaeBranching GPR
Click iconfor audio
Epidemiology
Found in soil and on plantsSaprophytic (nonpathogenic)
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Pathogenesis
Acquire by mechanical means –traumaElicit disease depends on:
Tissue involvedImmune systemAmount of exposure
Lesion
Skin, subcutaneous tissue, othersRARELY disseminates
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Clinical Significance
ChromoblastomycosisMycetoma
EumycoticActinomycotic
SporotrichosisPhaeohyphomycosis
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Chromoblastomycosis
Etiologic agents
Fonsecaea, Phialophora, Cladosporium
DistributionClinical disease
ChronicInvolves skin and subcutaneous tissueCauliflower-like lesionSecondary infection & ulceration
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CLS 419 Clinical Microbiology IIMycologySubcutaneous Molds2
Mycetoma
Etiologic agents
Eumycotic (fungal)
White grain:
 Acremonium, Fusarium,Pseudallescheria boydii
Black grain:
Exophiala jeanselmei, Madurellamycetomatis, Curvularia
Actinomycotic (bacterial)
Nocardia, Actinomadura, Streptomyces, Actinomyces
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Mycetoma
DistributionClinical disease
Chronic granulomatous infectionTriad of symptoms
SwellingSinus tractsSulfur granules
Slow progression tosurrounding tissue
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Sporotrichosis
Etiologic agent:
Sporothrix schenckii
Distribution is worldwideClinical disease
Chronic subcutaneous infectionPrimary lesionNodule lesionsLymphatic channels& lymph nodes
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Phaeohyphomycosis
Etiologic agents
Dematiaceous molds
Clinical disease
Subcutaneous, localized or systemicinfections
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What 2 general types of hyphae willbe seen in subcutaneous fungalinfections?
Both hyaline and dematiaceous septate hyphae.
What clinical picture is seen withchromoblastomycosis?
A chronic fungal infection acquired via a traumaticinoculation involving the skin and subcutaneous tissuemainly of the feet and legs. A papule develops at thesite of infection that slowly spreads to form warty ortumor-like lesions sometimes described as cauliflower-like in appearance.
 
CLS 419 Clinical Microbiology IIMycologySubcutaneous Molds3
What are the triad of symptoms seenin all mycetomas?
Swelling of subcutaneous tissue causingtumor-like deformitiesFormation of multiple sinus tracts that tunnelthrough the subcutaneous tissues to the surface•Sulfur granules present in the drainage
Laboratory Diagnosis
Specimen collectionDirect examinationCultureIdentification
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Specimens
Skin scrapingsAspirated debrisTissue biopsyPus/drainage from lesionSputum, BW
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Laboratory Diagnosis
Direct Examination
10% KOHCalcofluor white stainHistological stains
Methenamine silver stainHematoxylin-eosin (HE) stain
Gram stainModified acid fast stain
Laboratory Diagnosis
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Specimen processing
Sulfur granules
Crush before culturing
Tissue
Grind the tissue before culturingLaboratory Diagnosis
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Culture Media
Select two media types
General purpose
Sabouraud’s agarInhibitory mold agarBlood agar (actinomycotic)BHI
Selective –Mycosel agar
Antibiotics
Laboratory Diagnosis
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