Subcutaneous Mycoses

Ma. Christy V. Gonzales, RMT, MPH

College of Medical Laboratory Science
Our Lady of Fatima University
Mycology-Virology (MYV 322)
Characteristics:

• involve the deeper skin layers

• characteristic clinical features:
• progressive, nonhealing ulcers
• draining sinus tracts
• MOT: ______________________
• Habitat: soil or decaying vegetation
• Occupational hazard of agricultural workers
Subcutaneous mycoses

1. Subcutaneous phaeohyphomycosis
2. Chromomycosis
3. Mycetoma
• White grain mycetoma
• Black grain mycetoma
Subcutaneous Phaeohyphomycosis
Characteristics:
• caused by darkly pigmented fungi

Lifted form Textbook of Diagnostic Microbiology by Mahon, page 601

Subcutaneous Phaeohyphomycosis
1. Exophiala dermatitidis
• Macroscopic examination:
• olivaceous to black colonies
• Microscopic examination:
• conidia are borne from the tips of annellides
Subcutaneous Phaeohyphomycosis
2. Sporothrix schenckii
• Causes:
• lymphocutaneous sporotrichosis
• nodular and ulcerative lesions along the lymph channels
that drain the primary site of inoculation
• fixed sporotrichosis
• confined to the site of inoculation
• mucocutaneous sporotrichosis
• 1° and 2° pulmonary sporotrichosis
• Associated with gardening
• Rose thorns and sphagnum moss
Subcutaneous Phaeohyphomycosis
2. Sporothrix schenckii
Laboratory diagnosis:
• Specimen: Exudate aspirated from draining lesions
• Direct microscopic examination:
• small, cigar-shaped yeast (tissue form)
• Culture: most media with cycloheximide
• Macroscopic examination
• 22° C: white, glabrous, and yeastlike, turning darker and
more mycelial as they mature
• 37° C: cream colored to black, leathery colonies
• Microscopic examination
• rhizoid, septate, hyaline hyphae bearing rosette pattern/
flowerette arrangement/ sleeve arrangement conidia
Chromoblastomycosis
Characteristics:
• Also known as ______________________________
• Agents:
• Fonsecaea compacta
• Fonsecaea pedrosoi
• Phialophora verrucose
• Cladophialophora carrionii
• Rhinocladiella aquaspersa
• develops over months or years
• asymptomatic in the absence of secondary complications
• bacterial infections, carcinomatous degeneration, and
elephantiasis
• Diagnostic: presence of _______________
Chromoblastomycosis
Laboratory diagnosis:
• Direct microscopic examination:
• 10% KOH with scrapings from crusted lesions
• presence of the sclerotic bodies
• rounded, brown, and resemble
_________________having fission planes
• Culture: most media
• Macroscopic examination
• Heaped-up and folded, gray to olive to black and velvety or
suedelike colonies
• Reverse: jet black
Laboratory diagnosis:
• Microscopic examination
• Cladosporium (Cladosporium carrionii)
• long chains of elliptical conidia borne from erect, tall,
branching conidiophores
• Phialophora spp.
• Phialophora verrucosa: phialides, each with a distinct cup
or flask-shaped collarette
• P. richardsiae: phialides with a flattened collarette and
conidia are produced endogenously in clusters at the tip of
the phialide
• Fonsecaea spp:
• Conidial heads with sympodial arrangement of conidia,
with primary conidia giving rise to secondary conidia
Chromoblastomycosis

Lifted form Textbook of Diagnostic Microbiology by Mahon, page 599

Mycetoma
Characteristics:
• swelling, with characteristic exudate draining to the skin surface
through sinus tracts
• Caused by bacteria and fungi
• Agents:
• Pseudallescheria boydii
• Acremonium falciforme
• Madurella mycetomatis
• Madurella grisea
• Exophiala sp.
• Diagnostic: presence of _________
White Grain Mycetoma
Agents: Pseudallescheria boydii & Acremonium
Laboratory diagnosis:
• Culture: most media
• Macroscopic examination
• white, fluffy colony that changes in several weeks to brownish
gray
• Reverse: tan to dark brown
• Microscopic examination
Pseudallescheria boydii
• Sexual: brown to black cleistothecia w/ asci and ascospores
• Asexual: Scedosporium apiospermum
• golden brown, elliptical to-pyriform, single-celled conidia
borne singly from the tips of long or short conidiophores
(annellophores)
Black Grain Mycetoma
Agents:
Exophiala jeanselmei, Curvularia, & Madurella mycetomatis
Laboratory diagnosis:
• Culture: most media
• Microscopic examination
Madurella mycetomatis
• long, tapering phialides with collarettes and sclerotia
Curvularia
• Rhizoid, dematiaceous, septate hyphae with geniculate
conidiophore and golden brown, multicelled, and curved, with a
central swollen cell conidia
Exophiala jeanselmei
• Rhizoid, dematiaceous, septate hyphae with conidiophores that
are cylindrical and have a tapered tip
Eumycotic mycetomas

Fungus Color of granules Texture

Pseudoallescheria boydii white soft
Acremonium falciforme white soft
Madurella mycetomatis black hard
Madurela grisea black soft
Exophila spp. black soft
Thank you!!
__mcvg,RMT,MPH__