Mycetoma PDF - Dar Al Uloom University

3. Serology Antibodies can be determined by Enzyme-linked Immunosorbent Assay(ELIZA) Helpful in some cases for diagnosis and follow-up 4.PCR Treatment Eumycetoma: antifungal as Itraconazole, Voriconazole and Amphotericin B. Actinomycetoma: antibacterial as Trimethoprim-sulfamethoxazole...

3. Serology Antibodies can be determined by Enzyme-linked Immunosorbent Assay(ELIZA) Helpful in some cases for diagnosis and follow-up 4.PCR Treatment Eumycetoma: antifungal as Itraconazole, Voriconazole and Amphotericin B. Actinomycetoma: antibacterial as Trimethoprim-sulfamethoxazole Actinomycetoma generally respond better to treatment than eumycetoma. Therapy is suggested for several months or years (1-2 years or more) Surgical Care: In eumycetoma, debridement or amputation could be done in patients not responding to medical treatment. Chromoblastomycosis Subcutaneous chronic fungal infection Caused by different soil dematiaceous fungi (Produce brown pigment) The fungi are usually introduced into the body by trauma. The fungi produce thick-walled, single or multicellular clusters called sclerotic or muriform bodies. Muriform Bodies Clinical manifestations The patients display single or multiple lesions of different forms including, plaques ,nodules, cauliflower-like lesions which may ulcerate. The lesions extend along the lymphatics. The lesions are mostly found on exposed regions of the body. No person-to-person transmission Laboratory diagnosis The surface is scraped, and 10% potassium hydroxide (KOH) is added to the scrapings. Microscopic examination: dark brown, rounded fungal cells are seen in leukocytes or giant cells. Treatment Antifungal treatment as oral flucytosine plus local surgery if feasible. Sporotrichosis Subcutaneous fungal infection caused by a dimorphic fungus called Sporothrix schenckii. The mold form lives in nature(25oc), and the yeast form occurs in human tissue(37oc). When spores of the mold are introduced into the skin, following trauma, it causes a local pustule or ulcer with nodules along the draining lymphatics. The lesions are typically painless, and there is little systemic illness. Sporotrichosis Laboratory Diagnosis: Specimen: Biopsy tissue, ulcerative material Direct Microscopy: smear will show Finger-like yeast cells or Cigar shaped. Culture: On SDA at room temperature, hyphae occur bearing oval conidia (resembling a daisy). Treatment Antifungal treatment as Itraconazole Phaeohyphomycosis Fungal infections caused by dematiaceous (darkly pigmented) fungi widely distributed in the environment as Cladosporium and Phialophora Clinical syndromes : Localized :Subcutaneous nodules or erythematous plaques with no systemic involvement Disseminated :Brain abcess associated with inhaling the fungi. Phaeohyphomycosis Diagnosis Specimens: Pus, biopsy tissue Direct Microscopy: will show brown septate fungal hyphae Culture: On SDA Treatment The treatment of choice is Surgical excision of the lesion Antifungal ( Itraconazole, Posaconazole) Phaeohyphomycosis located in the foot