Kingdom: Fungi Phylum: Ascomycota Class: Euascomycetes Order ...

2/20/2006Alternative namesPresentation Developed by: Tom MarianiKatie ForteJenee ThurstonTerra Runyon◦ chromomycosis◦ cladosporiosis◦ verrucous dermatitis◦ phaeosporotrichosis◦ Pedroso’s disease◦ Fonseca’s diseasehttp://doctorsgates.blogspot.com/2011/03/case-ofchromoblastomycosis.htmlBIOL 4849: Medical Mycology 12◦ Kingdom:◦ Phylum:◦ Class:◦ Order:◦ Family:◦ Genus:FungiAscomycotaEuascomycetesChaetothyrialesHerpotrichiellaceaeFonsecaea, RhinocladiellaPhialophora, Cladophialophora,3 Most common:◦ Phialophora verrucosa◦ Fonsecaea compacta◦ Fonsecaea pedrosi• Only species isolated from evergreen forests in tropicalregions◦ Cladosporium carrionii• Found only in spiny desert areas◦ Rhinocladiella aquaspersa (Ramichloridiumcerophilum)4Mainly tropical andsubtopic regions (Brazil &Madagascar)Costa RicaBecause of gradual risingof temperature andincreased immigrationtravel, cases have beenspreading from tropicalto temperate areas.Rare reports fromCanada and U.S. Fonsecaea -no knownphase Primary conidiafunction as sympodialconidiogenous cells toform the secondaryconidia In vivo morphism Form ascospores bysexual reproduction561

2/20/2006 16 year old boy from Assam,India History of thorn prick indorsum of right foot 6 years ago. 8 month history of numerouswell-defined papulated plaquesover both upper and lowerextremities, trunk, and both ears,scalp and genitalia Lesions appeared initially ondorsum of right foot, radiatedsuperiorly Lesions appeared on trunk andforearm 2 months later During first 6 months, plaquesextended from dorsum of feet toright knee and mid calf of left legMycopathologia (2010) 169:381–386)Fig. 2Laboratory examinationsincluding haemogram, andblood chemistry werenormal, except for slightlyraised ESRPatient was tested and foundnegative for HIV1 and HIV2by ELISABiopsy and skin scrapingswere collected for directmicroscopy and cultures.Histopathologicalexamination of stainedbiopsy tissue showedepitheliomatous hyperplasia,with marked chronicinflammation and scleroticbodies. (Fig 2)A slide culture was alsoperformed, microscopyshowed conidiophores bearingoutwardly spreading, sparselybranching. Long acrepetalchains of ellipsoidal, smoothwalled,symmetrical, onecelledconidia. (Fig 4)Isolate was also tested forthermotolerance, failing togrow at 37°C and 42°CThe isolate was identified asCladophialophora carrioniiFig. 4 Mycopathologia (2010) 169:381–386• Microscopic examination ofskin scraping in 10% KOHrevealed oval, brown,septate sclerotic bodies (Fig6)• Patient was treated withFluconazole 150mg PO/dayfor 6 months• Patient returned for followup showing slight reductionof the lesions of his arms,with no reduction in size ofrest of the lesions (Fig 7)Fig 6Mycopathologia (2010) 169:381–386)Fig 7 55 year old Male working in a tea garden inAssam, India Presented with Cauliflower like painless mass inleft leg above ankle with 9 years duration History of trauma due to burn of left leg frommotorcycle silencer pipe 10 years ago Scaly papule first appeared 6 months after theinjury Lesion spread, first becoming wart like, thenforming a cauliflower like mass• Laboratory examinationsincluding haemogram, andblood chemistry were alsonormal• A biopsy was taken for directmicroscopy and incubation.• Direct microscopy in 20% KOHshowed brown, septate,sclerotic bodies• An Olivaceous-black, velvetycolony appeared after 10 daysof incubation at 25°C and 37°C,increasing in size to 3cm after1 month (Fig 3)Mycopathologia (2010) 169:381–386)Fig 33