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Infections
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Mycetoma is a subcutaneous fungal disease that is caused by certain environmental fungi, and is contracted by injury through the skin, mainly in tropical countries. It is a chronic soft-tissue infection that gradually spreads with swelling and dysfunction of the affected limb. There are deep abscesses and fibrosis, sinuses that discharge through the skin, and osteomyelitis if the underlying bone is involved (Figure 20.33). Visible grains of fungi discharge through the skin sinuses, which may be taken and viewed directly under the microscope to make the diagnosis.
Tropical infections and infestations
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Mycetoma is a chronic, specific, granulomatous, progressive, destructive inflammatory disease, which involves the skin, subcutaneous tissues and deeper structures. The causative organism may be true fungi, when the condition is called eumycetoma; when caused by bacteria it is called actinomyce- toma. The pathognomonic feature is the triad of painless subcutaneous mass, multiple sinuses and seropurulent discharge. It causes tissue destruction, deformity, disability, and death in extreme cases.
Ketoconazole
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Using the CLSI in vitro susceptibility testing of filamentous fungi (M38), some strains of Aspergillus spp. may be sensitive to ketoconazole. However, the MIC breakpoints for antifungals have not been defined. Similarly, the agents that cause chromoblastomycosis (Cladosporium, Fonsecaea, and Phialophora spp.) may be susceptible to ketoconazole. Its action against the zygomycetes of the order Mucorales, such as the genera Cunninghamella, Rhizopus, Absidia, and Mucor, is poor (Eng et al., 1981; Almyroudis et al., 2007). Zygomycetes of the order Entomophthorales of the genera Basidiobolus and Conidiobolus are sometimes sensitive (Drouhet and Dupont, 1983; Van Cutsem, 1983; Yangco et al., 1984). Fusarium spp. are generally resistant to ketoconazole (Reuben et al., 1989). Madurella spp. and Pseudallescheria boydii, which are causes of eumycetoma, may be sensitive to ketoconazole (Venugopal et al., 1990; Gilgado et al., 2006, respectively). It is highly active against many strains of the dermatophytes, including Microsporum, Trichophyton, and Epidermophyton spp. (Venugopal et al., 1993; Zhanel et al., 1997; Fernández-Torres et al., 2001).
The potential role of interleukin-37 in infectious diseases
Published in International Reviews of Immunology, 2020
Gamal Allam, Asmaa M. Gaber, Sarah I. Othman, Adel Abdel-Moneim
Eumycetoma is a chronic granulomatous subcutaneous inflammatory disease resulting from infection with Madurella mycetomatis (M. mycetomatis) and affecting deep subcutaneous tissues and bones leading to massive destruction, deformities and disabilities [73]. A recent study has demonstrated that eumycetoma patients showed higher circulating levels of IL-37. In addition, serum levels of IL-37 were positively correlated with diameters of mycetoma lesions and negatively correlated with levels of IL-1β. However, the levels of IL-1β were negatively correlated with diameters of lesions, and unit increment in IL-1β decreases the levels of IL-37 by 35.28 pg/ml. The study concluded that high levels of IL-37 may have a negative impact on eumycetoma progression and clinical outcomes [74].
Surface properties, adhesion and biofilm formation on different surfaces by Scedosporium spp. and Lomentospora prolificans
Published in Biofouling, 2018
Thaís P. Mello, Simone S. C. Oliveira, Susana Frasés, Marta H. Branquinha, André L. S. Santos
Scedosporium and Lomentospora species are filamentous fungi with a global distribution, being particularly prevalent in human-impacted environments, such as agricultural and garden soils, playgrounds, sewers and polluted ponds (Kaltseis et al. 2009; Rougeron et al. 2018). These fungal species have emerged as primary and opportunistic pathogens across a wide spectrum of human infections, causing severe and debilitating illnesses on both immunocompromised and immunocompetent individuals, and they carry a high morbimortality rate. Healthy individuals can succumb to eumycetoma, which is a subcutaneous infection resulting from a traumatic inoculation of fungal propagules and which can lead to profound disability/deformity of ligaments, joints, and bones. Pulmonary infections, initiated by the inhalation of airborne conidia of Scedosporium/Lomentospora species, occur commonly in persons with pre-existing pulmonary cavities (e.g. cystic fibrosis patients), and often culminate in a progressive and severe deterioration of the lung functions. These fungal species also induce considerable neurotropism, being the unique causative agents of the near-drowning syndrome, and they are recognized as opportunistic etiologic pathogens in transplanted recipients and in patients with hematological diseases (Cortez et al. 2008; Ramirez-Garcia et al. 2018; Rougeron et al. 2018).