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Phaeohyphomycosis Clinical: Subcutaneous or brain abscess caused by dematiaceous fungi Affected site: thigh , legs, feet, arms ..etc, brain (cerebral) Lesion: neuro and abcesses Etiology: Dematiaceous imperfect mold fungi, mainly: Cladosporium, Exophiala, Wangiella, Cladophialphora bantiana (C. bantianum) , Ramichloridum mackinziei, Bipolaris, Drechslera, Rhinocladiella, C. Cladosporoides, E. jeanselmei, W. dermatitidis’ Neutrophic fungi : cerebral PHM as R. mackinziei, C. bantianum Naturally in woody plant, woods, agricultural soil Laboratory diagnosis: Specimens: pus, biopsy tissue Direct microscopic examination: KOH and smear brown septat hyphae Culture on SDA and mycobiotic , it’s very slow growing black or grey colonies Chromoblastomycosis=chromomycosis Clinical: the lesion is hyperkeratosis, verrucous, pendeculus, violaceous, cauliflower, initially ulcerative, autochthonous spread Affected sites extremities, mainly feet and legs Etiology: Dematiaceous imperfect mold fungi in woods and woody plants. Phialophora verrucosa, Fonsecaea pedrosoi, Exophiala, cladosporium Laboratory diagnosis: Specimens, biopsy tissue Direct microscopic examination:10 % KoH and smear : brown cell with septa, brown muriform cells=(sclerotic bodies) Culture on SDA and mycobiotic very slow growing dematiaceous fungi Management: phaeohyphypho and chromo Subcutaneous: •Clean surgical excision of the lesion and antifungal •Cerebral phaeohypho: aspiration of pus and antifungal •Amphotericin B, %-fluorocytosine (5-FC) •Azoles (Voriconazole, posaconazole •Caspofungin Rhinosporidiosis Clinical: Mucocutaenous fungal infection Sites: nasal, oral, (palate, epiglottis), conjunctiva Lesion: polyps, papilomas, warts-like lesion More seen in communities near swamps Etiology: Rhinosporidium seebri Obligatory parasitic fungus Believed to be chytridiomycetes (div. mastigo), doesn't grow on artificial media but has been grown in tissue culture Laboratory diagnosis: specimens, biopsy tissue Direct microscopy: stained section or smears KOH, will show spherules with endospores Culture on SDA will be negative Management: cryosurgical excision of lesion-relapse common Lobomycosis Clinical Cutaneous-subcutaneous fungal infection Lesion: keloidal-verrucoid-nodular Site: face, ear, arms, legs Chronic-localized Etiology: Lacazia loboi=Loboa loboi Obligately parasitic fungus Does not grow in culture like SDA media or tissue culture Laboratory diagnosis: the specimen is biopsy tissue-direct microscopy will show chains of cells Culture of specimen will be negative management surgical excision of lesion Sportrichosis Clinical: Lymphocutaenouse and subcutaenous granulomatous lesion-suppurate, ulcerate. The lesion are nodules or ulcers in local lymphatics Affected sites: extremities, joints. In agriculture communities Etiology Dimorphic imperfect fungus in trees, sharps, plant depries Sporothrix chenckii. Yeast in human tissues and at 37C in culture. Mold in culture and room temperatures with floweret's of conidia. Laboratory diagnosis: specimen: Biopsy tissue, ulcerative material Direct microscopy: smear ---finger –like yeast cells or cigar shaped some are oval. Culture: On SDA at room temperature to grow mold , and on blood A at 37c to grow yeast. Treatment: septrin, KI,