Tinea Corporis Gladiatorum Presenting as a Majocchi Granuloma

Background. Wrestlers are at increased risk of developing cutaneous infections, including fungal infections caused by dermatophytes. Erythematous lesions due to tinea infections can be mistakenly diagnosed as an inflammatory dermatitis and incorrectly treated with potent topical corticosteroid treatments which cause localized skin immunosuppression. This can eventuate in a Majocchi granuloma which then becomes refractory to topical antifungal therapy. To our knowledge, this is the first case of tinea corporis gladiatorum presenting as a Majocchi granuloma. Observations. A 20-year-old wrestler presented with a 4-year history of a large pruritic, scaly erythematous plaque with follicular papules, and pustules on his right forearm. The lesion had the clinical appearance of a Majocchi granuloma. He had been treated with potent topical corticosteroids and topical antifungal therapy. KOH and fungal culture of the lesion were negative. An erythematous scaly lesion in the scalp was cultured and grew Trichophyton tonsurans. Oral Terbinafine therapy was initiated and complete resolution of both lesions occurred within 6 weeks. Conclusion. The purpose of this report is to inform dermatologists that tinea corporis gladiatorum can present as a Majocchi granuloma and needs to be considered in the differential diagnosis of persistent skin lesions in wrestlers.

Download Full-text

Feline Sino-orbital Fungal Infection Caused by Aspergillus and Scopulariopsis

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.91581 ◽

2019 ◽

Vol 47 ◽

Author(s):

Fernanda Vieira Amorim da Costa ◽

Andreia Spanamberg ◽

Ricardo Araujo ◽

Juliana Werner ◽

Laerte Ferreiro

Keyword(s):

Fungal Infection ◽

Fungal Infections ◽

Clinical Signs ◽

Response To Therapy ◽

Fungal Diseases ◽

Fungal Culture ◽

Upper Respiratory Tract ◽

First Case ◽

Increased Risk ◽

Upper Respiratory

Background: Deep fungal infections of the orbit and nasal passages causing rhinitis and ulcerative keratomycosis are uncommonly reported in cats. Hyalohyphomycetes and phaeohyphomycetes have rarely been associated with this disorder. Sino-orbital fungal diseases are emerging and more invasive than sino-nasal fungal diseases with poor response to therapy and a worse prognosis. Brachycephalic feline breeds seem to be at increased risk for development of upper respiratory fungal diseases. Diagnosis is based on the demonstration of fungal hyphae by cytology or histology and definitive confirmation by fungal culture and molecular methods. This is the first case report of a cat with clinical mixed fungal ball with Aspergillus and Scopulariopsis in Brazil.Case: A 3-year-old male Persian cat, in São José city, Santa Catarina, Brazil, was presented with exophthalmos and corneal ulcer of the left eye and protrusion, hyperemia, quemosis and fibroses of the left third eyelid. The retropulsion of the globe was negative in this eyeball and a presumptive diagnosis of a retrobulbar mass was made. The patient underwent a surgical procedure for inspection and collection of samples for bacterial and mycological culture. Culture revealed no bacterial growth, however, unique and abundant growth of Aspergillus spp. was present. A subconjunctival enucleation of the left eye was made and the mass was sent for histopathology examination. Histology showed inflammatory proliferative necrotizing pyogranulomatous reaction; with the presence of severe fungal infection evidenced by large number of hyaline septated regular and irregular mold hyphae. Molecular identification was performed using panfungal primers (ITS3-F / ITS4-R). Patient was treated with systemic itraconazole associated with amphotericin B and topical clotrimazole. A mass started to grow rapidly in the left pterygopalatine fossa and was surgically removed, but recurrence occurred seven days after. After 22 days of treatment, the animal died suddenly with a history of acute inspiratory dyspnea and cyanosis at the time prior to death. The diagnosis of sino-orbital fungal disease in the feline was based on clinical signs, mycological culture, histopathology and molecular methods.Discussion: Sino-orbital fungal diseases rare in cats and can result in significant injuries to the upper respiratory tract and eyes, sometimes resulting in enucleation and death. It seems feasible that a brachycephalic facial conformation may be an important risk factor for the development of sino-nasal fungal diseases in cats. Despite using selected drugs and eye enucleation to treat the disease, the cat developed a rapid growing oral mass that probably caused acute inspiratory dyspnea and death. Since no controlled studies exist on the treatment of feline fungal diseases, these cases are a challenge to the feline practitioner and this type of clinical manifestation should be included in the differential diagnosis of upper respiratory and ocular diseases.

Download Full-text

Clinical Appearance Of Tinea Corporis Resembles With Tinea Imbricata And Condyloma Acuminata Genital In A Reproductive Woman With HIV : A Case Report

JOURNAL OBGIN EMAS ◽

10.25077/aoj.5.2.285-300.2021 ◽

2021 ◽

Vol 5 (2) ◽

pp. 285-300

Author(s):

Indah Kencana ◽

Tutty Ariani ◽

Qaira Anum ◽

Yosse Rizal

Keyword(s):

Fungal Infections ◽

Severe Infection ◽

Clinical Findings ◽

Condyloma Acuminata ◽

Tinea Corporis ◽

Reproductive Age ◽

Fungal Culture ◽

Clinical Appearance ◽

Condyloma Acuminate ◽

The Right

Background: HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system that can cause immunodeficiency. Immunodeficiency results in increased susceptibility to fungal infections. The other opportunistic infection, condyloma acuminate is prevalent in groups at high risk for HIV acquisition and in HIV-infected individuals. Case: There were ring-shaped reddish patches with scaly and itchy on the right back since 3 weeks ago. Patients often scratch it especially when sweating and hot weather. The itchy reddish patches with scaly were increased in number and size on the right back then spreading over the edge to form ring-like patches. Patient complained ring-shaped reddish patches getting more red, scaly, itchy, and wider. 6 months ago, there was a lump that sometime felt itchy in below part of vulva. Patient in reproductive age and not married yet, but sexually active. Patient had a sexual relation with male who HIV 2 years ago. Patient also suffered HIV and got ARV since 6 month ago. There was no protection (condom) during the sexual intercourse. Dermatologic state in right back with efflorescence is plaque erythema with annular concentric ring forms, scale, and blackish crust. Venereologycal state show vegetation in vulva with size 0,2 - 1,5 x 1 x 0,5 cm with verrucous surface. Acetowhite test is positive result. KOH 10% of skin scrapping show fungal element and fungal culture result is tricophyton rubrum. Patient was diagnosed tinea corporis (TC) and condyloma acuminata (CA) genital griseovulfin 900 mg, cetirizin 10 mg, ketokonazol 2% cream twice a day, tricholoroacetat 90% and showed good improvement.Discussion: Diagnosis tinea corporis and CA genital based on clinical findings and mycological examination. Early diagnosis and proper treatment are important in HIV patients in order to prevent severe infection. After 4 weeks treatment, show improvement on TC however CA lesion no reduced. Keywords: tinea corporis,condyloma acuminate, tinea imbricata, HIV, Reproductive age

Download Full-text

Bittersweet: infective complications of drug-induced glycosuria in patients with diabetes mellitus on SGLT2-inhibitors: two case reports

BMC Infectious Diseases ◽

10.1186/s12879-021-05982-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Caroline Bartolo ◽

Victoria Hall ◽

N. Deborah Friedman ◽

Chloe Lanyon ◽

Andrew Fuller ◽

...

Keyword(s):

Diabetes Mellitus ◽

Fungal Infections ◽

Case Reports ◽

Sglt2 Inhibitor ◽

Sglt2 Inhibitors ◽

Urogenital Tract ◽

Hypoglycemic Agents ◽

Drug Induced ◽

First Case ◽

Increased Risk

Abstract Background Sodium-glucose co-transporter 2 (SGLT2) inhibitors are novel hypoglycemic agents which reduce reabsorption of glucose at the renal proximal tubule, resulting in significant glycosuria and increased risk of genital mycotic infections (GMI). These infections are typically not severe as reported in large systematic reviews and meta-analyses of the medications. These reviews have also demonstrated significant cardiovascular benefits through other mechanisms of action, making them attractive options for the management of Type 2 diabetes mellitus (T2DM). We present two cases with underlying abnormalities of the urogenital tract in which the GMI were complicated and necessitated cessation of the SGLT2 inhibitor. Case presentations Both cases are patients with T2DM on empagliflozin, an SGLT2 inhibitor. The first case is a 64 year old man with Candida albicans balanitis and candidemia who was found to have an obstructing renal calculus and prostatic abscess requiring operative management. The second case describes a 72 year old man with Candida glabrata candidemia who was found to have prostatomegaly, balanitis xerotica obliterans with significant urethral stricture and bladder diverticulae. His treatment was more complex due to fluconazole resistance and concerns about urinary tract penetration of other antifungals. Both patients recovered following prolonged courses of antifungal therapy and in both cases the SGLT2 inhibitor was ceased. Conclusions Despite their cardiovascular benefits, SGLT2 inhibitors can be associated with complicated fungal infections including candidemia and patients with anatomical abnormalities of the urogenital tract may be more susceptible to these infections as demonstrated in these cases. Clinicians should be aware of their mechanism of action and associated risk of infection and prior to prescription, assessment of urogenital anatomical abnormalities should be performed to identify patients who may be at risk of complicated infection.

Download Full-text

Xeroderma Pigmentosum with Severe Neurological Manifestations/De Sanctis–Cacchione Syndrome and a Novel XPC Mutation

Case Reports in Medicine ◽

10.1155/2017/7162737 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Esteban Uribe-Bojanini ◽

Sara Hernandez-Quiceno ◽

Alicia María Cock-Rada

Keyword(s):

Xeroderma Pigmentosum ◽

Excision Repair ◽

Genetic Disorders ◽

Clinical Manifestations ◽

Skin Lesions ◽

Panel Testing ◽

First Case ◽

Skin Malignancy ◽

Increased Risk ◽

History Of

Several genetic disorders caused by defective nucleotide excision repair that affect the skin and the nervous system have been described, including Xeroderma Pigmentosum (XP), De Sanctis–Cacchione syndrome (DSC), Cockayne syndrome, and Trichothiodystrophy. Cutaneous photosensitivity with an increased risk of skin malignancy is a common feature of these disorders, but clinical manifestations commonly overlap these syndromes. Several genes have been found to be altered in these pathologies, but we lack more genotype-phenotype correlations in order to make an accurate diagnosis. Very few cases of DSC syndrome have been reported in the literature. We present a case of a 12-year-old Colombian male, with multiple skin lesions in sun-exposed areas from the age of 3 months and a history of 15 skin cancers. He also displayed severe neurologic abnormalities (intellectual disability, ataxia, altered speech, and hyperreflexia), short stature, and microcephaly, which are features associated with DSC. Genetic testing revealed a novel germline mutation in the XP-C gene (c.547A>T). This is the first case of an XP-C mutation causing De Sanctis–Cacchione syndrome. Multigene panel testing is becoming more widely available and accessible in the clinical setting and will help rapidly unveil the molecular etiology of these rare genetic disorders.

Download Full-text

The challenge of Diagnosing Common Dermatomycosis by Reflectance Confocal Microscopy

Dermatology and Dermatitis ◽

10.31579/2578-8949/085 ◽

2021 ◽

Vol 6 (3) ◽

pp. 01-07

Author(s):

Jianyun Lu ◽

Jinrong Zeng ◽

Hanyi Zhang ◽

Yue Zhang ◽

Lihua Gao ◽

...

Keyword(s):

Confocal Microscopy ◽

Fungal Infections ◽

Pityriasis Versicolor ◽

Tinea Corporis ◽

Reflectance Confocal Microscopy ◽

Fungal Culture ◽

Image Characteristics ◽

Tinea Manus ◽

Microscopy Techniques

Background: Traditional detection of fungal infections of the skin relies on microscopy techniques or fungal culture. Currently, reﬂectance confocal microscopy (RCM) has been widely applied to assist the diagnosis of commondermatomycosis with advantages of non-invasiveness, celerity, real time, and repeatability. Materials and Methods: A total of 478 clinically suspected dermatomycosis patients were enrolled in this study including 148 cases of tinea manus and pedis, 188 cases of tinea corporis and cruris and 142 cases of pityriasis versicolor. RCM examination was performed to image the lesions. Aim: This study aimed to summarize the image characteristics of in vivo RCM examination on common dermatomycosis and retrospectively evaluate its accuracy as compared with microscopy results. Furthermore, we attempted to tackle the challenges of RCM diagnosis on common dermatomycosis. Results: Based on RCM images, 231 of 478 (48.3%) patients were detected with hyphae. Among all RCM confirmed cases, 58 out of 148 (39.2%) were tinea manus and pedis, 145 out of 188 (77.1%) were tinea corporis and cruris, and 28 out of 142 (19.7%) were pityriasis versicolor. The remaining patients (51.7%) could not be diagnosed by the dermatologist according to RCM. Hyphae structures were primarily identified during diagnoses of dermatomycosis by RCM. Conclusions: RCM is a novel optical imaging technique that confers high-resolution images of fungi. RCM has certain advantages in the diagnosis of tinea manus and pedis. RCM is not suitable for the diagnosis of pityriasis versicolor.

Download Full-text

Cerebral venous thrombosis secondary to an occult maxillary sinusitis in a young male from sub-Saharan Africa

10.36811/ojor.2019.110002 ◽

2019 ◽

pp. 08-12

Author(s):

Mazou N Temgoua ◽

Mickael Essouma ◽

Larry N Tangie ◽

Cedric Tsinda ◽

Drusille Feze Foko ◽

...

Keyword(s):

Venous Thrombosis ◽

Acute Stroke ◽

Cerebral Venous Thrombosis ◽

Fungal Infections ◽

Sinus Thrombosis ◽

Maxillary Sinusitis ◽

Case Reports ◽

Sub Saharan Africa ◽

First Case ◽

Increased Risk

Cerebral venous thrombosis (CVT) also termed cerebral venous sinus thrombosis (CVST), is a special type of cerebrovascular disease characterized by cerebral venous infarction [1]. As from 1825 when the first case was described by Ribes[2], epidemiological descriptions are still restricted to case reports and small retrospective cross-sectional studies yielding low butincreasing incidence: <10 cases per million per year in 1995 to about 13.2 cases per million per year in 2012.CVT mainly occurs in women of child bearing age, probably owing to the use of oral contraceptive pills, and mostly has an acute or subacute course [1]. It can be categorized as primary/idiopathicand secondary. Secondary CVT can further be classified into infective (mainly due to bacterial or fungal infections) and non-infective CVT; the latterbeing due tocoagulation disorders, neoplasms, procoagulant hemodynamic states, vascularitis,homocystinuria, or head trauma [3].With the advent of antibiotics, the epidemiology of CVT has shifted from predominant infective CVT to predominant non-infective CVT, leading to increased risk of misdiagnosis and delayed treatment [3]. We report occult purulent maxillary sinusitis-related CVT in a male Cameroonian patient who presented with headaches, seizures and acute stroke syndrome. The aim of this paper is to reiterate CVT as the main cause of acute stroke syndrome in young adults irrespective of ethnic origin and sex, and suggest systematic screening of infections in those patients, especially in regions with high rates of infections likesub-Saharan Africa.We describe this case with regard to CARE guidelines.

Download Full-text

Dementia-Like Symptoms Associated With Posaconazole

Journal of Pharmacy Practice ◽

10.1177/0897190020958235 ◽

2020 ◽

pp. 089719002095823

Author(s):

Carmela E. Corallo ◽

Steven P. Ivulich ◽

Dr Sakhee Kotecha ◽

Orla Morrissey

Keyword(s):

Lung Transplant ◽

Fungal Infections ◽

Transplant Recipients ◽

First Case ◽

Increased Risk ◽

Post Marketing ◽

Scedosporium Prolificans ◽

Lung Transplant Recipients ◽

Dose Dependent

Posaconazole is widely used in lung transplant recipients as pre-emptive therapy or universal fungal prophylaxis. In this patient group, posaconazole is increasingly used instead of voriconazole due to the concerns of an increased risk of squamous cell carcinoma (SCC) with voriconazole, particularly with its long-term use. Dose dependent toxicity has not been identified for posaconazole in the registration trials of intravenous (IV) and modified-release tablet formulations. This is supported by post-marketing experience. We describe a lung transplant recipient who experienced dementia-like symptoms almost 3 years after commencing posaconazole for treatment of Aspergillus fumigatus complex and Lomentospora prolificans (formerly Scedosporium prolificans) fungal infections. Symptoms resolved upon discontinuation of posaconazole, but recurred when re-challenged at a lower dose more than a year later. To the best of our knowledge, this is the first case reporting a dementia-like state with posaconazole.

Download Full-text

Combination of Systemic and Topical Treatment for Feline Dermatophytosis: A Case Report

Acta Veterinaria Indonesiana ◽

10.29244/avi.8.1.18-23 ◽

2020 ◽

Vol 8 (1) ◽

pp. 18-23

Author(s):

Soedarmanto Indarjulianto ◽

Yanuartono Yanuartono ◽

Alfarisa Nururrozi ◽

Slamet Raharjo ◽

Jeffi Chandra Ajiguna

Keyword(s):

Veterinary Medicine ◽

Case Report ◽

Hair Loss ◽

Fungal Infections ◽

Skin Lesions ◽

Fungal Culture ◽

Veterinary Clinic ◽

Direct Microscopic Examination ◽

Complete Series ◽

Pruritic Skin

Dermatophytoses or ringworm are the most common fungal infections in dogs and cats. This zoonotic disease is called dermatophytosis. A 2 years old male Persian cat referred to the Veterinary Clinic Faculty of Veterinary medicine, Universitas Gadjah Mada with multi-focal circular non-pruritic skin lesions and hair loss mainly on the head and ears. A complete series of dermatologic tests such as Wood’s light examination, direct microscopic examination, and fungal culture were performed. The cat was treated with itraconazole dosage orally for a period of 20 days and ketoconazole topical for 35 days, respectively. Thirty five days after treatments the cat showed reduction of lesions.

Download Full-text

Clinico-mycological study and comparison of efficacy of three different techniques of sample collection from skin lesions for potassium hydroxide mount preparation in dermatophytoses

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20185515 ◽

2019 ◽

Vol 5 (1) ◽

pp. 88 ◽

Cited By ~ 1

Author(s):

Veena Thimmappa ◽

Veeranna Shastry ◽

Jayadev Betkerur

Keyword(s):

Fungal Infections ◽

Tertiary Care ◽

Skin Surface ◽

Skin Lesions ◽

Tinea Corporis ◽

Alternative Methods ◽

Care Hospital ◽

Sample Collection ◽

Direct Microscopy ◽

Keratinized Tissue

Background: Dermatophytoses are superficial fungal infections which invade and multiply within keratinized tissue. The KOH mount is one of the useful procedures and believed to be more reliable than culture for demonstrating dermatophytes. A few studies in the past have demonstrated the usefulness of alternative methods of sample collection for KOH preparation, but data on sensitivity and specificity of these methods is lacking. The aim of the study was to study the clinic-mycological aspects of dermatophytoses and to compare the efficacy of three different sampling techniques from skin lesions and correlating KOH mount with culture results.Methods: 210 clinically diagnosed patients with dermatophytic infection attending outpatient department of Dermatology of a tertiary care hospital for duration of 2 years (September 2015 to October 2017) were included. The samples were collected from skin, hair and nail. These samples were used for direct microscopy by KOH mount and fungal cultures by Sabouraud dextrose agar media.Results: Of the total of 210 patients, maximum were in age group of <10 years (74 cases), male: female - 1.2:1. Tinea corporis was commonest presentation (40.5%). Overall direct microscopy positivity was 81% while three different techniques from the glabrous skin and groins lesions was scraping method (97%), cellophane tape method (96%), skin surface biopsy (SSB) (98%) and culture in (89%). T. rubrum was commonest species isolate (37.7%).Conclusions: Tinea corporis was the commonest clinical type followed tinea capitis. T. rubrum were commonest dermatophytes isolated. All three methods of sampling were suitable for routine sample collection. The KOH mount helped rapid confirmation of clinical diagnosis.

Download Full-text

Adalimumab-induced acute interstitial lung disease in a patient with rheumatoid arthritis

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37132014000100012 ◽

2014 ◽

Vol 40 (1) ◽

pp. 77-81 ◽

Cited By ~ 16

Author(s):

Olivia Meira Dias ◽

Daniel Antunes Silva Pereira ◽

Bruno Guedes Baldi ◽

Andre Nathan Costa ◽

Rodrigo Abensur Athanazio ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Interstitial Lung Disease ◽

Autoimmune Diseases ◽

Lung Diseases ◽

Fungal Infections ◽

Interstitial Lung Diseases ◽

Pulmonary Complications ◽

First Case ◽

Increased Risk ◽

History Of

The use of immunobiological agents for the treatment of autoimmune diseases is increasing in medical practice. Anti-TNF therapies have been increasingly used in refractory autoimmune diseases, especially rheumatoid arthritis, with promising results. However, the use of such therapies has been associated with an increased risk of developing other autoimmune diseases. In addition, the use of anti-TNF agents can cause pulmonary complications, such as reactivation of mycobacterial and fungal infections, as well as sarcoidosis and other interstitial lung diseases (ILDs). There is evidence of an association between ILD and the use of anti-TNF agents, etanercept and infliximab in particular. Adalimumab is the newest drug in this class, and some authors have suggested that its use might induce or exacerbate preexisting ILDs. In this study, we report the first case of acute ILD secondary to the use of adalimumab in Brazil, in a patient with rheumatoid arthritis and without a history of ILD.

Download Full-text