Cases reported "Dermatomycoses"

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1/15. An epidemic outbreak of malassezia folliculitis in three adult patients in an intensive care unit: a previously unrecognized nosocomial infection.

    BACKGROUND: malassezia is a lipophilic fungus commonly found in normal human skin. infection of the hair follicle by malassezia furfur occurs in patients with predisposing factors such as diabetes or immunosuppression, or who are undergoing antibiotic treatment. malassezia furfur folliculitis is an infrequent nosocomial infection which may be associated with fomite transmission. methods: We reviewed the clinical files of three adult patients from an intensive care unit (ICU) who simultaneously developed folliculitis through malassezia infection. We specifically analysed predisposing factors, possible transmission modes, characteristics of skin lesions, results of biopsies and cultures, treatment, and patient outcome. RESULTS: The three male patients were in neighboring beds and they all had factors that predisposed them to underlying immunosupression. Simultaneously, and within hours of each other, they developed erythematous follicular papules and pustules on the face and chest. The skin biopsies revealed an acute folliculitis with abundant round to oval yeasts of up to 5 microm in diameter. Stains for fungi (Schiff's peryodic acid, Grocott and silver methenamine) revealed numerous unipolar budding yeasts without hyphae, consistent with M. furfur. Conventional cultures were negative. The diagnosis of folliculitis by M. furfur was established and antifinigal treatment initiated, with adequate outcome of the dermatosis. After this outbreak, the aseptic and hygienic measures of the health care personnel of the ICU were reviewed and corrected. CONCLUSIONS: The simultaneous emergence of this superficial infection by M. furfur suggests fomite participation. This dermatomycosis is an infrequent nosocomial infection in adults, which to our knowledge has not been previously reported.
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ranking = 1
keywords = transmission
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2/15. mycetoma and phaeohyphomycosis caused by phialophora parasitica in thailand.

    phaeohyphomycosis caused by phialophora parasitica is rare and it has never been documented in thailand. The first two Thai cases of phaeohyphomycosis caused by P. parasitica were recognized in early 1990 at Ramathibodi Hospital, Bangkok, thailand. Both patients had underlying diseases. The fungus developed in abscesses with pigmented mycelium at the lower extremity. Cultures from pus and tissue biopsies were positive for dematiaceous fungi. light microscopic features suggested P. parasitica and which was illustrated by both scanning and transmission electron microscope. The first case was treated with itraconazole with a satisfactory initial response. The second case was successfully treated by surgical removal of the entire lesion.
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ranking = 0.5
keywords = transmission
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3/15. Invasive mycotic infections in the immunocompromised child.

    Oncologic therapy creates a highly vulnerable group of children with little or no natural immunity. In addition to the problems of coagulopathies, these children are prone to unusual infectious diseases. One group of saprophytic infections, the mycotic organisms, represents stubborn and often lethal diseases challenging present diagnostic and therapeutic skills. This is a case report of invasive aspergillus organisms in the nose and premaxilla in a 9-year-old child suffering from acute monocytic leukemia.
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ranking = 12.490725283198
keywords = infectious disease
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4/15. Palisading granulomas caused by infectious diseases.

    We recently encountered a palisading granuloma in which an infectious cause was not considered until special stains revealed hyphae and tissue culture revealed organisms of phaeohyphomycosis. A review of more than 2,500 cases of various granulomas revealed 11 cases of palisading-type granuloma caused by infection, including phaeohyphomycosis, nontuberculous mycobacteriosis, papulonecrotic tuberculid, tuberculoid syphiloderm, cat-scratch disease, sporotrichosis, cryptococcosis, and coccidioidomycosis. Infectious disease should be considered in the differential diagnosis of palisading granuloma. Special stains for bacteria, fungi, and acid-fast bacilli should be performed in biopsy specimens that have a palisading granuloma pattern with central necrosis, especially in immunosuppressed patients.
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ranking = 49.962901132792
keywords = infectious disease
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5/15. Cutaneous alternaria infection in renal transplant recipients: a report of two cases with an unusual mode of transmission.

    We report two cases of cutaneous alternariosis in renal transplant recipients. The diagnosis was made by mycologic and histologic examination. The patients were treated with itraconazole. In one patient who had undergone surgical resection of the cutaneous lesion along with antifungal treatment, the follow-up period was uneventful with no signs of recurrence. In the other patient, surgical excision of the lesion was not performed prior to antifungal therapy. The lesion disappeared following treatment but local recurrence was observed 1.5 years later with an unfavorable evolution despite administration of the second course of therapy. Resection of the lesion and prolongation of the treatment resulted in a satisfactory course with no signs of local recurrence over a follow-up period of 4.5 years. Interestingly, both of the patients had a previous history of a mild traumatic event with a stretcher in our outpatient clinic where the follow-up visits were made. A vast mycologic survey was then made in our department, which disclosed that some of the stretchers were contaminated by the fungi and could have potentially served as the reservoirs and vectors for the transmission of the fungus.
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ranking = 2.5
keywords = transmission
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6/15. trichophyton rubrum skin infection in two premature infants.

    trichophyton rubrum is a dermatophyte that causes tinea infection in adults and children but infection is surprisingly rare in the preterm infant. We present two cases of T. rubrum infection in preterm infants, in which mother-to-child transmission appears to have occurred. We describe the clinical features, differential diagnosis, appropriate investigation and management of this condition.
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ranking = 0.5
keywords = transmission
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7/15. Disseminated histoplasmosis presenting as an ulcerated verrucous plaque in a human immunodeficiency virus-infected man. Report of a case possibly involving human-to-human transmission of histoplasmosis.

    A 46-year-old homosexual man with disseminated histoplasmosis and human immunodeficiency virus (hiv) infection had a histoplasmosis-related ulcerated verrucous plaque above his left upper lip; systemic and cutaneous disease manifestations of histoplasmosis resolved with daily ketoconazole therapy. Disseminated histoplasmosis, with similar cutaneous features, also was present in his hiv-seropositive male sexual partner. The possibility of human-to-human transmission of histoplasmosis between these patients is considered and the skin lesions of systemic fungal infections in hiv-infected patients are reviewed.
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ranking = 2.5
keywords = transmission
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8/15. Evaluation of clinically normal appearing skin for systemic infectious diseases in human immunodeficiency virus seropositive patients.

    The observation of a human immunodeficiency virus (hiv)-infected patient with cutaneous ulcers which contained both fungal and viral pathogens, and in which the fungal organisms were grown in culture yet could not be demonstrated microscopically, suggested the possibilities: 1) that the skin lesions might have been primarily caused by the viral pathogen, and 2) that the concurrent presence of that fungal pathogen was coincidental and perhaps secondary to fungemia. Assuming that these postulates are valid, it is reasonable to hypothesize that fungal organisms would have been detected if perilesional or distal, clinically normal appearing, skin had been evaluated. This hypothesis could be further assessed by performing a prospective study of clinically normal appearing skin for pathogens of suspected systemic infectious diseases in hiv seropositive patients. Since the quantity of infectious pathogens in nonlesional skin may be limited, it might be difficult to grow the organisms in culture or demonstrate them microscopically using standard methods. Therefore, in addition to routine cultures and histologic evaluation, immunohistochemical techniques using monoclonal antibodies to pathogen antigens and dna amplification techniques based upon the polymerase chain reaction should be used to enhance the detection of the infectious pathogens.
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ranking = 62.453626415991
keywords = infectious disease
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9/15. Cold subcutaneous abscesses.

    Cold abscesses are defined as having no associated erythema, heat, or tenderness. They may be present in immunodeficiency disorders, deep mycoses, and other infectious diseases. As there is a dearth information on this subject in the dermatology, surgery, and infectious disease literature, we present a case of cold abscesses secondary to coccidioidomycosis and discuss the possible role of humoral immunity, cell-mediated immunity, prostaglandins, T cells, and other mediators in cold abscess pathogenesis. In addition, therapeutic guidelines for abscesses are reviewed.
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ranking = 24.981450566396
keywords = infectious disease
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10/15. Dermal alternariasis in a kidney transplant recipient.

    Dermal alternariasis represents one of the new infectious diseases related to immunodepression, especially in kidney recipients. periodic acid-Schiff and Grocott stains of paraffin sections and mycological cultures must be resorted to in order to establish the diagnosis. ketoconazole should be the best treatment.
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ranking = 12.490725283198
keywords = infectious disease
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