(Figure 4.29B, C) - True fungal infection (unlike actinomycetoma)
- Found in soil and plants; ↑ prevalence in Mexico, Central/South America, India, and Africa
- Commonly due to penetrating wound to foot (can also be on upper back, legs, or shoulders)
- Presents with slow progression of tumefaction, draining sinuses, and discharge of grains → scarring with deformity, ± bone involvement
- Histology: grains (aggregates of organism) admixed with chronic inflammation and fibrosis
- Treatment: oral antifungal (itraconazole, ketoconazole, griseofulvin) and debridement
| | | | | | | | Grain | | Organism | | | White | | Acremonium spp., Aspergillus spp., Fusarium spp. | | | White-yellow | | Pseudallescheria boydii | | | Black | | Exophiala jeansellmei , Curvularia spp., Madurella spp., Leptosphaeria spp., Pyrenochaeta romeroi |
| | | | | |
|
| | Figure 4.29
A: “Brass knuckles”
in lobomycosis
(Courtesy of CDC)
B: Mycetoma
(Courtesy of Dr. Paul Getz)
C: Exophiala jeansellmei
(Courtesy of Sandra Arduin,
Michigan Department of
Community Health) |
|
