Mycetoma and other Subcutaneous Mycoses

Question 1

Fungal infections involving the dermis, subcutaneous tissues, and muscle and may extend to bone.

Answer 1

Subcutaneous mycoses

Question 2

Subcutaneous mycoses are initiated by ________ to the skin.

Answer 2

trauma

Question 3

Fungal infections involving the ________, ________________, and __________ and may extend to ________.

Answer 3

dermis
subcutaneous tissues
muscle
bone

Question 4

Difficult to treat and surgical intervention is frequently employed.

Answer 4

Subcutaneous mycoses

Question 5

It is a chronic, granulomatous disease of the skin and subcutaneous tissue, which sometimes involves muscle and bones.

Answer 5

Mycetoma

Question 6

Mycetoma is characterized by _________, ____________, and _______________ that exude characteristic grains of clumped organisms.

Answer 6

swelling
abscess formation
multiple draining sinuses

Question 7

Mycetoma typically affects the ____________, but also other areas of the body like ______, ______, and _______.

Answer 7

lower extremities
hand
back
neck

Question 8

Mycetoma was first described in the ____________ of _________.

Answer 8

Madura district (Madura foot)
India

Question 9

Mycetoma is endemic in?

Answer 9

tropical, subtropical, and temperate regions

Question 10

Mycetoma is endemic in these places:

Answer 10

Sudan
Senegal
Somalia
India
Pakistan
Mexico
Venezuela

Question 11

Mycetoma is more common in men or women?

Answer 11

Men

Question 12

Mycetoma is common in men than in women with a ratio of?

Answer 12

3:1

Question 13

Mycetoma is common in people who work in _________ as ________.

Answer 13

rural areas
farmers

Question 14

Why are men more affected by mycetoma than women?

Answer 14

Since men usually work as farmers, this infection is most likely caused by trauma to the skin which is why they are more prone than women.

Question 15

Mycetoma is acquired via _______________.

Answer 15

trauma of the skin

Question 16

During trauma,
1. ________ subcutaneous firm _______ is observed.
2. massive swelling with skin rupture and _____________.
3. old sinuses close and new ones open, draining exudates with _______.

Answer 16

painless
nodule
sinus tract formation
grains (granules)

Question 17

Mycetoma is classified as ___________ and ____________.

Answer 17

Eumycetoma
Actinomycetoma

Question 18

It is caused by a several mould (filaments) fungi.

Answer 18

Eumycetoma

Question 19

It is caused by aerobic filamentous bacteria gram positive.

Answer 19

Actinomycetoma

Question 20

Most common eumycetoma

Answer 20

Madurella mycetomatis
Madurella grisea
Pseudallescheria boydii

Question 21

Most common actinomycetoma

Answer 21

Actinomadura madurae
Streptomyces somaliensis
Nocardia brasiliensis

Question 22

Color of grains in eumycetoma

Answer 22

Black/white

Question 23

Color of grains in actinomycetoma

Answer 23

Yellow
White
Yellowish-brown
Pinkish-red

Question 24

What color is not present in actinomycetoma?

Answer 24

Black

Question 25

Clinical samples in mycetoma:

Answer 25

Biopsy tissue Pus with grains Blood

Question 26

This type of biopsy is more accurate as clinical sample since superficial samples of the draining sinuses are inadequate.

Answer 26

Deep biopsy

Question 27

This clinical sample is only used for serology.

Answer 27

Blood

Question 28

In direct microscopic examinationof mycetoma, what are observed in grains?

Answer 28

size of the filaments color

Question 29

What is the color of grains that indicate P. boydii, Nocardia spp., or A. madurae infection.

Answer 29

White-yellow

Question 30

What color of grains that indicate Madurella spp. infection?

Answer 30

Black

Question 31

Culture media used for mycetoma to isolate fungi.

Answer 31

Sabouraud dextrose agar (SDA)

Question 32

For ____________, biochemical and other tests are used for identification.

Answer 32

Actinomycetes

Question 33

Why is deep biopsy more accurate than a superficial biopsy?

Answer 33

Because the superficial layer of the skin may contain mixed microbe at least the normal flora.

Question 34

__________ is suggested for several months or years.

Answer 34

Therapy

Question 35

Eumycetoma or actinomycetoma: which respond better to treatment?

Answer 35

Actinomycetoma

Question 36

This test is used if bone involvement is suspected.

Answer 36

Radiologic tests

Question 37

Treatment for eumycetoma

Answer 37

Itraconazole

Question 38

Treatment for actinomycetoma

Answer 38

Trimethoprim-sulfamethoxazole

Question 39

Treatment for actinomycetoma is trimethoprim-sulfamethoxazole with either _______ or __________.

Answer 39

dapsone streptomycin

Question 40

Dapsone is more common and is required to be given _________.

Answer 40

Intravenously

Question 41

It is a chronic localized firm subcutaneous masses.

Answer 41

Subcutaneous zygomycosis

Question 42

Subcutaneous zygomycosis typically affects the:

Answer 42

facial area hand arm leg thigh

Question 43

Characteristic feature of subcutaneous zygomycosis

Answer 43

Necrosis

Question 44

What differentiates subcutaneous zygomycosis from mycetoma?

Answer 44

No abscess or sinuses

Question 45

Subcutaneous zygomycosis is acquired via ____________________, needle-stick, tattooing, contaminated surgical dressings, and burn wound.

Answer 45

traumatic implantation of spores

Question 46

____________ (acute) subcutaneous zygomycosis caused by __________, ____________.

Answer 46

Mucorales Rhiceos Mucos

Question 47

_____________ (chronic) subcutaneous zygomycosis caused by ____________, _______________.

Answer 47

Entomophthorales Conidiobolus coronatus Basidiobolus ranarun

Question 48

Direct microscopy for subcutaneous zygomycosis, in stained sections/smears:

Answer 48

Broad non-septate hyphae

Question 49

Treatment for subcutaneous zygomycosis

Answer 49

Amphotericin B

Question 50

Is a group of fungal infections caused by dematiaceous (darkly pigmented) fungi widely distributed in the environment.

Answer 50

Phaeohyphomycosis

Question 51

Presents as nodules or erythematous plaques with no systematic involvement

Answer 51

Phaeohyphomycosis

Question 52

Affected sites for phaeohyphomycosis

Answer 52

Thigh Legs Feet Arms

Question 53

Phaeohyphomycosis shows _____ septate fungal hyphae.

Answer 53

brown

Question 54

Why does direct microscopy of phaeohyphomycosis shows brown septate fungal hyphae?

Answer 54

Because it is caused by dematiaceous which are darkly pigmented fungi.

Question 55

Clinical specimens used for phaeohyphomycosis?

Answer 55

Pus Biopsy tissue

Question 56

Treatment of choice for phaeohyphomycosis?

Answer 56

Surgical excision of the lesion

Question 57

It is a subcutaneous, deep cutaneous or systemic fungal infection.

Answer 57

Sporotrichosis

Question 58

Sporotrichosis can present as:

Answer 58

Plaque Lymphanginitic Dissiminated

Question 59

Dimorphic fungus

Answer 59

Sporothrix schenckii

Question 60

Finger-like yeast cells or cigar shaped

Answer 60

Sporotrichosis

Question 61

Treatment of sporotrichosis

Answer 61

Itraconazole Potassium Iodide

Question 62

Obligatory parasitic fungus of rhinosporidiosis

Answer 62

Rhinosporidium seeberi

Question 63

Obligatory parasitic fungus of lobomycosis

Answer 63

Lacazia loboi

Question 64

Spherules with endospores

Answer 64

Rhinosporidiosis

Question 65

Muriform cells (sclerotic bodies)

Answer 65

Chromoblastomycosis

Question 66

Chains of yeast cells

Answer 66

Lobomycosis

Question 67

Uncommon and not as isolated clinical problem

Answer 67

Bone and joint infections