Chapter 23 : Sequelae and Long-Term Consequences of Systemic and Subcutaneous Mycoses

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in

Sequelae and Long-Term Consequences of Systemic and Subcutaneous Mycoses, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555815486/9781555814304_Chap23-1.gif /docserver/preview/fulltext/10.1128/9781555815486/9781555814304_Chap23-2.gif


This chapter reviews the complications of the most common systemic mycoses and subcutaneous mycoses, including histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis, mycetoma, sporotrichosis, and chromoblastomycosis. Subcutaneous mycoses are chronic diseases of tropical and subtropical areas in which the etiologic agent is acquired after traumatic infection. Immunocompromised patients are very susceptible to the complications and sequelae of histoplasmosis. Osteomyelitis of the spine and tenosynovitis, mainly of the hands, may be present. Some of the chronic sequelae caused by the disease can be evidenced by radiological changes, such as osteopenia, joint space narrowing, bony destruction, and in some instances, ankylosis. Adequate treatment usually improves the patient condition, but in almost every case, the sequelae of the infection contribute to the morbidity of the disease. If the sequelae lesions harbor viable , relapses may occur. The complication rate of chromoblastomycosis is low, and probably in many cases, the disease is misdiagnosed, mostly as verrucous tuberculosis or the sequelae left by the surgical removal of the affected area. Secondary infection occurs in as many as 63% of patients with chromoblastomycosis. The complications and long-term sequelae of the extracutaneous form of sporotrichosis are rare and affect principally bones and weight-bearing joints, with or without tenosynovitis, periostitis, and ostheolisis. Fungemia is a rare complication generally associated with the disseminated form of the disease, although a few reports support the presence of the fungus in the bloodstream without evidence of disseminated sporotrichosis.

Citation: VÁsquez-del-Mercado E, Moreno G, Arenas R. 2009. Sequelae and Long-Term Consequences of Systemic and Subcutaneous Mycoses, p 415-423. In Fratamico P, Smith J, Brogden K (ed), Sequelae and Long-Term Consequences of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555815486.ch23

Key Concept Ranking

Central Nervous System Diseases
Immune Systems
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. Ahmed, A. O.,, And E. S. Abugroun. 1998. Unexpected high prevalence of secondary bacterial infection in patients with mycetoma. J. Clin. Microbiol. 36:850851.
2. Amromin, G.,, and C. M. Blumenfeld. 1953. Coccidioidomycosis of the epididymis. A report of two cases. Calif. Med. 78:136138.
3. Arbab, M. A.,, I. A. el Hag,, A. F. Abdul Gadir, and, H. el-R. Siddik. 1997. Intraspinal mycetoma: report of two cases. Am. J. Trop. Med. Hyg. 56:2729.
4. Arenas, R. 2008. Micología médica ilustrada, p. 113148, 3rd ed., McGraw Hill-Interamericana, México City, México.
5. Arsura, E. L.,, W. B. Kilgore,, J. W. Caldwell,, J. C. Freeman,, H. E. Einstein, and, R. H. Johnson. 1998. Association between facial cutaneous coccidioidomycosis and meningitis. West. J. Med. 169:1316.
6. Asbury, T. 1966. The status of presumed ocular histoplasmosis: including a report of a survey. Tr. Anf. Ophth. Soc. 64:371400.
7. Baker, R. D.,, and E. W. Brian. 1936. Blastomycosis of the heart. Report of two cases. Am. J. Pathol. 13:139147.
8. Bedell, A. J. 1914. Case of chronic sporotrichosis of the eye. Trans. Am. Ophthalmol. Soc. 13:720728.
9. Berman, S. S.,, G. A. Kazlow,, B. T. Fields, Jr., and, S. Weinberg. 1990. Disseminated histoplasmosis with embolic endovascular complications: a case report. J. Vasc. Surg. 12:577580.
10. Brett, M. T.,, J. T. C. Kwan, and, M. R. Bending. 1988. Caecal perforation in a renal transplant patient with disseminated histoplasmosis. J. Clin. Pathol. 41:992995.
11. Brummer, E.,, E. Castaneda, and, A. Restrepo. 1993. Paracoccidioidomycosis: an update. Clin. Microbiol. Rev. 6:89117.
12. Buss, W. C.,, T. E. Gibson, and, M. A. Gifford. 1950. Coccidioidomycosis of the meninges. Calif. Med. 72:167169.
13. Carnesale, P. L.,, and K. F. Stegman. 1956. Blastomycosis of bone. Report of four cases. Ann. Surg. 114:252257.
14. Castro, L. G.,, W. Belda, Jr.,, A. Salebian, and, L. C. Cuce. 1993. Mycetoma: a retrospective study of 41 cases seen in Sao Paulo, Brazil, from 1978–1989. Mycoses 36:8995.
15. Cuellar, M. L.,, L. H. Silveira, and, L. R. Espinoza. Fungal arthritis. Ann. Rheum. Dis. 51:690697.
16. Daniel, L.,, and I. Salit. 1984. Blastomycosis during pregnancy. Can. Med. Assoc. J. 131:759761.
17. Danoff, D.,, Z. M. Munk,, B. Case,, M. Finlayson, and, P. Gold. 1978. Disseminated coccidioidomycosis: clinical, immunologic and therapeutic aspects. Can. Med. Assoc. J. 118:390392.
18. Deepe, G. S. 2005. Histoplasma capsulatum, p. 3012–3026. In G. L. Mandell,, J. E. Bennet, and, R. Dolin (ed.), Principles and Practice of Infectious Diseases, 6th ed. Elsevier, Philadelphia, PA.
19. dos Santos Gon, A.,, and L. Minelli. 2006. Melanoma in a long-standing lesion of chromoblastomycosis. Int. J. Dermatol. 45:13311333.
20. Duane, R. 2005. Agents of chromoblastomycosis, p. 2988–2991. In Mandell, J. E. Bennet, and, R. Dolin (eds.), Principles and Practice of Infectious Diseases, 6th ed. Elsevier, Philadelphia, PA.
21. Elhardello, O. A.,, E. S. Adam, and, I. Adam. 2007. Abdominal wall mycetoma presented as obstructed incisional hernia of cesarean section in eastern Sudan. Infect. Dis. Obstet. Gynecol. 7:74643.
22. Esterre, P.,, J. L. Pecarrère,, C. Raharisolo, and, M. Huerre. Carcinome épidermoide développé sur des lesions de chromomycose: à propos de deux observations. Ann. Pathol. 19:516520.
23. Fahal, A. H.,, A. R. Sharfi,, H. E. Sheik,, A. M. el Hassan, and, E. S. Mahgoub. 1996. Internal fistulae formation: an unusual complication of mycetoma. Trans. R. Soc. Trop. Med. Hyg. 90:550552.
24. Farrel, G. E. 1961. Blastomycosis of sacro-coccygeal area. Report of a case. Ann. Surg. 154:9092.
25. Fartoukh, M.,, A. Khalil,, L. Louis,, M. F. Carette,, B. Bazelly,, J. Cadranel,, C. Mayaud, and, A. Parrot. 2007. An integrated approach to diagnosis and management of severe haemoptysis in patients admitted to the intensive care unit: a case series from a referral centre. Respir. Res. 8:11.
26. Fukushiro, R. 1983. Chromomycosis in Japan. Int. J. Dermatol. 22:221229.
27. Gillespie, R. 1986. Treatment of cranial osteomyelitis from disseminated coccidioidomycosis. West. J. Med. 145:694697.
28. Goldani, L. Z.,, C. Klock,, A. Diehl,, A. C. Monteiro, and, A. L. Maia. 2000. Histoplasmosis of the thyroid. J. Clin. Microbiol. 38:38903891.
29. Hector, R. F.,, and R. Laniado-Laborin. 2005. Coccidioido-mycosis: a fungal disease of the Americas. PLoS Med. 2:e2.
30. Heneghan, S. J.,, J. Li,, E. Petrossian, and, L. S. Bizer. 1993. Intestinal perforation from gastrointestinal histoplasmosis in acquired immunodeficiency syndrome. Case report and review of the literature. Arch. Surg. 128:464466.
31. Hood, A. B.,, F. G. Inglis,, L. Lowenstein,, J. B. Dossetor,, L. D. MacLean. 1965. Histoplasmosis and thrombocytopenic purpura: transmission by renal homotransplantation. Can. Med. Assoc. J. 93:587592.
32. Ismail, Y.,, E. Ward, and, L. Arsura. 1993. Eosinophilic meningitis associated with coccidioidomycosis. West. J. Med. 158:300301.
33. Johnson, W. 1981. Fatal disseminated coccidioidomycosis following an intestinal bypass operation for Obesity. West. J. Med. 31:324326.
34. Kauffman, C. A. 2007. Histoplasmosis: a clinical and laboratory update. Clin. Microbiol. Rev. 20:115132.
35. Kosinski, R. M.,, P. Axelrod,, J. H. Rex,, M. Butrday,, R. Sivaprasad, and, A. Wreiole. 1992. Sporothrix schenckii fungemia without disseminated sporotrichosis. J. Clin. Microbiol. 30:501503.
36. Kroe, D. M.,, N. Shulman,, C. M. Kirsch, and, J. H. Wehner. 1997. An anterior mediastinal mass with draining sternal sinus tracts due to Nocardia. West. J. Med. 167:4749.
37. Miller, M.,, R. Hendren, and, P. H. Gilligan. 2004. Posttransplantation disseminated coccidioidomycosis acquired from donor lungs. J. Clin. Microbiol. 42:23472349.
38. Minotto, R.,, C. D. V. Bernardi,, L. F. Mallman,, M. I. Edelweiss, and, M. L. Scrofemeker. 2001. Chromoblastomycosis: a review of 100 cases in the state of Río Grande do Sul, Brazil. J. Am. Acad. Dermatol. 44:585592.
39. Moholtz, M. S.,, J. H. Dauber, and, S. A. Yousem. 1994. Case report: fluconazole therapy in histoplasma mediastinal granuloma. Am. J. Med. Sci. 307:274277.
40. Mollano, A. V.,, H. Shamsuddin, and, J. S. Suh. 2005. Systemic blastomycosis with osseous involvement of the foot: case report. Iowa Orthop. J. 25:5356.
41. Morison, W. L. 1973. Chromoblastomycosis. Proc. Roy. Soc. Med. 66:178179.
42. Muhammed, K.,, G. Nandakumar,, K. K. Asokan, and, P. Vimi. 2006. Lymphangitic chromoblastomycosis. Indian J. Dermatol. Venereol. Leprol. 72:443445.
43. Ogawa, M. M.,, M. M. A. Alchorne,, A. Barbieri,, M. Castiglioni,, A. P. B. Penna, and, J. Tomimori-Yamashita. 2003. Lymphoscintigraphic analysis in chromoblastomycosis. Int. J. Dermatol. 42:622625.
44. Padhye, A. A.,, L. Kaufman,, E. Durry,, C. K. Banerjee,, S. K. Jindal,, P. Talwar, and, A. Chakrabarti. 1992. Fatal pulmonary sporotrichosis caused by Sporothrix schenckii var. luriei in India. J. Clin. Microbiol. 30:24922494.
45. Paul, C.,, B. Dupont,, G. Pialoux,, M. F. Avril, and, R. Pradinaud. 1991. Chromoblastomycosis with malignant transformation and cutaneous-synovial secondary localization. The potential role of itraconazole. J. Med. Vet. Mycol. 29:313316.
46. Persaud, V.,, and J. B. M. Holroyd. 1968. Mycetoma of the palpebral conjunctiva caused by Allescheria boydii (Mono-sporium apiospermum). Brit. J. Ophthal. 52:857.
47. Restrepo, A.,, and A. M. Tobón. 2005. Paracoccidiodes brasilensis, p. 3062–3068. In Mandell, J. E. Bennet, and, R. Dolin (ed.), Principles and Practice of Infectious Diseases, 6th ed. Elsevier, Philadelphia, PA.
48. Salhab, K. H.,, D. Baram, and, T. V. Bilfinger. 2006. Growing PET positive nodule in a patient with histoplasmosis: case report. J. Cardiothoracic. Surg. 1:23.
49. Sánchez Navarro, L. M.,, M. Escobar Vázquez,, R. Arenas,, V. Cruz Hernández, and, B. Delgado Velásquez. 2004. Micetoma por Nocardia sp con localización en la pared abdominal y diseminación hemolinfática, al hígado y al bazo. Dermatologia Rev. Mex. 48:9094.
50. Sarosi, G. A.,, and S. F. Davies. 1996. Endemic mycosis complicating human immunodeficiency virus infection. West. J. Med. 164:335340.
51. Saubolle, M. A.,, P. P. McKellar, and, D. Sussland. 2007. Epidemiologic, clinical, and diagnostic aspects of coccidioido-mycosis. J. Clin. Microbiol. 45:2630.
52. Sharif, H. S. 1992. Role of MR imaging in the management of spinal infections. Am. J. Roentgenol. 158:13331345.
53. Sharif, H. S.,, D. C. Clark,, M. Y. Aabed,, M. C. Haddad,, S. M. Al Deeb,, B. Yaqub, and, K. R. al Moutaery. 1990. Granulomatous spinal infections: MR imaging. Radiology 177:101107.
54. Symmers, W. 1960. Chromoblastomycosis simulating rhino-sporidiosis in a patient from Ceylon. J. Clin. Path. 13:287290.
55. Tomas, P. A. 2003. Current perspectives on ophtalmic mycoses. Clin. Microbiol. Rev. 16:730797.
56. Tseng, T. C.,, S. J. Liaw,, C. H. Hsiao,, C. Y. Wang,, L. N. Lee,, T. S. Huang, and, P. R. Hsueh. 2005. Molecular evidence of recurrent histoplasmosis with 9-year latency in a patient with Addison’s disease. J. Clin. Microbiol. 43:49114913.
57. Vaughan, J. E.,, and H. Ramírez. 1951. Coccidioldomycosis as a complication of pregnancy. Calif. Med. 74:121125.
58. Weyrauch, H. M.,, F. W. Norman, and, J. B. Basset. 1950. Coccidioidomycosis of the genital tract. Calif. Med. 72:465468.
59. Wheat, J. 1995. Endemic mycoses in AIDS: a clinical review. Clin. Microbiol. Rev. 8:146159.
60. Wong, P.,, S. Houston,, B. Power,, E. Lalor, and, V. G. Bain. 2001. A case of histoplasma causing granulomatous liver disease and Addisonian crisis. Can. J. Gastroenterol. 15:687691.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error