Chapter 122 : , and Other Melanized Fungi

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The chapter on , , , , and Other Melanized Fungi covers most of the agents of phaeohyphomycosis, chromoblastomycosis, and sporotrichosis, as well as a number of agents of superficial and cutaneous disease. In this chapter, the genera are treated according to their ordinal relationships. Phaeohyphomycoses are usually subcutaneous, but they can also be superficial or even systemic. Members of the order Pleosporales (most commonly , , and ) are able to cause subcutaneous infections, although more commonly they produce allergic sinusitis with occasional cerebral involvement in otherwise healthy individuals. A panfungal PCR assay has been developed that targets the ITS1 region of the rDNA gene cluster for detecting fungal DNA in fresh and paraffinembedded tissue specimens. This method was useful for the identifying species of , , and . The available in vitro data for dematiaceous fungi are increasing every day, and in general the antifungal susceptibility of the most clinically relevant species is known. Posaconazole activity is higher than voriconazole activity against spp., spp., and spp., although against the last the activity of both drugs was very poor. In the future, direct identification of fungal genera from tissue blocks using immunohistochemistry, in situ DNA hybridization, or DNA sequencing will be a promising approach to rapid detection and identification of these agents.

Citation: Guarro J, de Hoog G. 2011. , and Other Melanized Fungi , p 1943-1961. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch122
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Image of FIGURE 1

(a and b) Neoscytalidium dimidiatum; (c to e) Lasiodiplodia theobromae; (f ) Hortaea werneckii; (g and h) Pseudallescheria boydii; (i to l) Scedosporium boydii. Reproduced from reference .

Citation: Guarro J, de Hoog G. 2011. , and Other Melanized Fungi , p 1943-1961. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch122
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Image of FIGURE 2

(a and b) ; (c) ; (d) ; (e to g) ; (h and i) ; (j) ; (k) various pictures of Fonsecaea pedrosoi. Reproduced from reference

Citation: Guarro J, de Hoog G. 2011. , and Other Melanized Fungi , p 1943-1961. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch122
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Image of FIGURE 3

(a and b) (c and d) (e and f) (g) (h and i) (j) (k) . Reproduced from reference .

Citation: Guarro J, de Hoog G. 2011. , and Other Melanized Fungi , p 1943-1961. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch122
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Image of FIGURE 4

(a to c) ; (d) ; (e to h) ; (i) ; (j) ; (k to m) . Reproduced from reference .

Citation: Guarro J, de Hoog G. 2011. , and Other Melanized Fungi , p 1943-1961. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch122
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Image of FIGURE 5

(a) Hematoxylin and eosin stain of subcutaneous nodule biopsy sample showing branching hyphae of (b to d) brain tissue showing irregular, branching, and septate hyphae of , stained with hematoxylin and eosin stain (b), GMS stain (c), and PAS stain (d). Magnifications, ×250 (a) and ×400 (b to d). (Courtesy of E. Mayayo, Universitat Rovira i Virgili.)

Citation: Guarro J, de Hoog G. 2011. , and Other Melanized Fungi , p 1943-1961. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch122
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Image of FIGURE 6

(a and b) Lung tissue with numerous conidia and hyphae of stained with PAS (a) and GMS (b); (c) PAS stain of a subcutaneous nodule biopsy sample showing sclerotic cells of within a giant cell; (d) PAS stain of a fine-needle aspirate of a subcutaneous nodule showing sclerotic cells of (e) PAS stain of a hepatic vessel showing a massive embolization by showing characteristic elongate cells. Magnifications, ×400. (Courtesy of E. Mayayo, Universitat Rovira i Virgili.)

Citation: Guarro J, de Hoog G. 2011. , and Other Melanized Fungi , p 1943-1961. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch122
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Generic image for table

Overview of the clinically most relevant species and their attribution to the ordinal level

Citation: Guarro J, de Hoog G. 2011. , and Other Melanized Fungi , p 1943-1961. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch122

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