Invasion of muscle tissue in addition to dermis and subcutaneous tissue by Basidiobolus haptosporus is reported in a 40-year-old female housewife. This infection followed intramuscular injection injury of the right gluteal region. Oral KI cured the condition completely in 6 months. Intramuscular implantation of B. haptosporus by the injection needle is the probable mode of infection in this case. Possible blood vessel invasion seen in histology suggests the possibility of dissemination of the fungus.Basidiobolomycosis and conidiobolomycosis are not uncommon in our state and lymph node invasion has been frequent in most of the cases reported from our department [1-3]. The present is our first case with muscle invasion by Basidiobolus haptosporus and it is the second to have followed a penetrating wound by an injection needle. CASE REPORTA 40-year-old housewife was referred by a surgeon for a skin lesion which had started as a small asymptomatic nodule over the right gluteal area, within a few weeks of an intramuscular injection at that site for myalgia, and had spread intensively over a period of 6 months. She showed an extensive hyperpigmented, oedematous, well defined plaque with peau d'orange surface skin involving the right gluteal, the iliac, the lower half of the abdominal wall, the pubis, the upper quarter of the anterior aspect of the right thigh and the right labium majora (Fig. 1). The entire plaque was continuous and did not cross the midline either anteriorly or posteriorly. It felt Indiarubber-like or hard and was painful but not tender. The right iliac portion of the plaque was prominent and hanging over the inguinal crease. Due to enormous thickening of the skin it was not possible to palpate the right inguinal or iliac lymph nodes. Her left inguinal lymph nodes were normal. A possible carcinoma cervix and secondary cutaneous deposits had been excluded by the surgeon previously.
A study of Tinea capitis in Outpatient Clinic, Skin Department, Government General Hospital, Madras during a three year period from November, 1973 to October, 1976, has shown a gradual increase in incidence of 3.56%, 5.09% and 6.25% respectively. Findings suggest that Tinea capitis is endemic in South India. Male children were more commonly affected than female children and the age groups chiefly affected were between 5 and 10 years. A considerably number of adults were also affected. The disease showed no correlation to environmental temperature, humidity and rainfall but was correlated to all types of mycoses and total incidence of mycoses. Among 357 isolates, Trichophyton violaceum was the commonest in 264 (73.94%) and T. tonsurans was the next common in 47 (13.16%). The other agents were T. rubrum in 30 (8.4%), T. mentagrophytes in 11 (3.08%) and T. simii in 5 (1.4%). Noninflammatory lesions were more common than inflammatory lesions and both were produced by T. violaceum and T. tonsurans, suggesting strain differences in pathogenesis. Treatment with oral griseofulvin was satisfactory in all but had to be discontinued in 4 patients due to side effects.
Cryptococcus laurentii was isolated twice from cutaneous granulomas in the leg and foot of a 40-year-old man. Histologically the cells of C. laurentii were found in groups in the dermis and also inside giant cells. There was epithelioid cell infiltration in the dermis and subcutis. An atypical mycobacterium was isolated in addition to C. laurentii. Therapy with anti-tuberculous drugs after an initial amphotericin B infusion was found to be satisfactory.
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