Subcutaneous mycoses in coastal Karnataka in south India

Bhat, Ramesh M; Monteiro, Rochelle Cheryl; Bala, Nandakishore; Sukumar, D; Martis, Jacintha; Kamath, Ganesh; Kambil, Srinath M; Vadakayil, Ramay Asha

doi:10.1111/ijd.12943

Cited by 14 publications

(31 citation statements)

References 27 publications

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“…The most common occupation associated with deep mycoses in this study was agriculture (50%) in concordance with 52.8% reported by Yun et al 8 Bhat et al also observed agriculture to be the main occupation. 7 In this study, 63.4% of patients were from rural areas while 19.5% were from semi urban areas, similar to the observation by Bhat et al that subcutaneous mycoses were more prevalent in rural areas. 7 This is explained by the fact that subcutaneous mycoses result due to the inoculation of saprophytic fungi present in the soil, decaying vegetation and the rural population, especially the adult males are more exposed to such an environment.…”

Section: Discussionsupporting

confidence: 90%

“…7 In this study, 63.4% of patients were from rural areas while 19.5% were from semi urban areas, similar to the observation by Bhat et al that subcutaneous mycoses were more prevalent in rural areas. 7 This is explained by the fact that subcutaneous mycoses result due to the inoculation of saprophytic fungi present in the soil, decaying vegetation and the rural population, especially the adult males are more exposed to such an environment. 9 History of trauma was present in 48.8% of patients in this study, close to 41.2% reported by Yun et al 8 Most often, patients with subcutaneous mycoses which are characterised by long incubation periods, do not recall the trivial trauma.…”

Section: Discussionsupporting

confidence: 90%

“…The duration of illness in subcutaneous infections ranged from 2 months to 20 years in this study which was consistent with the study by Bhat et al in which duration of illness was about 4 months to 20 years. 7 Systemic comorbidities associated in this study were diabetes mellitus (63.6%) followed by renal transplantation (45%). Kindo et al too reported diabetes mellitus to be the most common co-morbidity.…”

Section: Discussionmentioning

confidence: 68%

“…5 In the study by Bhat et al, the youngest age was 14 years and the mean age of patients with subcutaneous infection was 49.4 years but in this study the mean age was 38.4 years. 7 The differences in the youngest age can be explained by the fact that, there were no children with basidiobolomycosis reported in those studies. The most common occupation associated with deep mycoses in this study was agriculture (50%) in concordance with 52.8% reported by Yun et al 8 Bhat et al also observed agriculture to be the main occupation.…”

Section: Discussionmentioning

confidence: 93%

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A prospective clinico mycological study of deep mycoses in a tertiary centre in Tamil Nadu

et al. 2018

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Background: Deep mycoses which includes subcutaneous mycoses and systemic mycoses, accounts for about 1% of the all the fungal infections seen in human beings. Though rare, these infections assume significance due to the increased morbidity and mortality associated with them. The objective of the study was to study the incidence, clinical presentation, aetiological agents and histopathological findings of deep mycoses in patients attending the mycology section, department of dermatology of a tertiary centre in Chennai.Methods: All Patients with clinical suspicion of deep mycoses who presented to mycology section during the period from November 2015 to September 2016 were screened. The samples from these patients were subjected to direct microscopy by potassium hydroxide wet mount, culture and histopathology.Results: Among the 8250 patients who attended mycology OPD, 41 patients (0.5%) had deep mycoses. The commonly affected age group was 41-50 yrs (29.7%). Males (73.2%) were predominantly affected. Of the 41 patients, 26.8% were immunocompromised. 37 patients (90.2%) had subcutaneous infection and 4 (9.8%) had opportunistic mycoses. Mycetoma (43.2%) was the most common subcutaneous mycoses. Mucormycosis (75%) and aspergillosis (25%) were the opportunistic mycoses observed. KOH positivity was 100%, while culture positivity was 65.7%. Madurella mycetomatis, Phialophora verrucosa, Rhizopus arrhizus and Aspergillus fumigatus were the common organisms isolated in this study.Conclusions: Mycetoma is the most common subcutaneous mycoses in this part of India. Eumycetoma is more common than actinomycetoma. Phaeohyphomycosis is on the rise. Simple KOH examination would pave way for an early diagnosis and prompt treatment of deep mycoses.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 93%

See 2 more Smart Citations

A prospective clinico mycological study of deep mycoses in a tertiary centre in Tamil Nadu

et al. 2018

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“…It is a broad group which includes the following species namely Fusarium, Penicillium, Scedosporium, Acremonium, Paecilomyces, Aspergillus etc [1]. In the study by Bhat et al [14] the mean age of patients with subcutaneous infection was 49.4 years and the youngest age was 14 years and was more prevalent in rural areas.…”

Section: Original Research Articlementioning

confidence: 99%

Histopathological features of subcutaneous mycosis: a retrospective study

R.¹,

Bhat

2019

Trop J Pathol Microbiol

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Background: Subcutaneous fungal infection is commonly seen in tropical and subtropical countries particularly in India. The lesions are usually presented as swelling, in the localized form. Subcutaneous mycosis is caused by penetration of causative fungi into the subcutaneous tissue. Histopathology is one of the main tools of diagnosis in mycology as it has the advantages of early diagnosis compared to culture, low cost and it provides a presumptive identification of the infecting fungus. It also gives information about tissue reaction and supplement culture report. It gives the idea about the fungus isolated in culture is contaminant or pathogenic. Many a times tissue might be sent in formalin as fungal infection is not suspected clinically. Role of histopathologist is very important in diagnosing these subcutaneous fungal lesions. Material & Methods: A retrospective study was conducted on subcutaneous fungal infections seen between January 2014 to December 2018 in the Department of pathology, IGMC&RI, Puducherry. Twenty-two patients with biopsy proven subcutaneous fungal infections were included in the study. In the present study, the varied histopathological features like type of inflammatory response, presence of granulomas, necrosis, eosinophils and abscess formation were seen in the tissue sections. Results: The most common histopathology feature was giant cell reaction seen in 21 (95.5%) cases, followed by epithelioid cell granuloma in 13(59%) cases and areas of necrosis in 13 (59%) cases. Eight (36%) cases showed numerous eosinophilic infiltration 10(46%) cases of scant eosinophils and 4 (18%) cases showed absent eosinophils. These fungal structures were identified in H&E stain itself in 13 (59%) cases. Conclusion: Histopathological study is most important in subcutaneous mycosis as most of the time diagnosis is unsuspected and delayed because of its rarity and varied presentation. Fungal infection should be suspected in cases with localized cystic swelling. High index of suspicion, careful microscopic examination and special stains are important for accurate diagnosis.

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