Case Number : 120 Posted By: Guest

Wayne Grayson - (Johannesburg, South Africa) Wrote:

What a great case. I agree entirely with what you have said, Phillip. One always tries to rise to the challenge by attempting to identify the organism, but this is not always possible beyond a reasonable doubt. Ultimately, fungal culture remains the final abrbiter in these difficult cases.

Submitted on 25/11/2010 17:34
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Phillip McKee - Overseas consultations (Sedona, Arizona, USA) Wrote:

I can understand why there is such a diversity of opinion in this case. The result of culture was Pseudallescheria boydii. It is always difficult to come to a definitive diagnosis with fungal infections when looking for septa and the angle of branching, with the exception of aspergillosis and zygomycosis which are instantly recognisable. One of the problems is that fungi do not always conform to their expected morphology. A good example is capsule deficient cryptocccus. Fusarium for example can branch at any angle it wants to whereas Pseudallescheria should rememble aspergillus but doesn't always conform!!

Submitted on 25/11/2010 15:43
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Phillip McKee - Overseas consultations (Sedona, Arizona, USA) Wrote:

I can understand why there is such a diversity of opinion in this case. The result of culture was Pseudallescheria boydii. It is always difficult to come to a definitive diagnosis with fungal infections when looking for septa and the angle of branching, with the exception of aspergillosis and zygomycosis which are instantly recognisable. One of the problems is that fungi do not always conform to their expected morphology. A good example is capsule deficient cryptocccus. Fusarium for example can branch at any angle it wants to whereas Pseudallescheria should rememble aspergillus but doesn't always conform!!

Submitted on 25/11/2010 15:42
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Naglaa - department of pathology, zagazig university (Egypt) Wrote:

Mucormycosis

Submitted on 25/11/2010 05:07
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Naglaa - department of pathology, zagazig university (Egypt) Wrote:

Mucormycosis

Submitted on 25/11/2010 05:07
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Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Dear Sir, I am just a little bit confused about the appearence of pseudallescheria. Some images in the internet shows it filamentous and describes it as thin walled and some describe it as septate branching hyphae indistinguishable from aspergillosis or fusarium?? It will be great if you gave us a description of the morphology of this fungus. Moreover, in the self assessment, the case of pseudallesheria showed different morphology than this image. Is the clue here the presence of subtle septations???

Submitted on 25/11/2010 04:51
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Phillip H. McKee - Overseas Consultations (Arizona, USA) Wrote:

The diagnosis is Pseudallescheria Boydii, which can form an eumycetoma. Better luck tomorrow. Any comments from Wayne on this one or any one else?

Submitted on 24/11/2010 22:52
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Rodrigo Restrepo - UPB/CES (Colombia) Wrote:

Mucormycosis

Submitted on 24/11/2010 22:14
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Stephen Pugh - (UK) Wrote:

Mucormycosis

Submitted on 24/11/2010 19:40
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Marwa Fawzi - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Subcutaneous phycomycosis.

Submitted on 24/11/2010 16:42
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Fevor subcutaneous phycomycosis.

Submitted on 24/11/2010 15:51
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Wayne Grayson - (Johannesburg, South Africa) Wrote:

Subcutaneous zygomycosis.

Submitted on 24/11/2010 15:49
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Mo - (India) Wrote:

Mucormycosis

Submitted on 24/11/2010 15:27
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Mpna Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

There is lots of esinophils and some smudgy esinophilic changes of the collagen (Splendore Hoeppli reaction) together with branching non septate hyphae. I prefer to consider this subcutaneous phycomycosis (the other member in the zygomycosis family, other than mucormycosis). This entity is caused by basidiobolus or conidiobolous , members of the entomopthorales family.

Submitted on 24/11/2010 14:11
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Donald Kent - (UK) Wrote:

Mucormycosis

Submitted on 24/11/2010 13:54
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Juan Carlos Garcés - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Good morning everyone! Mucormycosis

Submitted on 24/11/2010 13:51
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