Pheohyphomycosis B43.9

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Bantimykosis; Cladosporiosis; Pheosporonosis; Pheosporotrichosis

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Beurmann and Gougerot, 1907

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Group of rare, mainly cutaneously and subcutaneously localized, usually opportunistically occurring infections caused by different molds, whose representatives (Phaeohyophomycetes) are characterized only by hyphae, which have a dark, yellow or black-brown inherent color (phaeo = dark/cloudy). The melanized pathogens are also called black fungus (Dematiaceae).

S.u. mold fungus illnesses; see below Alternariosis, cutaneous.

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There are numerous species of fungi that can be considered as pathogens. They cause various clinical manifestations. Therefore, this is not one clinical entity. The only common feature of this mycosis is the brownish to yellow-black inherent colour of the hyphae in the tissue and also mostly in the culture.

Representatives of the Dematiazeten (molds whose hyphae show an inherent color, from yellow to brown and black). Typical are black discolorations of the affected tissue through the growth of the black to black-brown colored hyphae of the molds.

Most frequent pathogens: moulds of the genera Exophiala, Bipolaris, Phialophora, Aureobasidium, Cladosporium, Alternaria and Curvularia.

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Worldwide occurrence, mainly in the tropics.

Clinical features
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The most frequent manifestations are observed on the skin. Other localizations are: sinuses, lungs, CNS. Depending on the duration of the disease, brown to blackish, smooth or scaly or verrucous papules or plaques are found on the skin, which can conglomerate into 20-30 cm large, circumcircularly limited verrucous nodular conglomerates. The manifestations frequently occur as opportunistic infections (see also organ transplants, skin changes). Systemic and disseminated infections may also occur in immunocompromised patients.

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The acute tissue reaction consists of a non-specific mixed cell inflammation with formation of abscesses. With longer durations, an increasingly granulomatous character with histiocytes and multinuclear giant cells develops. Also in the HE section already conspicuous are filamentous, septated, brownish fungal elements of varying density, which stand out in the PAS or Grocott staining. They are mostly present extracellularly but also within multinucleated giant cells.

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Abscesses can be treated surgically. Recurrences are frequent. Fluconazole (300 mg/day) or itraconazole (500-600 mg/day) provide the best results of systemic therapy over a period of several months (1-48 months). There are reports of positive experiences with a combination of Terbinafine and Itraconazole.

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A mycosis that has round fungal cells with their own colour in the tissue instead of hyphae is called chromoblastomycosis.

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  1. Beurmann L, Gougerot H (1907) Associations morbides dans les sporotrichoses. Bull Soc Med Hosp Paris 24: 591
  2. Iwatsu T et al (1984) Phaemycotic cyst, a case with a lesion containing wooden splinter. Arch Dermatol 120: 1209-1214
  3. Nenoff, P (2010) Sporotrichose. In: Plettenberg A, Meigel W, Schöfer H (Eds.) Infectious diseases of the skin. Thieme publishing house Stuttgart, S.198
  4. Restrepo A (1994) Treatment of tropical mycosis. J Am Acad Dermatol 31: 91-102
  5. Rudolph M (1914) About the Brazilian "Figueira". Arch ship and tropics Hyg 18: 498-499
  6. Salfelder K et al (2000) Fungal infections in humans. Omnimed Verlag, Hamburg, Munich, S. 236-248
  7. Wortman PD (1995) Concurrent chromoblastomycosis caused by fonsecaea pedrosoi and actinomycetoma cause


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Last updated on: 29.10.2020