Mycoses
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Case Reports
Tinea faciei incognito due to Trichophyton rubrum as a result of autoinoculation from onychomycosis.
The localisation of a dermatophytosis on the face is rare. Differential diagnoses include a broad range of dermatological disorders, e. g. contact dermatitis, psoriasis vulgaris, seborrhoeic dermatitis, demodicosis, and polymorphic photo eruptions. ⋯ Both patients were suffering from tinea pedis and tinea unguium caused by the same dermatophyte species. An infection caused by Trichophyton rubrum of the face always occurs following autoinoculation from a pre-existing tinea pedis and tinea unguium of feet and toenails, sometimes of the fingernails.
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Pityriasis versicolor (PV) is a superficial fungal infection where Malassezia species play a definite causative role, but the clinical significance of each of these species is not fully understood. The aim of our study was to analyse the prevalence of Malassezia species in PV lesions and to examine if the range of species varies with patient sex, age, direct microscopy findings and some clinical data. Ninety patients with PV completed the study. ⋯ The most frequently isolated species from clinically healthy skin were M. globosa (49%), M. sympodialis (37%) and M. furfur (5%). We found significant difference in the distribution of Malassezia species between lesional and non-lesional skin and in the distribution of Malassezia species according to the direct microscopy findings. M. globosa in its mycelial phase is the predominant species involved in the aetiology of PV.
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Randomized Controlled Trial Clinical Trial
Delayed ABLC prophylaxis after allogeneic stem-cell transplantation.
Invasive fungal infections (IFI) are frequent causes of mortality after allogeneic stem-cell transplantation (SCT). A very important risk factor for IFI is the use of steroids. We used a risk-based chemoprevention in an open-labelled pilot study. ⋯ The twice weekly ABLC was well tolerated. This risk-based chemoprevention appears to be effective and might diminish the role of steroids as risk factor for IFI after allogeneic SCT. The relatively high incidence of early IFI suggests that additional prophylaxis for IFI may be indicated for poor-risk patients prior to day +30.
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Case Reports
Pseudomembranous and obstructive Aspergillus tracheobronchitis - optimal diagnostic strategy and outcome.
Pseudomembranous and obstructive Aspergillus tracheobronchitis (PMATB/OATB) are still considered to be refractory to therapy and to have a fatal outcome. To evaluate the optimal diagnostic strategy and to describe factors affecting the outcome of PMATB and OATB. Retrospective analysis of four new cases of PMATB and OATB combined with 16 previously reported cases over a 10-year period (1995-2004). ⋯ Prognosis of PMATB and OATB remains poor. Microscopy of respiratory specimens is the most sensitive tool to confirm the diagnosis. The characteristic appearance of the disease makes it possible to start antifungal therapy immediately.
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A case of pityriasis versicolor atrophicans caused by Malassezia globosa is reported in a 49-year-old woman. Diagnosis was based on direct microscopic examination and culture. Differential diagnosis was performed with respect to other skin diseases manifesting with cutaneous atrophy.