1.A Case of Rhinocerebral Mucormycosis Caused by Mucor Species.
Sung Jun KIM ; Jae Young LIM ; Ho Sun JANG ; Chang Keun OH ; Kyung Sool KWON
Korean Journal of Medical Mycology 2001;6(2):84-89
Mucormycosis refers to infections caused by the order Mucorales of the class Zygomycetes. They are acute, rapidly developing, often fatal, opportunistic infections of immunocompromised patient. We report a case of rhinocerebral mucormycosis in a 73-year-old man with a 20-year history of poorly controlled diabetes mellitus. He had black necrotic ulcers on the hard palate, left blepharoptosis, left visual loss, left facial palsy and left hemiparesis. Brain and sino-orbital MRI scan showed protrusion of left eyeball, sinusitis on the both maxillary and ethmoid sinus and left middle cerebral artery infarction. Swab of black necrotic ulcer on the hard palate yielded large fungal hyphae on KOH preparation and inoculation of necrotic tissue on Sabouraud dextrose agar revealed a rapid growth of white to gray cottony colonies that soon turned gray to dark brown. Slide culture showed globose sporangia and no rhizoid or apophysis. These morphologic characteristics were those of the Mucor species. Histopathologic examination of the palatal lesion showed large, non-septated fungal hyphae in the dermis. The patient was treated with amphotericin B 50 mg/day for 45 days but died 114 days after admission.
Agar
;
Aged
;
Amphotericin B
;
Blepharoptosis
;
Brain
;
Dermis
;
Diabetes Mellitus
;
Ethmoid Sinus
;
Facial Paralysis
;
Glucose
;
Humans
;
Hyphae
;
Immunocompromised Host
;
Infarction, Middle Cerebral Artery
;
Magnetic Resonance Imaging
;
Mucor*
;
Mucorales
;
Mucormycosis*
;
Opportunistic Infections
;
Palate, Hard
;
Paresis
;
Sinusitis
;
Sporangia
;
Ulcer
2.Onychomycosis in the Elderly.
Korean Journal of Medical Mycology 2001;6(2):77-83
BACKGROUND: Onychomycosis is a common disease and has a tendency to increase in its incidence. Although there have been many reports about onychomycosis, very few studies about onychomycosis in the elderly have yet been conducted. OBJECTIVE: The purpose of this study was to investigate the clinical and mycological features of onychomycosis in the elderly, and to evaluate the concept and attitude of the elder patients towards onychomycosis, which would affect the treatment and further infections of onychomycosis. METHOD: Sixty eight onychomycosis patients over 60 years old were examined clinically and surveyed by questionnaire to evaluate their concern about the onychomycosis. All the patients were confirmed by potassium hydroxide (KOH) examinations and underwent cultures on the both cornmeal potato agar with and without cycloheximide. An additional culture was done a week later when the initial culture showed contamination or no growth. RESULTS: Among 648 patients with onychomycosis, 68 patients (10.5%) were over 60 years old. Fifty (73.5%) were female and 18 (26.5%) were male. Twenty six (38.2%) had systemic illness. The average duration of onychomycosis was 13 years and the average number of onychomycosis involving nails was 4.7. Sixty three patients (92.6%) had toe nail onychomycosis. Sixty six patients (97.1%) showed distal subungal onychomycosis. Trichophyton rubrum was the main causative organism in 38 patients (55.9%). Forty one patients (60.3%) discontinued the medication in 4 weeks, and 11 (16.2%) were treated over 12 weeks. From the questionnaire, only 10 patients reported previous treatment for this problem, but with duration of treatment no longer than one month. Fifty three patients had mere understanding atypical alternation in their nails before the visit. The main reasons of the discontinuing the medication were the cost of the treatment, physical discomfort due to age, and extended duration of the therapy. CONCLUSION: From this study, we noticed that the elder onychomycosis patients could be long time carriers of fungi because of their lack of the knowledge of onychomycosis and insufficient treatment. Therefore, it is necessary to educate and support to treat the elder patients effectively.
Agar
;
Aged*
;
Cycloheximide
;
Female
;
Fungi
;
Humans
;
Incidence
;
Male
;
Middle Aged
;
Onychomycosis*
;
Potassium
;
Solanum tuberosum
;
Toes
;
Trichophyton
;
Surveys and Questionnaires
3.Malassezia Species Cultured From the Lesions of Seborrheic Dermatitis.
Yang Won LEE ; Ho Jung KANG ; Kyu Joong AHN
Korean Journal of Medical Mycology 2001;6(2):70-76
BACKGROUND: Malassezia yeasts were suggested to be one of the etiologic factors of seborrheic dermatitis. The genus Malassezia was recently revised into seven species. OBJECT: The study was done to classify the Malassezia yeasts cultured from the lesions of seborrheic dermatitis into one of the revised species and to find out the relationship between certain species of Malassezia and seborrheic dermatitis. METHODS: The specimen obtained from the lesions (face) of twenty cases of seborrheic dermatitis were cultured on Leeming & Notman's media. The obtained strains were placed into one of the seven species by their colony morphologies, microscopic morphologies and physiological characteristics. RESULTS: M. restricta occupied most (more than seventy percents) of the cultured colonies in 13 cases, M. globosa in 6 cases and M. furfur in 1 case respectively. CONCLUSION: M. restricta could be considered to be mostly implicated species in the seven revised Malassezia species in the lesions of seborrheic dermatitis of the face.
Dermatitis, Seborrheic*
;
Malassezia*
;
Yeasts
4.Enhancement of Human Monocyte Activities against Aspergillus fumigatus by Interleukin-15.
Jeong Ho CHO ; Kyung Hee CHANG ; Hyo Youl KIM ; Young Goo SONG ; Chang O KIM ; Yoon Soo PARK ; Sung Kwan HONG ; Aejung HUH ; Joon Sup YEON ; June Myung KIM
Korean Journal of Medical Mycology 2001;6(2):64-69
BACKGROUND: Despite recent advances in antifungal chemotherapy, invasive aspergillosis remains an important cause of morbidity and mortality in immunocompromised patients. Interleukin-15 (IL-15) is a cytokine that is known to enhance antifungal activities of monocytes against Candida albicans. OBJECTIVE: The purpose of this study is to investigate the potentials of IL-15 to enhance antifungal activities of monocytes against Aspergillus fumigatus. METHODS: Peripheral blood monocytes from healthy adults were incubated with 0, 1, 10, 100 ng/ml of IL-15 for 1, 2, and 4 days. Then, the ability of IL-15 to elicit the production of superoxide anion, the damage of hyphae by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and the killing ability of Aspergillus fumigatus conidia was investigated. RESULTS: Incubation of peripheral blood monocytes with 100 ng/ml of IL-15 enhanced hyphal damage after 2 days (p<0.05), conidicidal activity from the first day (p<0.05), and increased the production of superoxide anion (O2- ) in response to phorbol myristate acetate. CONCLUSION: Our results indicate that IL-15 augments the microbicidal activity of human monocytes against Aspergillus fumigatus.
Adult
;
Aspergillosis
;
Aspergillus fumigatus*
;
Aspergillus*
;
Candida albicans
;
Drug Therapy
;
Homicide
;
Humans*
;
Hyphae
;
Immunocompromised Host
;
Interleukin-15*
;
Monocytes*
;
Mortality
;
Spores, Fungal
;
Superoxides
;
Tetradecanoylphorbol Acetate
5.Epidemiology of Patients with Superficial Fungal Diseases and Their Family Members in Korea.
Korean Journal of Medical Mycology 2001;6(2):57-63
BACKGROUND: Superficial fungal disease is one of the most common human infectious diseases. A recent clinical survey reported that more than half of patients with superficial fungal diseases might be infected at home. OBJECTIVE: The aim of this study is to investigate the correlation of the fungal infection between the patients and their family members. METHODS: Dermatologists of 71 general hospitals were involved and evaluated 7,323 patients and 1,037 their family members who were confirmed microscopically to have superficial fungal diseases. RESULTS: According to the survey results, 46.1% of the patients answered they might have been infected at home and 33.6% of the patients remembered there were other fungus-infected patients among their family members at the same time. The isolated organisms were Trichophyton rubrum (1686 cases, 80.9%), Trichophyton mentagrophytes (269 cases, 12.9%), Candida albicans (112 cases, 5.4%), Microsporum canis (12 cases, 0.6%), Trichophyton tonsurans (3 cases, 0.1%), Epidermophyton floccosum (2 cases, 0.1%). On the basis of the fungus culture, it was proven that 85.4% of the patients and their family members had the same kind of microorganism. CONCLUSION: As a result, we could conclude that there is a high possibility of transmitting the fungal infection from one family member to another.
Candida albicans
;
Communicable Diseases
;
Epidemiology*
;
Epidermophyton
;
Fungi
;
Hospitals, General
;
Humans
;
Korea*
;
Microsporum
;
Trichophyton
6.Diagnoses and Differential Diagnoses of Superficial Mycoses.
Korean Journal of Medical Mycology 2001;6(2):49-56
The diagnoses of superficial mycoses such as dermatophytosis, cutaneous candidiasis and Malassezia infections are relatively easy, and direct smear with KOH and culture with Sabouraud's dextrose agar media are the most useful and valuable methods. Recently, the incidence of onychomycosis has been increasing and some other diagnostic methods, especially for onychomycosis, and their significance has been introduced and investigated. This review was focused especially on the findings and significance of histopathologic and KONCPA methods (KOH Treated Nail Clippings Stained with PAS) for the diagnosis of onychomycosis. Summaries and brief comments were also made for the findings and significance of other diagnostic methods as well as for the differential diagnoses of superficial mycoses.
Agar
;
Candidiasis, Cutaneous
;
Diagnosis*
;
Diagnosis, Differential*
;
Glucose
;
Incidence
;
Malassezia
;
Mycoses*
;
Onychomycosis
;
Tinea
7.A Case of Kerion Celsi Caused by Trichophyton verrucosum.
Ji Young KIM ; Young Ji HWANG ; Jong Hyun KO ; Byung Ho OH ; Yang Won LEE ; Yong Beom CHOE ; Kyu Joong AHN
Korean Journal of Medical Mycology 2010;15(2):83-87
Kerion Celsi is a highly inflammatory, suppurative fungal infection of the scalp caused by zoophilic or geophilic dermatophytes. We report a case of Kerion Celsi caused by Trichophyton verrucosum in a 19-year-old female presenting with an indurated, pus-discharging, erythematous boggy mass on the frontal scalp for 2 weeks. Restriction fragment length polymorphism shows 100% concordance with Trichophyton verrucosum, which we had maintained as our standard strain. Systemic treatment with steroid and antifungal agents was administered.
Antifungal Agents
;
Arthrodermataceae
;
Female
;
Humans
;
Polymorphism, Restriction Fragment Length
;
Scalp
;
Sprains and Strains
;
Tinea Capitis
;
Trichophyton
;
Young Adult
8.A Case of Majocchi's Granuloma of the Face of an Immunocompetent Patient Caused by Trichophyton rubrum.
Hyo Sang AHN ; Jung Eun KIM ; Hyun Jeong PARK ; Baik Kee CHO ; Moo Kyu SUH
Korean Journal of Medical Mycology 2010;15(2):77-82
Majocchi's granuloma is well recognized but uncommon infection of dermal and subcutaneous tissue by fungal organisms usually limited to the superficial epidermis. The organism most commonly associated with Majocchi's granuloma is Trichophyton(T.) rubrum, however, other dermatophytes may be the causative agent. A 44-year-old male patient presented with a 6 month history of two well defined erythematous nodular plaques on his right jaw and preauricular area. Histopathologic findings were consistent with the Majocchi's granuloma, showing perifolliculitis and granulomatous inflammation in the dermis. Many fungal elements were noted within the giant cells of the perifollicular dermis of PAS stained section. T. rubrum was cultured from the biopsy specimen and confirmed by slide culture. After 10 weeks of terbinafine (Lamisil(R)) therapy (250 mg/day), lesions were cleared with mild erythematous patches and atrophic scars.
Adult
;
Arthrodermataceae
;
Biopsy
;
Cicatrix
;
Dermis
;
Epidermis
;
Giant Cells
;
Granuloma
;
Humans
;
Inflammation
;
Jaw
;
Male
;
Naphthalenes
;
Subcutaneous Tissue
;
Trichophyton
9.Effect of Anti-inflammation and Skin Hydration of AF-343 on Macrophage Raw 264.7 Cells and NC/Nga Mice with Atopic Dermatitis.
Beom Joon KIM ; Yun Young LIM ; Hyeong Mi KIM ; Eun Joo PARK ; Myeung Nam KIM ; Soo Muk CHO ; Chang Suk CHOI ; Ki Moon PARK ; Hyun Suck KIM ; Jong Keun KIM ; Yeon Pyo HONG
Korean Journal of Medical Mycology 2010;15(2):61-76
BACKGROUND: Inflammatory response on LPS and IFN-gamma induced Macrophage Raw 264.7 cells was secreted NO (nitric oxide) and PGE2 (prostaglandin E2) though expression of iNOS and COX-2. And many pro-inflammatory cytokines (TNF-alpha, IL-1beta, IL-6 etc.) was secreted on LPS and IFN-gamma induced Macrophage Raw 264.7 cells, too. Atopy dermatitis was inflammatory skin disease with pruritus, xeroderma and specific eczema. OBJECTIVE: We sought to effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. METHODS: The immune response of Raw 264.7 cells were induced by LPS and IFN-gamma. Then LPS and IFN-gamma induced Raw 264.7 cells was measured NO, PGE2 production after treatment of different concentrations for AF-343. The related genes (iNOS, COX-2) for NO, PGE2 production were detected using Western blot in LPS and IFN-gamma induced Raw 264.7 cells after treatment of different concentrations for AF-343. Pro-inflammatory cytokines were detected, too. NC/Nga mice as Atopy dermatitis model was induced atopy dermatitis. Then NC/Nga mice with atopy dermatitis were performed oral administration of AF-343 for 1weeks. After oral administration of AF-343, TEWL was measured on skin tissues of NC/Nga mice with atopy dermatitis according to whether were performed oral administration of AF-343 or not. And pro-inflammatory cytokines and IgE was measured in serum, protein of skin tissues of NC/Nga mice. Skin tissues of NC/Nga mice were performed H&E staining, immunohistochemical staining for PCNA, Involucrin and filaggrin. RESULTS: LPS and IFN-gamma induced Raw 264.7 cells was decreased NO, PGE2 production in dose-dependent after treatment of different concentrations for AF-343. The expression level of iNOS, COX-2 protein was decreased in dose-dependent, too. The related pro-inflammatory cytokines in media with LPS and IFN-gamma induced Raw 264.7 cells were decreased after treatment of different concentrations for AF-343. TEWL level of NC/Nga mice skin (back, ear) with atopy dermatitis according to whether were performed oral administration of AF-343 or not was decreased in NC/Nga mice with atopy dermatitis group was performed oral administration by AF-343. When NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343, induced pro-inflammatory cytokines and IgE expression in serum, protein of back, ear skin tissues of each NC/Nga mice group was decreased. H&E stained Skin tissues of NC/Nga mice was confirmed that thickness of epidermis, dermis were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis. The expression of PCNA, involucrin and filaggrin were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis as results of immunihistochemical staining using specific antibodies such as PCNA as cell proliferation marker, involucrin and filaggrin as keratinocytes differentiation markers for skin tissues (back, ear) of NC/Nga mice. CONCLUSION: We confirmed effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. In conclusion, AF-343 is expecting as therapeutics for atopic dermatitis.
Administration, Oral
;
Animals
;
Antibodies
;
Antigens, Differentiation
;
Blotting, Western
;
Cell Proliferation
;
Cytokines
;
Dermatitis
;
Dermatitis, Atopic
;
Dermis
;
Dinoprostone
;
Ear
;
Eczema
;
Epidermis
;
Ichthyosis
;
Immunoglobulin E
;
Inflammation
;
Interleukin-6
;
Intermediate Filament Proteins
;
Keratinocytes
;
Macrophages
;
Mice
;
Proliferating Cell Nuclear Antigen
;
Protein Precursors
;
Pruritus
;
Skin
;
Skin Diseases
;
Taraxacum
10.The Development and Evaluation of Multiplex PCR Technique for Identification of Malassezia Yeast.
Hyeong Mi KIM ; Yun Young LIM ; Eun Joo PARK ; Young Jin CHUN ; Myeung Nam KIM ; Beom joon KIM ; Dong Hoon LEE
Korean Journal of Medical Mycology 2010;15(2):51-60
BACKGROUND: Malassezia yeasts as major pathogenic fungi causes the common skin diseases including dandruff, psoriasis, seborrheic dermatitis and atopic dermatitis etc. various molecular techniques were developed to identify and classify the Malassezia species until now. But, these methods were discovered the problems. So, the development of the better molecular methods required to identify and classify of Malasseiza species. OBJECTIVE: We sought to develop of molecular techniques to identify and classify of six Malassezia species (M. restricta, M. globosa, M. furfur, M. slooffiae, M. sympodialis, M. obtusa). METHODS: We designed primers about ITS1 (Internal transcribed space 1) region that were well-known region useful to identify of Malassezia species. Because, ITS1 region that is located between 18S and 5.8S rDNA of ribosomal DNA was comparatively mutated quickly. The mono PCR using ITS1 primers was performed to confirm the specificity of ITS1 primers with six Malassezia standard strains. Then, Malassezia Multiplex detection kit was developed on the basis of technique using ITS1 regions. Malassezia Multiplex detection kit was used to perform multiplex PCR with six Malassezia standard strains and clinical isolates. RESULTS: The results of mono PCR using ITS1 primers about six Malassezia standard strains was detected each Malassezia standard strains. Also, the multiplex PCR using developed Malassezia Multiplex detection kit was confirmed to classify about six Malassezia standard strains and clinical isolates. CONCLUSION: In this study, we verified that six Malassezia yeasts was classified using Malassezia Multiplex detection kit from Malasszia standard strains and clinical isolates. And we anticipate that Malassezia Multiplex detection kit is able to do accurate diagnosis about six Malassezia yeasts (M. restricta, M. globosa, M. furfur, M. slooffiae, M. sympodialis, M. obtusa).
Dermatitis, Atopic
;
Dermatitis, Seborrheic
;
DNA, Ribosomal
;
Fungi
;
Malassezia
;
Multiplex Polymerase Chain Reaction
;
Polymerase Chain Reaction
;
Psoriasis
;
Sensitivity and Specificity
;
Skin Diseases
;
Yeasts