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A Case of Systemic Fungal Infection due to Fusarium oxysporum in a Patient with Acute Lymphocytic Leukemia.

Sung Bin CHO ; Jin Wook LEE ; Young Hun CHO ; Kwang Hoon LEE

Korean Journal of Medical Mycology.2003;8(3):122-126.

Fusariosis is a rare infectious disease caused by species of the genus Fusarium that has been increasingly documented as an emerging agent of opportunistic infections in immunocompromised patients and, occasionally, immunocompetent hosts. We describe an 18-year-old Korean male, previously diagnosed as acute lymphocytic leukemia, presented with 2~4 cm-sized erythematous to necrotic papulonodules on the trunk and extremities for a week. White blood cell count was 200 cells/L and biopsy specimen showed structures resembling fungal elements in the dermis and subcutaneous fat. Cultures from a biopsy sample growing whitish cottony colonies contained fusoid multiseptated macroconidia. He was diagnosed as fusariosis and treated with intravenous amphotericin B. But white blood cell count and clinical symptoms didn't improve and he was expired after 6 days of treatment.
Adolescent ; Amphotericin B ; Biopsy ; Communicable Diseases ; Dermis ; Extremities ; Fusariosis ; Fusarium* ; Humans ; Immunocompromised Host ; Leukocyte Count ; Male ; Opportunistic Infections ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Subcutaneous Fat

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A Case of Actinomycosis Presenting as an Oral Ulcer in a Healthy Child.

Bang Jin LEE ; You Chan KIM ; Kyeong Han YOON ; Eun So LEE ; Hee Young KANG

Korean Journal of Medical Mycology.2003;8(3):118-121.

Actinomycosis is a chronic suppurative and granulomatous bacterial infection most commonly presenting as an abscess, soft tissue swelling, or mass in the cervicofacial region. Although the organisms often invade soft tissues through damaged oral mucosa, actinomycosis presenting acutely as a superficial oral ulcer is extremely rare. We report a case of actinomycosis in a 6-year-old boy who presented a painful ulcer on the right buccal mucosa. Histopathologic examination showed sulfur granules and granulation tissue with mixed inflammatory infiltrate in the dermis. The granules contained numerous Gram-positive filamentous organisms consistent with actinomycosis. We propose that actinomycosis should be kept in mind in the diagnosis of oral ulcerations.
Abscess ; Actinomycosis* ; Bacterial Infections ; Child* ; Dermis ; Diagnosis ; Granulation Tissue ; Humans ; Male ; Mouth Mucosa ; Oral Ulcer* ; Sulfur ; Ulcer

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The Compliance and Long-term Follow up of Onychomycosis Treatment.

Ji Eun KIM ; Hyun Jeong PARK ; Jun Young LEE ; Baik Kee CHO

Korean Journal of Medical Mycology.2003;8(3):110-117.

BACKGROUND: Modern antifungal drugs achieve high cure rates in onychomycosis of the toes, but little is known about the long-term evolution of the treated patients. OBJECTIVE: We evaluated the compliance and long-term follow up of onychomycosis after treating the 438 patients with one of the 3 drugs including itraconazole, terbinafine and fluconazole. METHODS: On the basis of the patients' charts, photographs and telephone visiting, we investigated the positivity of the diagnostic methods, compliance and long-term follow up results of the onychomycosis treated with one of the three drugs including itraconazole, terbinafine and fluconazole from January 1999 to August 2002 in the Department of Dermatology, St. Mary's hospital, the Catholic University of Korea, Seoul. RESULTS: 1. The positivity rates of the KOH smear, fungus culture and KONCPA test were 68% (283/418), 18% (65/354) and 89% (178/200), respectively. 2. The percentage of the patients who had completely finished the course of the treatment were 61% (191/315) in the itraconazole-treated, 43% (30/69) in the terbinafine-treated and 21% (3/14) in the fluconazole-treated. 3. Cure rates after 1 year of the treatment were 34% (56/167) in the itraconazole-treated, 29% (10/35) in the terbinafine-treated and 86% (6/7) in the fluconazole-treated. Cure rate after 2 years of the treatment were 33% (17/51) in the itraconazole-treated, 8% (1/12) in the terbinafine-treated. Cure rates after 3 years of the treatment were 29% (9/31) in the itraconazole-treated, 10% (1/10) in the terbinafine-treated. 4. Cure rates after more than 1 year of the treatment were 33% (82/249) in the itraconazole-treated, 21% (12/57) in the terbinafine-treated. 5. Cure rates of the completely treated groups were 36%, 37% and 40% after 1 year, 2 years and 3 years in the itraconazole-treated and 44%, 20% and 20% after 1 year, 2 years and 3 years in the terbinafine-treated. CONCLUSION: In the treatment of onychomycosis, compliance rate varied very much according to the duration or method of medication, but the cure rates are different after more than 2 years of follow up between the itraconazole-treated and the terbinafine-treated.
Compliance* ; Dermatology ; Fluconazole ; Follow-Up Studies* ; Fungi ; Humans ; Itraconazole ; Korea ; Onychomycosis* ; Seoul ; Telephone ; Toes

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Molds Identification I.

Shin Ok KIM

Korean Journal of Medical Mycology.2003;8(3):97-102.

Fungi constitute nonmotile eukaryotic organism that are devoid of chlorophyll and reproduce by spores. There are 100, 000 validly described species of fungi and over 275 species of those described fungi have been reported to cause disease in man and animals. Molds called filamentous fungi belong to the class Hyphomycetes. In the identification of Molds, the cultures have been purified and then observe their colony characteristics and microscopic morphology. Visual colony examination is important identifying marker concerning color, texture, diffusible pigments, exudates, macroscopic structures, growth rates and colony topography. In addition to the overall appearance of the colony, final identification should be made by microscopic examination. Microscopic features provide by the asexual/sexual spores, cells per spore, color of spores, spore formation and fragmentation of hyphae. Biochemical tests are not as important as markers for identifying filamentous fungi as they are for yeasts and dermatophytes.
Animals ; Arthrodermataceae ; Chlorophyll ; Exudates and Transudates ; Fungi* ; Hyphae ; Mitosporic Fungi ; Spores ; Yeasts

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Simultaneous Occurrence of Tinea corporis Caused by Microsporum canis in a Grandmother and a Granddaughter.

Bo In LEE ; Jee Hyun LEE ; Jun Young LEE ; Young Min PARK

Korean Journal of Medical Mycology.2014;19(2):52-57.

Microsporum (M.) canis is one of the zoophilic dermatophytes which can cause ringworm in cats and dogs and is responsible for 3~30% of tinea corporis and tinea capitis in human. It is most likely transmitted by contact with infected animals, but rare cases of person-to-person transmission and an outbreak among school girls have also been reported. Herein we report on interesting cases of tinea corporis caused by M. canis in a grandmother and a granddaughter. A 63-year-old woman presented with pruritic, scaly, erythematous plaques on the post. neck and trunk which had started 2 months ago. Also her 9-year-old granddaughter presented with pruritic, annular, erythematous plaques on chest and back for 7 days. They denied contact with animals. KOH smear showed several hyphaes on microscope. Fungus culture on potato dextrose agar showed growth of colonies with whitish fluffy surface and radial folds, the dorsal surface of the colonies showed golden-brown color which were identified as M. canis in both patients. As for the grandmother the lesions improved with oral itraconazole 200 mg/day for 7 days and topical antifungal cream for 5 weeks which resulted in marked improvement of the lesions.
Agar ; Animals ; Arthrodermataceae ; Cats ; Child ; Dogs ; Female ; Fungi ; Glucose ; Humans ; Hyphae ; Itraconazole ; Microsporum* ; Middle Aged ; Neck ; Solanum tuberosum ; Thorax ; Tinea Capitis ; Tinea*

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Chromoblastomycosis Caused by Fonsecaea monophora.

Byeong Su KIM ; Jin Hwa CHOI ; Seung Hyun SOHNG ; Dong Hoon SHIN ; Jong Soo CHOI ; Moo Kyu SUH

Korean Journal of Medical Mycology.2014;19(1):18-24.

Chromoblastomycosis is a chronic subcutaneous mycotic infections caused by dermatiaceous fungi. Clinically, chromoblastomycosis presents frequently with erythematous or nodular plaque. In Korea, 10 cases of chromoblastomycosis have been reported and Fonsecaea pedrosoi is the most common agent. A 61-year-old woman who was diagnosed as chronic inflammatory demyelinating polyneuropathy 3 years ago, and had been treated with systemic corticosteroids and azathioprine, presented with pruritic, scaly erythematous plaques on the right forearm for 3 years. She had no history of trauma. Histological examination showed pseudoepitheliomatous hyperplasia, mixed granulomatous inflammatory cell infiltrate and multinucleated giant cells with sclerotic cells in the dermis. Tissue culture showed slowly growing, dark brown, velvety colony. DNA was extracted from the cultured colonies and the DNA sequence of the internal transcribed spacer (ITS) region of the clinical sample was matched for that of Fonsecaea monophora. The patient was treated with local heat therapy and topical terbinafine application.
Adrenal Cortex Hormones ; Azathioprine ; Base Sequence ; Chromoblastomycosis* ; Dermis ; DNA ; Female ; Forearm ; Fungi ; Giant Cells ; Hot Temperature ; Humans ; Hyperplasia ; Korea ; Middle Aged ; Polyneuropathies

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Tinea Barbae Caused by Trichophyton mentagrophytes.

You Bum SONG ; Ji Young YOO ; Moo Kyu SUH ; Gyoung Yim HA ; Tae Jung JANG ; Jong Soo CHOI

Korean Journal of Medical Mycology.2014;19(1):13-17.

Tinea barbae is a dermatophyte infection of the bearded areas of the face and neck. The incidence of tinea barbae has decreased as improved sanitation. We report a case of tinea barbae in a 49-year-old-man, who presented with relatively well-defined erythematous patch with pustules on the upper lip. A fungal culture from tissue of the lesions was grown on Sabouraud's dextrose agar and showed typical Trichophyton mentagrophytes. The nucleotide sequence of internal transcribed spacer for clinical isolate was identical to that of Arthroderma vanbreuseghemii IHEM 4411. The patient was treated with oral itraconazole for 3 months. The skin lesions improved 3 months after treatment, and recurrence has not been observed.
Agar ; Arthrodermataceae ; Base Sequence ; Glucose ; Humans ; Incidence ; Itraconazole ; Lip ; Neck ; Recurrence ; Sanitation ; Skin ; Tinea* ; Trichophyton*

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Isolation of Trichophyton rubrum from Diabetic Foot Ulcers of 4 Patients.

Weon Ju LEE ; Kyung Hea PARK ; Yong Hyun JANG ; Seok Jong LEE ; Do Won KIM

Korean Journal of Medical Mycology.2014;19(1):9-12.

Trichophyton rubrum is a common cause of superficial dermatophytosis in humans, such as tinea pedis, tinea unguium, tinea corporis and tinea cruris. T. rubrum usually attaches to keratin of the epidermis and uses it as a source of nutrients. Therefore, isolation of T. rubrum from non-keratinous skin, such as ulcer, is very rare. We describe 4 patients with T. rubrum-infected diabetic foot ulcer.
Diabetic Foot* ; Epidermis ; Humans ; Onychomycosis ; Skin ; Tinea ; Tinea Pedis ; Trichophyton* ; Ulcer*

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Comparative Study of In Vitro Inhibitory Effects of UVC, Terbinafine Hydrochloride 1% and Paeonia Natural Extracts on Trichophyton rubrum.

Ho Jung JUNG ; Yang Won LEE ; Yong Beom CHOE ; Kyu Joong AHN

Korean Journal of Medical Mycology.2014;19(1):1-8.

BACKGROUND: Trichophyton(T.) rubrum is most common fungal pathogen that causes tinea pedis and onychomycosis. It recurrently infects human and usually persists for very long time, provoking public health concern. Due to the limitation in current treatment options, alternative therapies are desirable. We investigated the inhibitory effect of UVC, terbinafine hydrochloride 1% and paeonia natural extracts on T. rubrum in vitro. OBJECTIVE AND METHOD: Total 25 T. rubrum strains were cultured for 10 days on Mycosel agar plate; 5 strains of T. rubrum and 5 copies for each strain. They were divided into 5 groups: control, UVC irradiation, terbinafine spray, paeonia natural extracts spray, UVC and paeonia natural extracts sprays. The cultured media were irradiated for 1 hour daily for 3 weeks in the germicidal lamp emitting 253.7 nm (UVC), power of 2.875 mW/cm2 at 10 cm distance. Terbinafine and paeonia extracts was sprayed twice on the surface to fully cover the colony area. The median diameter of each colony were measured every other day for 3 weeks. The change of colony diameter and the growth rate were analyzed. RESULTS: The UVC had virtually no effect on restraining the growth of T. rubrum, similar with the growth of the control group. However, both the terbinafine spray and paeonia extracts slowed down the growth rate remarkably and showed a similar effect. CONCLUSION: We could only figure out the fungistatic effect, and not the fungicidal effect of paeonia extract and terbinafine hydrochloride in vitro. UVC irradiation setting in this study was totally ineffective. More studies are needed on more variable wavelength and the fluence of UVC irradiation. In addition, further verification on the mechanism and the effect of anti-fungal activity by paeonia extracts are needed.
Agar ; Complementary Therapies ; Humans ; Onychomycosis ; Paeonia* ; Public Health ; Tinea Pedis ; Trichophyton*

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A Case of Candida albicans Pneumonia Diagnosed by Endobronchial Biopsy.

Yerim PARK ; Eun Hee SONG ; Yoon Kyou PARK ; Haksoo KIM ; Jaemin LIM ; Gilhyun KANG ; Jun Hee WOO

Korean Journal of Medical Mycology.2015;20(3):76-81. doi:10.17966/KJMM.2015.20.3.76

Candida species is indigenous fungus of healthy individuals, and frequently found in sputum culture. Candida isolation from the respiratory tract is not generally considered as a marker of lung infection, and definitive diagnosis of Candida pneumonia is confirmed by tissue biopsy. A few cases of Candida pneumonia pathologically confirmed by transthoracic needle aspiration of mycetoma have been reported. In Korea, a case of Candida pneumonia diagnosed by bronchial washing and blood culture was reported, but there is no case report diagnosed by biopsy. We report a case of Candida pneumonia diagnosed by endobronchial biopsy, and antifungal therapy resulted in successful resolution of the pneumonia.
Biopsy* ; Candida albicans* ; Candida* ; Diagnosis ; Fungi ; Korea ; Lung ; Mycetoma ; Needles ; Pneumonia* ; Respiratory System ; Sputum

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