MEDICAL MYCOLOGY

Dr Tadayo Hashimoto M.D.
Professor
Department of Microbiology & Immunology

22. All of the following statements concerning chromomycosis are correct EXCEPT that it:

is caused by a group of dermatiaceous fungi that produce melanin-like pigments
is a deep-seated systemic mycotic infection
is most often caused by traumatic implantation
is characterized by granulomatous nodules and epithelial hyperplasia
affects both immunocompetent and immuno-compromised individuals

(B) Chromomycosis is not a deepseated systemic mycotic infection. The infection usually occurs on the exposed lower extremities. It is primarily a cutaneous and subcutaneous infection caused by traumatic implantation of any one of several dematiaceous fungal species into the subcutaneous tissues. The pathology typically consists of granulomatous nodules and epithelial hyperplasia. The infection is often complicated by secondary bacterial infections. Dematiaceous fungi are imperfect fungi that produce varying amounts of melaninlike pigments. Species generally recognized as agents of chromomycosis are Fonsecaea pedrosoi, Phialophora verrucosa, Cladosporium carrionii, Rhinocladiella aquaspersa, and Fonsecaea compacta. The natural reservoir of these fungi is soil and plant debris. Both immunocompetent and immunocompromised individuals are susceptible to these fungi. Flucytosine has achieved the most success in the treatment of this infection. (Joklik et al, pp. 1117-111; Ryan et al, pp. 614-615)

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