Sivayogana, R (2017) Clinico Epidemiological Mycological and Mycopathological study of Deep Mycoses. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: Systemic and subcutaneous fungal infections are increasingly being recognized among both normal and immunocompromised individuals. The importance of these infections is due to the morbidity and mortality cause by them. As minimal data on these infections have been quoted in Indian literature, this study was taken up to study the epidemiology, clinical presentation, associated comorbidities, aetiological agents and histopathological findings. AIM AND OBJECTIVE: To study the clinico epidemiological profile, mycological and mycopathological correlation of subcutaneous and systemic mycoses. MATERIALS AND METHODS: All Patients presented to Mycology section in Department of Dermatology during the period from November 2015 to September 2016 with clinical suspicion of deep fungal infections were enrolled for the present study. The samples from these patients were subjected to direct microscopy by potassium hydroxide mount, culture in modified DA medium and histopathological examination using H&E, PAS, and GMS. Imaging studies like X-ray, CT, and MRI were also done. RESULTS: Incidence of deep fungal infection in this study was 0.49%. Total of 41 patients were diagnosed to have deep fungal infection. The most common age group was 41-50yrs (29.7%) and males (73.2%) were predominantly affected. Most people were doing farming work (43.9%). Duration of illness ranged from 1month to 20 years. Immunocompromised patients were 26.8%. Diabetes mellitus (63.6%) was found to be the most common co-morbid condition associated followed by post renal transplantation (45.4%). Out of 41 patients 37 (90.2%) had subcutaneous infection and 4 (9.7%) had opportunistic mycoses. Mycetoma (43.2%) was the most common cause of subcutaneous mycoses observed in this study followed by phaeohyphomycosis (32.4%). Mucormycosis (75%) and aspergillosis (25%) was the opportunistic mycoses reported in this study.Lower limb (58.5%) was the most common affected site in subcutaneous mycoses. Eumycotic mycetoma (93.7%) was more common than actinomycotic mycetoma (6.2%). The incidence (7%) of phaeohyhpomycosis is increasing in post renal transplant patients. Identification of fungus in 10% KOH was 88%. Culture in modified SDA gave positive results in 65.7% of patients. Madurella mycetomatis (87.5%) was the common organism isolated in eumycotic mycetoma. Phialophora verrucosa (81.8%) was the common organism in phaeohyphomycosis. Rhizopus species was isolated in mucormycosis. Percentage of yield of diagnosis by histopathological diagnosis in H&E was 77.1%. By PAS it was 90.9% and in GMS it was 100%. CONCLUSION: Incidence of deep mycoses is on the rise especially the phaeohyphomycosis in post renal transplant patients. Through knowledge about the clinicoepidemiological profile, mycological and mycopathological finding in various deep mycoses is necessary for early diagnosis and management. This will reduce the morbidity and prevent the mortality rate, especially in immunocompromised patients.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | Reg.No.201430005 |
| Uncontrolled Keywords: | Subcutaneous Mycoses, Opportunistic mycoses, immunosuppresed patients |
| Subjects: | MEDICAL > Dermatology Venereology and Leprosy |
| Depositing User: | Subramani R |
| Date Deposited: | 22 Jul 2020 17:05 |
| Last Modified: | 22 Jul 2020 17:05 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12645 |
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