A prospective clinico mycological study of deep mycoses in a tertiary centre in Tamil Nadu
Keywords:Subcutaneous mycoses, Mycetoma, Phaeohyphomycosis, Mucormycosis, Aspergillosis, Immunosuppression
Background: Deep mycoses which includes subcutaneous mycoses and systemic mycoses, accounts for about 1% of the all the fungal infections seen in human beings. Though rare, these infections assume significance due to the increased morbidity and mortality associated with them. The objective of the study was to study the incidence, clinical presentation, aetiological agents and histopathological findings of deep mycoses in patients attending the mycology section, department of dermatology of a tertiary centre in Chennai.
Methods: All Patients with clinical suspicion of deep mycoses who presented to mycology section during the period from November 2015 to September 2016 were screened. The samples from these patients were subjected to direct microscopy by potassium hydroxide wet mount, culture and histopathology.
Results: Among the 8250 patients who attended mycology OPD, 41 patients (0.5%) had deep mycoses. The commonly affected age group was 41-50 yrs (29.7%). Males (73.2%) were predominantly affected. Of the 41 patients, 26.8% were immunocompromised. 37 patients (90.2%) had subcutaneous infection and 4 (9.8%) had opportunistic mycoses. Mycetoma (43.2%) was the most common subcutaneous mycoses. Mucormycosis (75%) and aspergillosis (25%) were the opportunistic mycoses observed. KOH positivity was 100%, while culture positivity was 65.7%. Madurella mycetomatis, Phialophora verrucosa, Rhizopus arrhizus and Aspergillus fumigatus were the common organisms isolated in this study.
Conclusions: Mycetoma is the most common subcutaneous mycoses in this part of India. Eumycetoma is more common than actinomycetoma. Phaeohyphomycosis is on the rise. Simple KOH examination would pave way for an early diagnosis and prompt treatment of deep mycoses.
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