Presentation
In the present case, a 38-year-old man who was also a farmer presented with secretory sinus and swelling on his right foot. As clinical presentations are not always pathognomonic, detection of species by laboratory examination is essential [9]. [ncbi.nlm.nih.gov]
Fever in aspergillus mycetoma Free Abstract Two patients with aspergillus mycetoma presenting with fever as a major sign are described. [thorax.bmj.com]
The authors present a case of a patient presenting with painful tearing which elicited further evaluation with CT imaging. This revealed a maxillary sinus fungus ball as the cause for the patient's tearing. [pubmed.ncbi.nlm.nih.gov]
It presents as a chronic sinusitis with headache, nasal discharge and obstruction. [aspergillus.org.uk]
Respiratoric
- Cough
The initial manifestations of the disease on admission included cough, dyspnea, hemoptysis, pulmonary infiltrate, and renal failure. [ncbi.nlm.nih.gov]
They can experience unintended weight loss, a chronic cough that produces mucus, the coughing up of blood, fatigue, and shortness of breath. Less often, fever or night sweats can occur. [rarediseases.org]
[…] breath Kidney or liver failure Shock Bloody cough or massive bleeding from the lungs Allergic bronchopulmonary aspergillosis may cause: Coughing accompanied by mucus or blood Wheezing or worsening of asthma Fever Increased mucus or sputum secretions [my.clevelandclinic.org]
– you may cough up blood or lumps of mucus wheezing (a whistling sound when breathing) a high temperature of 38C or above weight loss If you already have a lung condition, your existing symptoms may get worse. a cough for more than 3 weeks a lung condition [nhs.uk]
Often, no treatment is needed, unless you are coughing up blood. Sometimes, antifungal medicines may be used. If you have bleeding in the lungs, your provider may inject dye into the blood vessels (angiography) to find the site of bleeding. [medlineplus.gov]
- Hemoptysis
[…] those with hemoptysis due to other causes. [jcm.asm.org]
The initial manifestations of the disease on admission included cough, dyspnea, hemoptysis, pulmonary infiltrate, and renal failure. [ncbi.nlm.nih.gov]
Occasionally due to surrounding reactive vascular granulation tissue, hemoptysis may be present. Occasionally, erosion into a bronchial artery may lead to life-threatening hemoptysis 1. [radiopaedia.org]
Amongst symptomatic, the most common symptoms include cough and hemoptysis. [thoracicmedicine.org]
In such cases surgical resection is indicated if significant hemoptysis occurs. [aacijournal.biomedcentral.com]
- Chronic Cough
They can experience unintended weight loss, a chronic cough that produces mucus, the coughing up of blood, fatigue, and shortness of breath. Less often, fever or night sweats can occur. [rarediseases.org]
A case report • A 71-year-old Chinese male was admitted with complaint of chronic cough and malaise for two months. He had been in Tucson, Arizona, USA, visiting for four months right before the symptoms occurred. [slideshare.net]
- Pulmonary Disorder
Chandler. (2008) The Pathology of Pulmonary Disorders Due to Aspergillus spp. Archives of Pathology & Laboratory Medicine 132 :11, 1713-1714. Online publication date: 1-Oct-2009. [archivesofpathology.org]
- Productive Cough
Patients will usually have very minor symptoms, such as a mild cough, and little evidence of systemic inflammation. When symptoms progress, patients may present with weight loss, productive cough, fatigue and shortness of breath. [journal.copdfoundation.org]
Musculoskeletal
- Osteoporosis
Radiographs revealed fungal involvement of the heads of the tibia and fibula, cavitation in femur, patella periosteal bone deposition and diffuse osteoporosis. [medicaljournals.se]
Skin
- Cutaneous Manifestation
The clinical manifestation of cutaneous aspergillosis by A. flavus is described by the presence of macules, plaques, papules, nodules, ulcerations, pustules, or subcutaneous abscesses. [ncbi.nlm.nih.gov]
- Foot Ulcer
A clinicomicrobiological study on incidence of mycotic infections in diabetic foot ulcers. Int J Sci Study. 2017;4(12):50–54. [Google Scholar] 4. Raiesi O., Siavash M., Mohammadi F., et al. [ncbi.nlm.nih.gov]
Workup
Certain associated atypical symptoms may warrant further workup. The authors present a case of a patient presenting with painful tearing which elicited further evaluation with CT imaging. [ncbi.nlm.nih.gov]
Microbiology
- Aspergillus Fumigatus in the Sputum
Clinical and immunologic significance of Aspergillus fumigatus in the sputum. Am Rev Respir Dis. 1959 Aug;80:167–180. [ncbi.nlm.nih.gov]
Treatment
Since the initial treatment was based on bone tumor, after the evidence mentioned above and diagnosis of mycetoma, the treatment was started with itraconazole 200 mg daily. [ncbi.nlm.nih.gov]
Treatment Therapies that work against mycetoma are limited, may have to be taken for a long time, and can be expensive. The treatment for mycetoma depends on whether it is caused by bacteria (actinomycetoma) or fungi (eumycetoma). [cdc.gov]
Treatment Treatment of eumycetoma remains problematic. Historically, the treatment of eumycetoma has included surgical treatment, medical treatment, or both. Combined surgical and medical treatment appears to be the management option of choice. [emedicine.medscape.com]
Successful medical treatment of an Aspergillus terreus mycetoma of the nostril/lip in a 16-year-old Fjord pony gelding with pituitary pars intermedia dysfunction. Veterinary Dermatology, 2017, 28 (6), pp.629-e155. ⟨10.1111/vde.12471⟩. ⟨hal-03290175⟩ [hal-vetagro-sup.archives-ouvertes.fr]
Prognosis
[…] which is a hypersensitive asthmatic reaction to Aspergillus antigens invasive aspergillosis, which is an acute infection that produces septicemia, thrombosis, and infarction of virtually any organ, especially the heart, lungs, brain, and kidneys Varied prognosis [quizlet.com]
Prognosis CNPA has a significant mortality of up to 40%, even if promptly recognised and treated. It is easy to miss and, in such cases, carries a worse prognosis. [patient.info]
Treatment and prognosis An asymptomatic aspergilloma does not necessarily require treatment, and the cavity is essentially isolated from any systemic administration of antifungal 3. [radiopaedia.org]
Voriconazole (VFEND) With proper treatment, the prognosis is general good as the disease responds well to both antibiotic and antifungal medications. [lymphedemapeople.com]
Treatment and prognosis The treatment is chosen only after distinguishing if the disease is an actinomycetoma or a eumycetoma. [afwgonline.com]
Etiology
Aspergillus nidulans is a rare etiological agent, causing pale grain mycetoma. Only 7 cases of Aspergillus nidulans mycetoma have been reported in literature - 1 from India (Rajasthan, 1985), 6 from Africa. [ijidonline.com]
The etiologic agents range from bacteria to fungi existing free in nature as soil or plant saprophytes gaining entrance into the tissues through abrasion or implantation. Actinomycetoma is caused by aerobic species of actinomycetes. [aspergillus.org.uk]
Pseudallescheria boydii is the most common etiologic agent of eumycetoma in the United States. Madurella mycetomatis accounts for most cases worldwide. Madurella grisea is a common etiologic agent in South America. [emedicine.medscape.com]
Root canal treated teeth with overextension of the root canal sealer or solid materials such as gutta-percha or silver cones into the sinus might be the main etiological factor for aspergillosis of the maxillary sinus in healthy patients. [ncbi.nlm.nih.gov]
Epidemiology
Epidemiological profile and spectrum of neglected tropical disease eumycetoma from Delhi, North India. Epidemiol Infect. 2019;147:e294. Chander J. Subcutaneous mycosis mycetoma. In: A Textbook of Medical Mycology. 3rd ed. [jpad.com.pk]
Eumycetoma and actinomycetoma–an update on causative agents, epidemiology, pathogenesis, diagnostics and therapy. J Eur Acad Dermatol Venereol 2015;29:1873-1883. van de Sande WW. [afwgonline.com]
A Mycological and Molecular Epidemiologic Study on Onychomycosis and Determination In Vitro Susceptibilities of Isolated Fungal Strains to Conventional and New Antifungals. [ncbi.nlm.nih.gov]
The injuries were classified in five categories that pointed injuries such as pricking that had special importance in the epidemiology of mycetoma and the other included cuts, operated injuries, scratch and war injuries. [scialert.net]
Pathophysiology
Stefano Veraldi1, Anna Grancini2, Luigia Venegoni1, Valentina Merlo1, Elena Guanziroli1, Claudia Menicanti1, Gianluca Nazzaro1 and Annamaria Tortorano3 1Department of Pathophysiology and Transplantation, Università degli Studi di Milano, IRCCS Foundation [medicaljournals.se]
[…] accumulation of fungal hyphae Essential features Dense fungal growth with no tissue invasion Fruiting heads (sexual reproduction) may be seen Terminology Fungal ball, mycetoma, chronic noninvasive fungal sinusitis Sites Maxilla is most commonly affected Pathophysiology [pathologyoutlines.com]
Author Contacts Gianluca Nazzaro, MD Department of Pathophysiology and Transplantation Università degli Studi di Milano, I.R.C.C.S. [karger.com]
Pathophysiology The foot is the most common site of infection, and 70% of all mycetomas affect the foot. [emedicine.medscape.com]
Pathophysiology In a healthy, immunocompetent individual, macrophages and neutrophils normally defend against the inhaled fungus. [patient.info]
Prevention
Health care providers and researchers believe that wearing shoes might prevent injuries that can lead to mycetoma. [cdc.gov]
[…] of HIV HIV Transmission and Prevention in Specific Populations Systematic Review of HIV Behavioral Prevention Research in African Americans Lynae A. [hivinsite.ucsf.edu]
These problems are addressed and measures of prevention such as smoking cessation are included. [books.google.com]
Prevention The best prevention of aspergillosis is a healthy way of life that is capable of normal immune system. [medical-enc.com]
Centers for Disease Control and Prevention. Disease condition caused by species of aspergillus and marked by inflammatory granulomatous lesions in the skin, ear, orbit, nasal sinuses, lungs, and sometimes in the bones and meninges. [icd10data.com]