Evidence of Vertical Transmission of the Snake Fungal Pathogen Ophidiomyces ophiodiicola

Snake fungal disease (ophidiomycosis) is an emerging infection of snakes caused by Ophidiomyces ophiodiicola. Little is known about mechanisms of this pathogen's transmission and its implications for conservation of wild snake populations. We report four cases with evidence of vertical transmission of O. ophiodiicola from dam to offspring.

[A preschooler with a skin lesion on the face]

A 4-year-old girl presented to the paediatric department with a red squamous spot around her right eye. Based on the clinical presentation and anamnesis, we suspected a zoonotic dermatomycosis obtained via her guinea pigs. PCR of the skin flakes revealed dermatophytes.

Environmental detection of Microsporum canis arthrospores in the households of infected cats and dogs

Microsporum canis is the dermatophyte most frequently recovered from canine and feline ringworm cases. The household environment can be contaminated both by symptomatic animals and through asymptomatic M canis carriage, resulting in a potential human health risk. The load of M canis arthrospores was determined in households harbouring infected pets, in order to evaluate the infectivity of the animals versus the environment. The environments inhabited by 30 symptomatic animals (21 cats and 9 dogs) infected by M canis were examined by sampling both surfaces and indoor air. The surfaces were examined by means of contact plates; the air sampling was performed with a Sas super-100 AIR SAMPLER (PBI, Italy). Environmental contamination was detected in all households with cats, while only four out of nine houses harbouring dogs were found positive. The frequence of isolation in each sampling, and the results in terms of colony forming units per plate in the different houses appeared to be quite homogeneous. Heavily infected environments harboured kittens only. Infected owners were observed in eight households, in all of which at least one infected cat was present. No history of human dermatophytosis in households harbouring dogs was found. On the basis of our results, infected cats appear to cause substantial environmental contamination, and provoke a substantial presence of viable airborne fungal elements. Dogs seem to be of lower importance in the spread of M canis: they contaminated surfaces, but they never contaminated the air. The results of this study confirm the potential leading role of the feline species in the environmental spread of M canis.

Infection and transmission heterogeneity of a multi-host pathogen (Batrachochytrium dendrobatidis) within an amphibian community

The majority of parasites infect multiple hosts. As the outcome of the infection is different in each of them, most studies of wildlife disease focus on the few species that suffer the most severe consequences. However, the role that each host plays in the persistence and transmission of infection can be crucial to understanding the spread of a parasite and the risk it poses to the community. Current theory predicts that certain host species can modulate the infection in other species by amplifying or diluting both infection prevalence and infection intensity, both of which have implications for disease risk within those communities. The fungus Batrachochytrium dendrobatidis (Bd), the causal agent of the disease chytridiomycosis, has caused global amphibian population declines and extinctions. However, not all infected species are affected equally, and thus Bd is a good example of a multi-host pathogen that must ultimately be studied with a community approach. To test whether the common midwife toad Alytes obstetricans is a reservoir and possible amplifier of infection of other species, we used experimental approaches in captive and wild populations to determine the effect of common midwife toad larvae on infection of other amphibian species found in the Peñalara Massif, Spain. We observed that the most widely and heavily infected species, the common midwife toad, may be amplifying the infection loads in other species, all of which have different degrees of susceptibility to Bd infection. Our results have important implications for performing mitigation actions focused on potential 'amplifier' hosts and for better understanding the mechanisms of Bd transmission.

[Dermatophytes transmitted by pets and cattle]

Most inflammatory skin and hair dermatophytoses are caused by one of four zoophilic dermatophyte species: Microsporum canis (from cats and dogs), Trichophyton verrucosum (from cattle), Arthroderma benhamiae (from Guinea-pigs) and Arthrodermna vanbreuseghemii (generally from cats and dogs). In cases of highly inflammatory tinea corporis, tinea faciae and tinea capitis in humans, it is important to identify with certainty the precise etiologic agent and to examine pets as the possible source of infection. The recurrence of infections or new infections can be prevented by adequately treating incriminated domestic animals and their environments. Cooperation between the medical and veterinary professions is required in this situation.

Cutaneous congenital candidiasis in a full-term newborn from an asymptomatic mother

A male infant of 2,900 g was born at term to a 19-year-old primigravida woman who had adequate prenatal care and no major complications detected during the pregnancy. The only reported medical event was an episode of urinary tract infection by E. coli one month before delivering, which resolved without complications using nitrofurantoin. There was no history of maternal herpes simplex infection and her serologic screening was negative for syphilis.

Molecular analysis of dermatophytes suggests spread of infection among household members

Dermatophyte infection from the same strains may be an important route for transmission of dermatophytoses within a household. In this study, we used molecular methods to identify dermatophytes in members of dermatophyte-infected households and evaluated variables associated with the spread of infection. Fungal species were identified by polymerase chain reaction (PCR) using primers targeting the internal transcribed spacer (ITS) regions (ITS1 and ITS4). For strain differentiation, fungal DNA was probed with a ribosomal DNA-specific probe (containing ITS1, 5.8S ribosomal DNA, and ITS2) to detect restriction fragment length polymorphisms (RFLPs). Associations between the spread of a dermatophyte infection and fungal/host variables were determined using χ² and logistic regression analyses. Among the 50 households enrolled in this study, 18 included multiple infected members (MIMs). Trichophyton rubrum was the most commonly isolated dermatophyte species, followed by Trichophyton mentagrophyts and Epidermophyton floccosum. Sixteen T rubrum strains (TR-A to TR-P) were identified, with spread of infection detected in 8 MIM households. Factors that were significantly (P<.05) associated with the spread of infection included the presence of strains TR-B or TR-D, a history of concomitant tinea pedis and onychomycosis, and plantar scaling and/or nail discoloration. This study is unique in that it used molecular evidence to demonstrate the association of certain strains with the spread of dermatophyte infection among members of the same household.

Current problems concerning parasitology and mycology with regard to diseases of the skin and its appendages

Current issues concerning Parasitology and Mycology with regard to diseases of the skin and its appendages are presented. Aspects of diagnostics, clinical picture and therapy of skin and nail mycoses, as well as difficulties in the diagnosis and treatment of both native parasitoses (toxoplasmosis) and imported human tropical parasitoses (malaria, filariosis) have been emphasised. The clinical importance of environmental mould fungi in nosocomial infections and fungal meningitis, as well as selected properties of fungi isolated from patients with head and neck neoplasms treated by radiotherapy are discussed. Other mycological topics include the characteristics of newly-synthesized thiosemicarbazides and thiadiazoles as potential drugs against toxoplasmosis and their biological activity against Toxoplasma gondii tachyzoites, selected molecular mechanisms of resistance to azoles, Candida albicans strains and a new tool (barcoding DNA) for describing the biodiversity of potential allergenic molds. The importance of environmental factors in pathogenesis of mycoses and parasitoses is noted. The characteristics of pathogenic fungi isolated from natural ponds in Bialystok and potentially pathogenic yeast-like fungi isolated from children's recreation areas in Lodz are presented. The ongoing problem of anthropozoonoses is considered, as are the roles of stray cats and dogs in contaminating soil with the developing forms of intestinal parasites. The characteristics of the human microbiome, including population composition, activity and their importance in normal human physiology, are presented, as are the major goals of the Human Microbiome Project initiated by National Institutes of Health (NIH).

[Animals as a potential source of human fungal infections]

Changing environment is a reason, that many saprotrophic fungi became opportunists and in the end also maybe a pathogenic. Host specific adaptation is not so strong among fungi, so there are many common fungal pathogens for people and for animals. Animals suffering from dermatomycosis are well recognize as source of human superficial mycoses. Breeding of different exotic animals such as parrots, various Reptiles and Amphibians, miniature Rodents and keeping them as a pets in the peoples houses, have become more and more popular in the recent years. This article is shortly presenting which animals maybe a potential source of fungal infections for humans. Looking for the other mycoses as systemic mycoses, especially candidiasis or aspergilosis there are no data, which allow excluding sick animals as a source of infection for human, even if those deep mycoses have endogenic reactivation mechanism. Immunocompromised people are in high-risk group when they take care of animals. Another important source of potentially pathogenic, mostly air-born fungi may be animal use in experimental laboratory work. During the experiments is possible that laboratory workers maybe hurt and these animals and their environment, food and house boxes could be the possible source of microorganisms, pathogenic for humans or other animals. Unusual way to inoculate these potentially pathogens into the skin of laboratory personnel may cause granulomatous, local lesions on their hands.

Behaviour of Australian rainforest stream frogs may affect the transmission of chytridiomycosis

The amphibian disease chytridiomycosis, caused by the pathogen Batrachochytrium dendrobatidis, has been implicated in mass mortalities, population declines and extinctions of amphibians around the world. In almost all cases, amphibian species that have disappeared or declined due to chytridiomycosis coexist with non-declining species. One reason why some species decline from chytridiomycosis and others do not may be interspecific differences in behaviour. Host behaviour could either facilitate or hinder pathogen transmission, and transmission rates in the field are likely to vary among species according the frequency of factors such as physical contact between frogs, contact with infected water and contact with environmental substrates containing B. dendrobatidis. We tracked 117 frogs (28 Litoria nannotis, 27 L. genimaculata and 62 L. lesueuri) at 5 sites where B. dendrobatidis is endemic in the rainforest of tropical northern Queensland and recorded the frequency of frog-to-frog contact and the frequency of contact with stream water and environmental substrates. Frequency of contact with other frogs and with water were highest in L. nannotis, intermediate in L. genimaculata and lowest in L. lesueueri. Environmental substrate use also differed among species. These species-specific opportunities for disease transmission were correlated with conservation status: L. nannotis is the species most susceptible to chytridiomycosis-related declines and L. lesueuri is the least susceptible. Interspecific variation in transmission probability may, therefore, play a large role in determining why chytridiomycosis drives some populations to extinction and not others.

[Questions of dermatoinfectology in the practice]

The importance of bacterial, viral and fungal diseases has significantly increased during the past decades. The reasons are numerous, but the most important ones are as follows: appearance of new variance of microbes, appearance and spread of antibiotic resistant bacterial strains, and increasing number of patients with various degree of immunodeficiency. For such reasons we consider extremely important to overview and upgrade our current knowledge and practice regarding to these diseases. This manuscript will discuss the hottest practical questions of dermato-infectology.

Mycetes and urban areas

Mycetes are ubiquitous organisms that can cause mycoses in human and animals. The role of animals in the epidemiology of human mycoses in urban areas is multiform, but here will be discuss only two features: A) animals as vectors of mycoses and B) animal substrates as growth factor of pathogenic fungi. A) Animals as vectors of mycoses: this role is important as zoofilic dermatophytes are very important agents of zoonosis; the urban dermatophytozoonoses are prevalent caused by Microsporum canis which is prevalent in cats and dogs. Cats are often asymptomatic carriers. The pattern of human dermatomycoses has changed in Italy during the past century: at the beginning of the century anthropophilic fungi were prevalent while at present the zoophilic fungi are the most important causes. B) Animal substrata as growth factor of pathogenic fungi: soil "animalization" (i.e., the addition of such debris as hair, skin scales, dropping and other organic matters) creates an optimal substratum for the growth and the multiplication of geophilic or saprophyitic fungi, such as Microsporum gypseum and Cryptococcus neoformans. The present human lifestyle, which favours a an overpopulation of birds, wild animals, domestic mammals and sinanthropic together with man in crowded areas seems to favour the formation of environments adapted to the abundant growth of some pathogenic fungi with consequent infection for man and animals. Finally, an environment heavily populated by fungi can cause allergic pulmonary reactions as well as reactions in other organs and tissues. The control of human and animal fungi, and the efficient use of a monitoring system require ample knowledge of mycological problems both in human and veterinary medicine and of efficient laboratories capable of resolving the needs of both disciplines. Close collaboration between veterinarians, doctors and mycologists is necessary in order to resolve health problems linked to mycosis.

Survey of dermatophytes on clinically normal cats in the southeast of England

OBJECTIVES

To report the incidence of dermatophytes on the hair coat of asymptomatic cats in the southeast of England. Asymptomatic cats are often blamed for transmission of dermatophytes between animals and humans. This study may help to clarify whether cats are responsible for the increase in fungal infections among the human population.

METHODS

A total of 169 clinically healthy cats without any dermatological signs were sampled using the Mackenzie brush technique and cultured for dermatophytes. Thirty cats were from a closed colony and 139 were feral or from domestic households in the southeast of England.

RESULTS

The incidence of Microsporum canis and Trichophyton mentagrophytes in household and feral cats was 2.16 per cent for each dermatophyte. This survey shows little difference in the isolation rates of M. canis between the southeast and southwest of England, which was reported on in 1994.

CLINICAL SIGNIFICANCE

Given the low number of dermatophytes isolated, asymptomatic cats are unlikely to be responsible for the increasing incidence of human infection. Asymptomatic carriers with T. mentagrophytes in the hair coat have not been previously reported and may need to be considered when treating humans with trichophytosis.

[Dermatophytoses transmitted from animals]

Dermatophytoses are infectious skin diseases caused by some sorts of Fungi - dermatophytes. Based on their source dermatophytes are classified to geophilic, zoophilic and antrophophilic groups. Animals are primary afflicted by zoophilic Fungi, manifestations on their skin are highly infectious and Fungi can be transmitted to humans. Some members of zoophilic dermatophytes are: Microsporum canis, Trichophyton mentagrophytes var. mentagrophytes and Trichophyton verrucosum. Most common clinical findings in humans and also in some animals are described. If a zoophilic dermatophytosis is diagnosed at a patient, not only treatment of that person is necessary. Isolation and treatment of the afflicted animal, disinfection of its environment and locking for other infected persons and animals are essential. Finally, three various cases of zoophilic dermatophytoses are described.

Malassezia pachydermatis carriage in dog owners

Malassezia pachydermatis is commonly carried on the hands of dog owners and may cause disease in immunocompromised persons.

Yeasts of the genus Malassezia serve as both commensal microorganisms and pathogens on the skin of humans and domestic animals. Although rare, cases of life-threatening fungemia in people have been attributed to Malassezia pachydermatis, for which dogs are a natural host. Zoonotic transfer has been documented from dogs to immunocompromised patients by healthcare workers who own dogs. We investigated the role of pet dogs as risk factors for mechanical carriage of M. pachydermatis on human hands. Dogs and their owners were sampled as pairs, by fungal culture and nested polymerase chain reaction (PCR). Although fungal culture was not a reliable means by which to detect carriage of the yeast on human hands, PCR identified M. pachydermatis on most (≈93%) human participants. Human carriage of ubiquitous opportunistic pathogens such as M. pachydermatis underscores the importance of good hand hygiene by healthcare professionals.

Zoonotic skin diseases of dogs and cats

Although there are over 250 zoonotic diseases, only 30-40 of them involve dogs and cats. Transmission of zoonotic infections occurs via bites, scratches or touch; exposure to saliva, urine or feces; inhalation of particles or infectious aerosols; contact with a transport or intermediate host (e.g. ticks, fleas); or exposure to contaminated water, soil or vegetation. This paper summarizes the most important common zoonotic dermatological diseases of dogs and cats. The most common dermatological zoonoses are flea and tick infestations and the diseases they transmit; dermatophytosis; and mite infestations (Sarcoptes and Cheyletiella). Prevention of zoonotic infestations or infections can be accomplished easily by the use of routine flea and tick control, screening of new pets for dermatophytosis, and routine hand-washing.

[Update on the diagnosis of dermatomycosis]

Dermatomycosis are mycotic diseases of skin caused by a few mycetes: dermatophytes, and some opportunistic fungi as Malassezia, Candida (not C. albicans), Trichosporon, Rhodutorula, Cryptococcus or Aspergillus, Geotrichum, Alternaria, etc. Dermatophytes are a group of closely related filamentous fungi that invade keratinized tissue (skin, hair, nails) of humans and other animals and produce infection called dermatophytosis or ringworm or "tinea". The etiological agents of dermatophytosis are classified in three genera: Microsporum, Trichophyton and Epidermophyton (Deuteromycetes). On the basis of their primary habitat dermatophytes are divided in Anthropophilic dermatophytes (parasitic organisms that infect humans), Zoophilic dermatophytes (parasitic organisms that infect animals, but also humans: agents of zoonosis) and Geophilic dermatophytes (saprobic fungi associated with keratinous materials in soil). In the soil there are also structure associated with contagion, ("spore", "arthroconidium", or "clamydospore") of anthropophilic and zoophilic dermatophytes that may persist for years, in the environment, in hair or skin scales. Since on the skin of animals there are many saprobic organisms (Malassezia) and many fungi may infect the fur, it is important to make an accurate diagnosis. Dermatophytosis are communicable diseases acquired from infected animals or from fomites. Infections caused by dermatophytes is a ringworm. These infections may range from mild and superficial, almost subclinical, to a few areas of scaling to a highly inflammatory reaction with extensive areas of scarring and alopecia. Granuloma formations (mycetoma-like) may occur especially in cats. Dermatophytes, as filamentous fungi, undergo radial fungi: collection of skin material is best made by collecting the scales near the edges of the rings. Hairs are best sampled by plucking; a scalpel may be used to scrape scales; brushes have also been used. Sample materials are best transported in dry packet. The Wood's light may be used to identify infected fluorescent hairs. Direct microscopy, although false negative up to 50% of cases, is a highly efficient screening technique. Scraping and hairs should mixed to 10-15% KOH. Culture is a valuable adjunct to direct microscopy and is essential to identify more dermatophytes. A medium selective against most nondermatophytic moulds and bacteria is used as a primary isolation medium. Many typical isolates of common dermatophytes can be identified directly from primary isolation media. Identification characters include: colony pigmentation, texture, morphological structure (macroconidia, microconidia, spirals, pectinate branches, etc). Nutritional requiment, growth in special media, "in vitro" perforation, mating studies are procedures used to identify atypical isolates. Serological approaches have revealed difficulties. Many kinds of molecular biologic techniques have been made available for clinical diagnosis recently; almost all of these techniques involve the polymerase chain reaction (PCR).

[Current types of human dermatophytoses transmitted from animals]

Microsporum canis, Trichophyton verrucosum and T. mentagrophytes are the most common dermatophytes isolated from human and animals. M. canis infection in human is closely related to companion animals such as cats and dogs. According to a recent epidemiological survey in Japan, human M. canis infection is decreasing. T. verrucosum is usually transmitted from cows to human. T. verrucosum infection in human is not restricted to daily farming prefectures, however, suggesting that this species has already been spread widely in Japan. T. mentagrophytes is one of the most common pathogens in human tinea. Recent molecular methods show the infection is caused by one teleomorph of T. mentagrophytes, Arthroderma benhamiae, which has already been spread throughout Japan by companion animals. This pathogen is believed not to have existed in Japan until 1980. The chance of human fungal infection caused by unusual pathogens is increasing because of the changes in types of companion animals. Animal dermatophytoses is now an important issue not only for veterinary doctors but also for dermatologists.

Cutaneous Alternaria infection in renal transplant recipients: a report of two cases with an unusual mode of transmission

We report two cases of cutaneous alternariosis in renal transplant recipients. The diagnosis was made by mycologic and histologic examination. The patients were treated with itraconazole. In one patient who had undergone surgical resection of the cutaneous lesion along with antifungal treatment, the follow-up period was uneventful with no signs of recurrence. In the other patient, surgical excision of the lesion was not performed prior to antifungal therapy. The lesion disappeared following treatment but local recurrence was observed 1.5 years later with an unfavorable evolution despite administration of the second course of therapy. Resection of the lesion and prolongation of the treatment resulted in a satisfactory course with no signs of local recurrence over a follow-up period of 4.5 years. Interestingly, both of the patients had a previous history of a mild traumatic event with a stretcher in our outpatient clinic where the follow-up visits were made. A vast mycologic survey was then made in our department, which disclosed that some of the stretchers were contaminated by the fungi and could have potentially served as the reservoirs and vectors for the transmission of the fungus.

Curvularia keratitis after laser in situ keratomileusis from a feline source

Fungal keratitis following laser in situ keratomileusis (LASIK) is extremely rare. Except in cases that follow trauma, the source of fungal organisms is unknown in published reports. We report a case of keratitis following LASIK that could be directly traced to a fungal skin infection of the patient's pet cat.

[Sports-induced infections--an overview]

Sportive activities are playing an increasing role for the spare time in our society. Subsequently, practicing of various kinds of sport can lead to direct and indirect exposures to and transmission of microorganisms between athletes and also passive observers. As a result, different microbial pathogens can be transmitted and might lead predominantly to cutaneous or mucosal infections. These include both bacteria--Staphylococcus aureus, streptococci and gram-negative bacteria, like Pseudomonas, viruses--herpes simplex virus, human papilloma virus--and, last but not least, also dermatophytes--e.g. Trichophyton tonsurans as particular pathogenic agent of tinea gladiatorum. Beside single cases of infections outbreaks through various virus-, bacteria- and dermatophytes-induced infections might happen and have indeed been reported. Surprisingly, there is only limited knowledge among physicians concerning sport-induced infections. Therefore, sport-induced infections are reviewed giving details about their route of transmission. Awareness of these infections might facilitate implementation of early treatment and preventive measures.

Study of the dermatophytes in dogs and the risk of human infection

BACKGROUND

The infiltrative growth of fungi that multiplies in the tissues (dermatophytes, candida, agents of visceral mycoses) is the generally known proof of "active" functioning of these organisms. The relative importance of fungi as inducers of human and animal diseases grows constantly.

METHODS

The study was carried out on dogs that showed skin changes. The frequency of examinations was determined on the basis of anamneses. Skin scrapings and affected fragile or dull hair and skin swabs were subject to Laboratory diagnostic examinations based on cultivation and microscopical examination. Our evaluations were focused on the type of parasite--ecothrix, endothrix, neoendothrix, and the size of arthrospores.

RESULTS

The results of our study are presented as the incidence of dermatophytes and other micromycetes in 100 samples of skin scrapings and swabs from 100 dogs of both sexes, different breeds and age categories that had exhibited skin problems. We isolated 12 species. Malassezia pachydermatis was the most frequently detected species and was isolated from 31 cases. Trichophyton mentagrophytes was isolated from 2 samples, species Microsporum canis was isolated only from one case, Candida albicans was isolated from 3 samples. The agent Candida krusei was isolated from 5 samples, Candida pulcherrima a relatively rare candidal species, was isolated from skin of an 8-year old Dalmatian bitch, Candida sp. in 5 cases. Trichosporon cutaneum was isolated from a 3-year old Laika etc.

CONCLUSION

This study confirms the need of constant research in this area. This indicates that the incidence of mycoses in dogs and other pets is of importance in the exposure of people to the risk of acquiring mycotic infections. (Tab. 1, Fig. 5, Ref. 57).

[Epidemiology of dermatomycoses in Slovakia]

The authors analyze the incidence of dermatomycoses in the Slovak Republic in 1994-1999. They found an increase of these infections in particular epidermophytoses, trichophytoses and candidoses. From 25,762 examined subjects with suspicion of dermatomycosis they isolated in 1990 till 1999 8,237 cultures of dermatophytes. The most frequent causal agent was Trichophyton rubrum (81.61%). In the conclusion the authors draw attention to the inevitability of introduction of effective preventive measures.

Skin colonization by Malassezia species in neonates: a prospective study and relationship with neonatal cephalic pustulosis

OBJECTIVES

To assess skin colonization by Malassezia species in full-term healthy newborns, to investigate factors associated with colonization, and to look at acnelike cephalic pustulosis associated with this carriage.

DESIGN

Samples were obtained from neonates and their mothers 0 to 5 days after birth and again 3 weeks later. Clinical patterns of common acnelike pustulosis were reported as mild (<10 papulopustules), moderate (> or =10 papulopustules), or absent. Direct examination and culture of sample. Identification of yeasts was based on microscopic and physiologic criteria.

SETTING

A maternity hospital and the pediatric dermatology unit of a university hospital.

PARTICIPANTS

Consecutive series of 102 neonates and their mothers.

MAIN OUTCOME MEASURES

Incidence of skin colonization and type of Malassezia species found in neonates and correlation with neonatal cephalic pustulosis (neonatal acne).

RESULTS

At the first visit, 11 neonates and 36 mothers had cultures positive for Malassezia. Malassezia sympodialis and Malassezia globosa were preferentially cultured. At 3 weeks, 29 (52%) of 56 neonates and 18 (32%) of 56 mothers had cultures positive for only M sympodialis and M globosa. Breastfeeding was not associated with a higher prevalence of Malassezia carriage in neonates. Malassezia colonization was higher when pustulosis was more severe and M sympodialis was found in pustules.

CONCLUSIONS

Malassezia colonization begins at birth and increases in the first weeks of life. A high prevalence of M sympodialis in neonates is noted from birth. Its association with neonatal acne is confirmed. Further investigation is needed to study the role of sebum secretion rate and quality in the neonatal period.

Imported skin diseases in dermatology

Millions of afflicted people suffer from conditions which Japanese dermatologists may rarely encounter. Many of our patients travel extensively either as part of work-related business trips or during vacationing. From three to ten percent of travelers experience skin, hair or nail disorders. With worldwide travel heightening exposure to the causative agents, there is an increasing likelihood that a patient with leishmaniasis, Boutonneuse fever, onchocerciasis, loaiasis, dengue fever, cutaneous larva migrans or other recently acquired skin conditions from a far away land will visit your office for diagnosis and treatment. The clinical characteristics, diagnostic tests and therapeutic options for such imported tropical diseases will be discussed.

Scytalidium dimidiatum melanonychia and scaly plantar skin in four patients from the Maghreb: imported disease or outbreak in a Belgian mosque?

Scytalidium dimidiatum is a geophilic dematiaceous, non-dermatophyte mould that can become a pathogen for plants and humans particularly in tropical and subtropical regions. We report 4 cases of S. dimidiatum onychomycosis presenting clinically as thickened and dark toenails. The skin of the soles was scaly. The time and location of the contaminations were uncertain. Indeed, the patients were ancient immigrants from the Maghreb to Belgium. They were also regularly travelling to their countries of origin. They were also often barefoot in the same Belgian mosque. The disease was unresponsive to current oral antifungal treatments.

Effectiveness of terbinafine in the eradication of Microsporum canis from laboratory cats

In this study, the coats of 20 cats with no dermatophytosis lesions were sampled for colonization by Microsporum canis, which was isolated in 45% of cases. All cats were treated with oral terbinafine for 3 weeks. The drug was administered orally at a daily dosage 8.25 mg kg-1. Mycologic status was assessed at the end of the treatment; and after follow-up at 2 days, and 4 and 9 weeks. The final evaluation revealed a complete mycologic cure of all cats by obtaining negative cultures, thereby demonstrating that terbinafine is an effective method of eradication of dermatophyte colonization.

Two cases of tinea corporis by infection from a rabbit with Arthroderma benhamiae

The first cases of tinea corporis with Arthroderma benhamiae in Japan are reported. A 7-year-old girl and a 30-year-old mother in Shimane prefecture suffered from dermatophyte infections on the neck, shoulder, arms and leg. Three isolates from the two patients and a rabbit by which they supposedly were infected, were identified as Trichophyton mentagrophytes. On the bases of mating tests using the tester strains of both the African race and the Americano-European race of A. benhamiae, they were identified as A. benhamiae African race mating type (-). Our results are the first to indicate that both races of A. benhamiae exist in Japan.

Experimental transmission of cutaneous chytridiomycosis in dendrobatid frogs

In a series of three experiments during March-October, 1998, two species of captive-bred poison dart frogs (Dendrobates tinctorius and D. auratus) were exposed to Batrachochytrium dendrobatidis, a recently-described chytridiomycete fungus (chytrid) that was originally isolated from a blue poison dart frog (D. azureus). All frogs exposed to the chytrids developed a fatal skin disease, whereas none of the control frogs developed skin lesions. The most consistent clinical sign in chytrid-exposed frogs was excessive shedding of skin. Gross lesions were subtle, usually affected the legs and ventrum, and consisted of mild skin thickening and discoloration. Microscopic examination of shed skin pieces and/or skin imprints demonstrated the presence of chytrids and was used for ante mortem and post mortem confirmation of chytrid infection. Histologically, there was epidermal hyperkeratosis, hyperplasia, and hypertrophy associated with low to moderate numbers of chytrids in the keratinized layers. These experiments demonstrated that Batrachochytrium dendrobatidis can be a fatal pathogen in poison dart frogs. The experimentally-induced disease in these frogs resembled cases of cutaneous chytridiomycosis that have recently been described in several other species of captive and wild amphibians.

[Dermatophytoses due to domestic animals]

Dermatophytoses are superficial skin infections due to dermatophytes which are filamentous fungi. Some dermatophytes can be hosted by domestic animals. In Belgium, Microsporum canis, Trichophyton (T.) mentagrophytes variety mentagrophytes, T. verrucosum and T. equinum are zoophilic species capable of infecting humans. Animals, clinical aspects in humans and the investigations needed will be reviewed. Treatment should target animal and patient but also limit the spread of the infection. Topical therapy is sufficient in cases restricted to the skin. When hair is involved, systemic treatment becomes mandatory. The withdrawal of griseofulvin from the Belgian market more than two years ago has made it necessary to introduce the mode of use of the newer antifungals such as fluconazole, Itraconazole and terbinafine.

[Tropical cutaneous mycoses]

In the field of cutaneous mycoses, some are cosmopolitan and others keep a geographical territory of predilection. Such a fact is bound to the fungus identity and natural biotope, and to the overall quality of public health in the region under consideration. Some of the tropical mycoses of cutaneous origin remain superficial in extension. Others are semi invasive or are even at risk of systemic dissemination.

Presence of keratinophilic fungi with special reference to dermatophytes on the haircoat of dogs and cats in México and Nezahualcoyotl cities

In order to study the presence of keratinophilic fungi with special reference to dermatophytes on the coat of dogs and cats living in the cities of Mexico and Nezahualcoyotl in the Metropolitan area of Mexico City, two hundred samples were collected from dogs and one hundred from cats by using the MacKenzie's tooth brush technique, they were processed by routine mycological methods for dermatophyte fungi, results were analyzed by means of the statistical packages SAS. There were isolated 67 and 90 keratinophilic strains from cats and dogs samples, respectively. The most commonly fungi isolated in pure culture in this study were Chrysosporium spp (25%), followed by Trichophyton terrestre (22%), Microsporum gypseum (5%), M. canis (4%), as well as mixed cultures like Chrysosporium spp. & M. gypseum (2%) and T. terrestre & T. mentagrophytes (1%). Keratinophilic fungi were found in higher numbers in the cat haircoat (67%) than in the dog's (45%) and the same was true with regard to dermatophytes with 12 isolates out of a 100 samples in cats and 7 Isolates out of 200 samples from dogs. This may represent a health risk for humans in contact with a dermatophyte infected cat or dog.

[Farm animals as disease vectors of parasitic epizoonoses and zoophilic dermatophytes and their importance in dermatology]

Different pest arthropods and dermatophytes occurring primarily in farm animals may be transmissible to man and produce human dermatoses. The movement and cutaneous penetration habits of external parasites often cause crusted papules, severe itching and dermatitis or may damage their hosts by blood-sucking or by sensitizing them to their saliva. Furthermore different dermatophytes should be considered a possible cause of human skin lesions. Farm animals (cattle, pig, poultry, and rabbit) can transmit external parasites (ticks: Ixodes ricinus, Argas reflexus; fleas: Ceratophyllus gallinae, Spilopsyllus cuniculi, and mites: Sarcoptes scabiei var. bovis, Sarcoptes scabiei var. suis, Dermanyssus gallinae, Cheyletiella parasitovorax), and dermatophytes (Trichophyton sp., and Microsporum sp.). People who have close contact to infested farm animals are more often exposed to epizoonotic infections. Certain professions, such as farmers, and veterinarians, are especially vulnerable.

Parasitic relationship between Microsporum canis and the cat

Cats are often cited as reservoirs of M. canis but it is questionable whether M. canis is part of the resident flora of the cat's skin and hair or only a transient organism. Studies indicate that M. canis is most often isolated from cats at risk of infection or exposure from other infected cats or from a contaminated environment. Many more cats are culture-positive for M. canis than have dermatophytosis. Culture isolation alone is not an indication of dermatophytosis; the diagnosis of dermatophytosis requires microscopic evidence of infection as well as culture evidence of the presence of the dermatophyte. The cat's hair coat adopts the culture image of its surroundings. Diverse factors may influence the frequency of isolation of M. canis. Nevertheless, isolation of M. canis implies either active disease or fomite carriage and warrants aggressive investigation of the clinical situation.

[Dermatomycosis in human and animals]

Dermatomycosis including dermatophytosis, sporotrichosis and cryptococcosis commonly occurs in humans and animals all and are considered to be zoonotic diseases. Recently, human cases of dermatophytosis transmitted from animals are increasing in number due to changes in the environments of human and animal life. Three species of dermatophytes, Microsporum canis, Trichophyton mentagrophytes and T. verrucosum are the most important pathogens from animal to human, respectively. Therefore, it is necessary to understand their biological and ecological characteristics to correctly diagnose and treat the disease. Some human cases of sporotrichosis and cryptococcosis were reported to be transmitted from animals in Europe and America, suggesting that medical doctors should be careful in taking the history of human patients with reference to their contacts with animals. Close cooperation between medical and veterinary doctors is required in clinical studies on mycotic infection.

Experimental exposure of Canadian toads to Basidiobolus ranarum

Experimental transmission of the fungus Basidiobolus ranarum was induced in two treatment groups of Canadian toads (Bufo hemiophrys) and caused a fatal mycotic dermatitis. Seven of 10 (70%) toads that had their ventral skin mildly abraded and exposed to B. ranarum developed hyperemia, and sloughing of their ventral skin and died. Toads with abraded ventral skin or exposure to infected skin also were affected statistically at a higher rate than those with abraded skin and exposure to pure cultures of B. ranarum inoculated into their water source. Of toads showing clinical disease, B. ranarum was identified by both impression smears and histology in all cases, but not from toads that appeared clinically healthy. The organism was cultured from 5 of 7 (71%) toads with clinical disease but not from any toad that appeared clinically healthy (n = 28). This study documents methods of experimental transmission of B. ranarum, an organism responsible for causing a mycotic dermatitis that is fatal to toads.

Occurrence of dermatomycosis (ringworm) due to Trichophyton verrucosum in dairy calves and its spread to animal attendants

Persistent dermatomycosis (ringworm) caused by Trichophyton verrucosum affected 20 dairy calves aged between 3 months and 1 year and housed together. The infection also spread to 2 animal attendants working among the calves. The major clinical lesions observed on the affected calves were extensive alopecia and/or circumscribed thick hairless skin patches affecting the head, neck, flanks and limbs. The observed lesions persisted for more than 17 weeks and most of the calves did not respond to topical treatment with various anti-fungal drugs within the anticipated period of 9 weeks. Two animal attendants developed skin lesions that were circumscribed and itchy and there was good response to treatment following the application of anti-fungal skin ointment. Although ringworm in dairy animals in Kenya has not previously been associated with spread to humans, the potential is evident from this report.

[Cutaneous zoonoses transmitted by dogs and cats]

Pets like dogs and cats are responsible for a series of zoonotic disorders. Some of these diseases are inflicted by bites, scratches or licking. Others result from a close contact with fur, or are transmitted by ectoparasites or by the contaminated environment. Some systemic infectious and parasitic diseases are transmitted from animals to humans and vice versa. Such situation may lead to endemic problems in some communities.

Cutaneous manifestations of Paecilomyces lilacinus infection induced by a contaminated skin lotion in patients who are severely immunosuppressed

BACKGROUND

New opportunistic fungal infections cause significant morbidity and death in patients who are severely immunocompromised. Cutaneous lesions may be the first clinical manifestation and give the clue to early diagnosis.

OBJECTIVE

The purpose of this study was to describe the clinical and histologic manifestations of Paecilomyces lilacinus infection in patients who are severely immunosuppressed.

METHODS

Within a 3-month period, we observed 5 patients with allogenic bone marrow transplantation and 4 patients with aplasia after chemotherapy for hematologic malignancies who developed skin eruptions caused by invasive P lilacinus.

RESULTS

The skin lesions began in 7 cases during or shortly after recovery of pancytopenia. Most of the skin lesions were located on the lower extremities. The cutaneous manifestations were highly variable including erythematous macules, nodules, pustules, vesicular lesions, and necrotic crusts. In 3 biopsy specimens, histologic examination revealed hyphae in periodic acid-Schiff-stained sections. In all patients P lilacinus was isolated from skin tissue samples. P lilacinus was identified from all lesions either by skin biopsy or needle aspiration from clinically evident lesions. In 3 additional cases, the patient's hands were colonized without skin lesions. The source of the epidemic outbreak was finally traced down to several contaminated lots of a topical moisturizing agent. Two patients died; one patient had septic lesions in the eye and kidney as the result of P lilacinus.

CONCLUSION

Clinical and histologic findings of P lilacinus infection with cutaneous manifestations in patients who are severely immunosuppressed are summarized. P lilacinus is resistant to all systemic antimycotics available, and in general, recovery of immunosuppression is necessary to eradicate the mold. Contaminated topical dermatologic agents should be included in the differential diagnosis as a source for severe epidemic cutaneous manifestations of fungal infection in patients who are severely immunosuppressed. This fact implies that additional safety guidelines are necessary for topical dermatologic agents used for patients who are severely immunosuppressed.

[Zoophilic dermatophytes as epizoonoses pathogens and their significance to dermatology]

Different dermatophytes occurring primarily in animals may be transmissible to man and produce human disease; such zoophilic fungi should be considered a possible cause of skin lesions of unclear origin. Several species including Trichophyton verrucosum, Trichophyton mentagrophytes and Microsporum canis may infect human skin, causing a variety of signs and symptoms. People who have close contact to infested cattle or cats are more often exposed to fungal infections. Certain professions, such as farmers, and children are especially vulnerable. Finally, less common ways of transmission of dermatophytoses from other animal species to man are discussed.