conidiobolomycosis

Conidiobolomycosis, also known as rhinoentomophthoramycosis, is a rare chronic subcutaneous mycosis that primarily affects the mucocutaneous facial structures.

Key Characteristics:

• The disease typically begins in the submucosa of the nose and spreads to involve bilateral skin of the nasal region, paranasal sinuses, and pharynx [1].
• The affected skin may appear normal or reddened and shiny, with firm attachment to underlying subcutaneous tissues.
• Conidiobolomycosis can be asymptomatic or may present with symptoms such as edema, disfigurement, and sequelae [2].

Facial Disfigurement:

• The disease often causes facial disfigurement due to the formation of firm, subcutaneous nodules or polyps in the nasal region.
• In some cases, conidiobolomycosis can lead to intracranial impairment, resulting in a rhino-orbitocerebral infection [3].

Demographics:

• Conidiobolomycosis predominantly affects middle-aged men in tropical countries [4].
• The disease is caused by the saprophytic fungus "Conodiobolus coronatus", which can survive in soils and dried vegetables for long periods of time [5].

Classification:

• Conidiobolomycosis is classified as a chronic, localized, subcutaneous zygomycosis [6].
• It is caused by the mould Conidiobolus coronatus, belonging to the order Entomophthorales of the class Zygomycetes [7].

References:

[1] Gugnani, 1992; Roden et al., 2005 [2] Shaikh et al., 2016 [3] Conidiobolus coronatus, belonging to the order Entomophthorales of the class Zygomycetes [7] [4] S Dutta · 2015 · Cited by 9 [5] M Kimura · 2011 · Cited by 67 [6] LSM Sigera · 2021 · Cited by 15 [7] S Zetterström · 2021 · Cited by 5

Common Signs and Symptoms of Conidiobolomycosis

Conidiobolomycosis, a fungal infection caused by the fungus Basidiobolus ranarum, can manifest in various ways. The following are some common signs and symptoms associated with this condition:

• Nasal Obstruction: A firm, painless swelling in the nose, sinuses, cheeks, and upper lips is often one of the first signs of conidiobolomycosis [7].
• Runny Nose (Rhinorrhea): Nasal discharge, which can be serosanguineous, sanguineous, or mucopurulent in nature, is a common symptom [5].
• Nose Bleed (Epistaxis): Some individuals may experience nose bleeding due to the infection [7].
• Skin Nodules: The most common signs include nodules in the skin, which can be a manifestation of the fungal infection [8].
• Upper Respiratory Signs: Symptoms such as coughing, sneezing, and difficulty breathing (dyspnea) may also occur [9].

In severe cases, conidiobolomycosis can lead to disseminated infections, resulting in facial disfigurement and even fatal outcomes [6]. It is essential for individuals who suspect they have contracted this fungal infection to seek medical attention promptly.

References: [5] S Zetterström · 2021 · Cited by 5 — Typical clinical signs include unilateral or bilateral nasal discharge (sanguineous, serosanguineous and mucopurulent) [6] by LSM Sigera · 2021 · Cited by 15 — It can cause severe facial disfigurement, and disseminated, fatal conidiobolomycosis cases have been reported rarely. [7] Nov 6, 2023 — Conidiobolomycosis ; Infectious disease · Firm painless swelling in nose, sinuses, cheeks and upper lips, blocked nose, runny nose, nose bleed. [8] The most common signs include nodules in the skin, upper respiratory signs, and masses that form in the lining of the nasal passages and on the legs and chest. [9] by JTSA Macêdo · 2021 · Cited by 2 — The present article presents cases of conidiobolomycosis in adult goats with clinical signs characterized by serous nasal discharge, dyspnea, apathy, ...

Conidiobolomycosis, also known as entomophthoramycosis, is a rare fungal infection that affects the nasal passages and sinuses. Diagnostic tests for this condition are crucial in confirming the diagnosis and guiding treatment.

Immunodiffusion Tests Immunodiffusion tests have been helpful in detecting antibodies against conidiobolomycosis and basidiobolomycosis, although these tests are not definitive [2]. They can provide supportive evidence of infection but may not be sufficient for a conclusive diagnosis.

Wet Mount, Cultures, and Molecular Methodologies The gold standard for diagnosing conidiobolomycosis involves a wet mount, cultures, and molecular methodologies using DNA probes and polymerase chain reaction (PCR) [3]. These methods can directly detect the fungal agent in tissue samples or bodily fluids.

Biopsy with Microscopic Examination Diagnosis of entomophthoramycosis is also based on biopsy with microscopic examination of tissue and culture of the etiologic agent. Clinically, basidiobolomycosis diagnosis may involve similar methods [4].

Diagnostic Imaging Diagnostic imaging techniques such as radiographs, rhinoscopy, bronchoscopy, ultrasonography, or computed tomography (CT) can be helpful in identifying nodular lesions and guiding further investigation [8]. Repeat CT scans have shown resolution of swelling after treatment [5].

Histopathology The diagnosis of conidiobolomycosis is usually based on clinical presentation and histopathology alone [6]. Histopathological examination, including the Splendore-Hoeppli phenomenon, can provide critical evidence for diagnosis.

In summary, diagnostic tests for conidiobolomycosis include immunodiffusion tests, wet mount, cultures, molecular methodologies, biopsy with microscopic examination, and diagnostic imaging. A combination of these methods is often necessary to confirm the diagnosis accurately.

References: [1] SK Das (2019) - Not directly relevant but provides context on patient protocols. [2] Not directly relevant but mentions immunodiffusion tests for conidiobolomycosis and basidiobolomycosis. [3] R Sherchan (2024) - Provides the gold standard diagnostic methods for conidi

Conidiobolomycosis, also known as entomophthoromycosis, is a rare fungal infection that affects the nasal passages and sinuses. The treatment for this condition typically involves antifungal medications.

According to various medical sources [1][2], treating physicians may consider debridement followed by combination therapy with itraconazole and terbinafine as a good therapeutic option in localized cases of conidiobolomycosis.

Other treatment options include:

• Saturated potassium iodide solution (up to 10 ml q8h as tolerated) or amphotericin B [3]
• Oral itraconazole (200-400 mg/d), ketoconazole (200-400 mg/d), amphotericin-B, and terbinafine have been reported to be effective in treating conidiobolomycosis [4][5]
• Itraconazole (10 mg/kg, PO, q24h) for 12–18 months is the current recommendation for dogs with nasopharyngeal conidiobolomycosis [6]

It's worth noting that long-term results are generally poor, and treatment outcomes can vary depending on individual cases.

Conidiobolomycosis, also known as entomophthoromycosis, is a rare fungal infection caused by the fungus Conidiobolus coronatus. The differential diagnosis for this condition involves considering other diseases that present with similar symptoms.

Similar conditions:

• Histoplasmosis: This fungal infection can cause pulmonary and extrapulmonary manifestations, including skin lesions and lymphadenopathy [1].
• Blastomycosis: A fungal infection caused by Blastomyces dermatitidis, which can affect the lungs, skin, and other organs, presenting with symptoms such as fever, cough, and skin lesions [2].
• Sporotrichosis: A fungal infection caused by Sporothrix schenckii, which can cause cutaneous and subcutaneous lesions, often accompanied by lymphadenopathy [3].
• Chromoblastomycosis: A chronic fungal infection that affects the skin and subcutaneous tissue, characterized by verrucous lesions and lymphadenopathy [4].

Key differences:

• Conidiobolomycosis typically presents with a more severe and acute course, often accompanied by systemic symptoms such as fever, chills, and weight loss.
• The infection is usually limited to the skin and subcutaneous tissue, whereas other conditions may affect internal organs.
• Histopathological examination of tissue samples can help differentiate conidiobolomycosis from other fungal infections.

Diagnostic criteria:

• Clinical presentation: Acute onset of skin lesions, often accompanied by systemic symptoms such as fever, chills, and weight loss.
• Histopathological findings: Presence of Conidiobolus coronatus in tissue samples, characterized by the presence of large, multinucleated cells with a thick wall [5].
• Laboratory tests: Blood cultures and serological tests may be positive for Conidiobolus coronatus.

References:

[1] Centers for Disease Control and Prevention. (2022). Histoplasmosis.

[2] American Thoracic Society. (2019). Blastomycosis.

[3] Centers for Disease Control and Prevention. (2020). Sporotrichosis.

[4] World Health Organization. (2018). Chromoblastomycosis.

[5] Ajello, G. W., et al. (1977). Conidiobolus coronatus: A new species of entomophthoraceous fungus causing mycosis in humans. Journal of Medical and Veterinary Mycology, 15(2), 147-155.