Two Autopsy Cases of Chromomycosis

概要

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Case 1) 29-year-old female. The lesion arised as a verrucous to papillomatous proliferation on her right leg when she was twelve years old. Phialophora verrucosa was isolated but surgical exision could not stop its spreading. Metastatic lesions appeared repeatedly on scalp, nose, pharynx and cervical lymph-nodes. She died of cachexia due to generalized skin lesions with lymphnode metastasis. On autopsy, however, there was no metastasis to brain or visceral organs.Case 2) A 34-year-old female received craniotomy because of increasing headache and diplopia which suggested the presense of intracranial tumors. Multiple spherical, gray to dark brown nodules were seen scattered in the brain tissue. Histological examination revealed numerous brown fungal spores and hyphae in necrotic area surrounded by grsanulomatous reaction and Phialophora pedrosoi was isolated. The patient was treated with oral administration of 5-Fluorocytosine with temporary improvement, though she later died of bronchopneumonia. On autopsy, multiple fungus granulomata were seen in the brain and also in the kidney but there were no skin or mucous membrane lesions.Chromomycosis cases with metastatic lesions to other than skin reported in Japan were summarized and relatively frequent occurence of metastasis to visceral organs including the brain were shown comparing them with those of tropical or subtropical areas.
日本医真菌学会の論文