From Big Medical Encyclopedia

MOULD MYCOSES (grech, mykes a mushroom) — group of fungus diseases of the person and the animals called by mold fungi of the Mucoraceae family and other families.

Many mold fungi, eurysynusic in the nature as saprophytes, under certain conditions, napr, during the weakening of protective forces of an organism, can become the reason of development of mycoses. P.'s distribution m, according to a number of researchers, is promoted by broad use of antibiotics, corticosteroid drugs and tsitostatik. At the same time defeats by mold fungi arise as an endogenous way (fungi from saprophytes turn into pathogenic), and exogenous (fungi get into an organism of the owner from the outside).

Wedge, P.'s manifestations m vary over a wide range. Mold fungi can affect skin, nails, internals, bone system. Most of researchers, e.g. Konant (N. F. Conant, 1971), Emmons (Page W. Emmons, 1977), Koch (N. of Koch, 1981) consider inexpedient to allocate group P. of m and describe defeats by fungi according to localization — otomycoses (see), pneumomycoses (see), mycotic keratitis (see) or allocate independent nozol, forms depending on the activator which caused P. of m — aspergillosis (see), tsefalosporioz (see), mycetomas of gribnovy genesis (see. Madura foot ), akaulioz skin (see), akladioz skin (see), peniciliosis (see), and also allesheriaz, geotrichosis (conditionally), mukoroz, skopulyariopsioz.

Allesheriaz (allescheriasis; a synonym petriyellidoz) — the mycosis caused by Allescheria boydii Sher or a perfect form of a fungus — Mopo-sporium of apio spermum. Fungi strike feet, both soft tissues, and a bone tissue more often; process proceeds with the expressed destructive changes, abscessing, formation of fistulas (see. Madura foot ).

Geotrichosis (geotrichosis) — the mycosis caused by yeast-like fungi of the sort Geotrichum is more often than G. candidum. As well as at candidiasis, mucous membranes of an oral cavity, genitalias, a bladder, and also lungs, bronchial tubes, intestines are surprised. On skin can be, though it is rare, the ulcer, pustular centers. Allocation of culture of a fungus specifies the diagnosis.

Mukoroz (Mucorosis; synonym: a mucoromycosis, zigomikoz, fikomikoz) — the rare chronically proceeding mycosis caused by different types of mold fungi from this. Mi-sogaseaye, the sorts Mucor, Phizopus and Absidia, at Krom are surprised skin, including hypodermic cellulose, ears, eyes, a respiratory organs and c. N of page. The disease is for the first time described by Paltauf (A. Paltauf, 1885), in Russia — R. S. Klisich (1899). Usually develops for the second time at the persons suffering from chronic debilitating diseases (a severe form of a diabetes mellitus, a disease of blood, malignant new growths). At the same time in the struck fabrics slight inflammatory reaction in the form of leukocytic and lymphocytic infiltration with considerable number of eosinophils, necrotic changes, sometimes abscessing is observed. Necroses and heart attacks of internals develop as a result of thromboses of the vessels arising owing to germination by fungi of their walls. The ascending blood clots of arteries of lungs, eye-sockets and adnexal bosoms of a nose can lead to damage of a brain, sometimes with a lethal outcome. A wedge, manifestations of a mukoroz have no specifics. On skin of fingers of brushes, e.g., there can be indistinctly limited sites of infiltration, opacification of nail plates with free and side edges, and also a hyperemia and a peeling of skin of outside acoustical pass is possible, during the involvement in process of a middle ear purulent discharges appear. At a mukoroza of lungs focal pneumonia quite often with allocation of a hemorrhagic phlegm is observed; owing to hematogenous innidiation from the centers in lungs, a mucous membrane of an oral cavity, a nose and a nasopharynx the c is surprised. N of page. The gullet, a stomach, a small bowel can be involved in process; at the same time diffusion peritonitis develops. Generalized mukoroz, usually beginning with primary center in lungs or other localization, leads to bystry death of the patient.

Skopulyariopsioz (scopulariopsio-sis) — chronically proceeding mycosis caused by a mold fungus of Scopulariopsis brevicaulis. Patol. changes of fabrics at it are not specific and practically do not differ from those at an aspergillosis and peniciliosis (see). Fungi often strike nail plates, especially thumbs of feet — nails get yellowish-green or even black coloring, are thickened with front or side edges, easily break off and crumble. Damages of skin are observed seldom, characterized by a slight hyperemia, cracks, a peeling and can remind superficial or deep trichophytosis (see). Perhaps defeat is deeper than the located fabrics in a look inf. granulomas, and also internals.

The diagnosis of the mycoses caused by mold fungi on the basis a wedge, pictures is complicated and shall be confirmed with repeated obtaining the same culture of a mold fungus throughout a long time, and also detection (repeatedly) certain type of a fungus in patol, material (pus from abscesses, the closed cavities, gistol, a research of the fabrics received at a biopsy).

Differential diagnosis of P. of m is carried out with hron, pyoderma (see), actinomycosis (see), panniculitis (see), a tuberculosis cutis (see. Tuberculosis extra pulmonary ), other mycoses; at the same time, except a wedge, manifestations, major importance in differential diagnosis has allocation of the activator.

Treatment generalized forms P. of m is developed insufficiently; use intravenous administration of Amphotericinum In, inhalations of sodium salts of nystatin and levorinum. Inside apply Mycoheptinum, amfoglyukamin, the drugs raising immunol, reactivity of an organism; outwardly — aniline dyes, 1% solution of liquid of Castell-@, pimafukort.

Forecast at localized (especially on skin) forms of defeat favorable; visceral, generalized forms of defeat at the mycoses caused by mold fungi proceed, as a rule, hard and quite often with a lethal outcome.

Prevention includes fight against dust content of rooms, a close check behind use of antibiotics, corticosteroid drugs, routine maintenances of the population.

See also Mycoses .

Bibliography: Cat's P. N. and Shek varnishes N. D. Guide to a medical mycology, page 233, M., 1978; Kashkin P. N., Hokhryakov M. K. and Cat's A. P. Opredelitel of mushrooms, pathogenic, toxicogenic and harmful to the person, JI., 1979; Bader G. Die viszera-len Mykosen (Pathologie, Klinik und Therapie), Jena, 1965, Bibliogr.; EmmonsCh. W. a. o. Medical mycology, Philadelphia, 1977.

H. D. Sheklakov.