ISSN 2398-2950      

Saprophytic fungi (Phaeohyphomycosis / Hyalohyphomycosis)

ffelis

Synonym(s): For Hyalohyphomycosis and Phaeohyphomycosis both: Mold, Mycetoma, Fungal granuloma, Opportunistic fungal infection, Saprophytic fungi, Soil fungi, Yeast infection. For Phaeohyphomycosis alone: Black fungi, Black mold, Black yeast, Chromomycosis, Dematiaceous fungi.


Introduction

Classification

Taxonomy

  • Phylum: Ascomycota (Classes Ascomycetes and Deuteromycetes). 
  • Order: three orders are included among the dematiaceous fungi: Chaetothyriales, Pleosporales, Ochroconiales. The majority of the clinically relevant species fall within the Chaetothyriales order. 
  • Family: Herpotrichiellaceae.  
  • Over a hundred species so far associated with phaeohyphomycosis and hyalohyphomycosis in humans and animals.  
  • Pathogens causing phaeohyphomycosis Phaeohyphomycosis and Hyalophyphomycosis in dogs and cats include species from Alternaria, Bipolaris, Cladophialophora and Curvularia genera. Genera with species causing disease in cats, but not in dogs, are Exophiala, Fonsecaea, Macrophomina, Microsphaerosis, Moniliella, Phialophora, Phoma, Scolecobasidium and Stemphylium.  
  • Genera with species causing hyalohyphomycosis in cats (and other mammals) include Fusarium, Acremonium, Paecilomyces, Pseudallescheria, Sagemonella, Phialosimplex and Scedosporium. 

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Clinical Effects

Epidemiology

Habitat

  • Ubiquitous in the environment.
  • Saprophytic soil fungi.
  • Worldwide. 
  • Most common in hot, humid climates. 

Transmission

  • Implanted by trauma (eg wood splinter, soil contamination of open wounds). 
  • More rarely by inhalation. 
  • Hematogenous spread to internal organs possible. 
  • Not transmitted between animals or from animals to humans. 

Pathological effects

  • Cutaneous or subcutaneous lesions .
  • Nodules - often on the face or limbs - can be ulcerated with draining tracts.
  • Fungal pigmentation may be evident in affected tissues.
  • Also cerebral involvement associated with abscess formation, presenting with CNS signsation. 
  • Generalized systemic disease may also occur, presenting as effusions, solid masses, pneumonia. 
  • While most case reports did not feature immunosuppressed FeLV or FIV positive cats, cats who are immunosuppressed are likely to be more severely affected.

Control

Control via animal

  • A combination of surgery and chemotherapy can be used in local infection: prognosis guarded.
  • Prognosis in CNS disease and generalized systemic disease is very poor. 

Control via chemotherapies

  • Itraconazole Itraconazole 10 mg/kg per os q24h. 
  • Posaconazole 5 mg/kg per os q24h. 
  • Fluconazole Fluconazole 2.5 -10 mg/kg per os q12h.
  • Voriconazole 4.2 mg/kg per os q24h. 
  • Ketoconazole Ketoconazole 10 mg/kg per os q12h.  
  • Amphotericin B Amphotericin B 0.25 mg/kg q48h IV to a total dose of 4–16 mg/kg. 

Other countermeasures

  • Surgical excision with wide margins.
  • Topical anti-fungal treatments: 

Diagnosis

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Rahimi T, Mohammadi R (2020) Identification of Dermatophyte and Nondermatophyte Molds Isolated from Animal Lesions Suspected to Dermatomycoses. Adv Biomed Res 9,4 PubMed
  • Daly JA, Hubka V, Kubátová A, Gimeno M, Barrs V R (2019) Feline disseminated cutaneous phaeohyphomycosis due to Exophiala spinifera. Med Mycol Case Rep 27, 32-35 PubMed.   
  • Velázquez-Jiménez Y, Hernández-Castro R, Romero-Romero L, Salas-Garrido C G, Martínez-Chavarría L C (2019) Feline Phaeohyphomycotic Cerebellitis Caused by Cladosporium cladosporioides-complex: Case Report and Review of Literature. J Comp Pathol 170, 78-85 PubMed
  • Brooks I J, Walton S A, Shmalberg J, Harris A (2018) Novel treatment using topical malachite green for nasal phaeohyphomycosis caused by a new Cladophialophora species in a cat. JFMS Open Rep 4(1), 2055116918771767 PubMed.  
  • Leao A C, Weiss V A, Vicente V A, Costa F, Bombassaro A, Raittz R T, Steffens M B, Pedrosa F O, Gomes R R, Baura V, Faoro H, Sfeir M Z, Balsanelli E, Moreno L F, Najafzadeh M J, de Hoog S, Souza E M (2017) Genome Sequence of Type Strain Fonsecaea multimorphosa CBS 980.96T, a Causal Agent of Feline Cerebral Phaeohyphomycosis. Genome Announc 5(7), e01666-16 PubMed.  
  • Overy D P, Martin C, Muckle A, Lund L, Wood J, Hanna P (2015) Cutaneous Phaeohyphomycosis Caused by Exophiala attenuata in a Domestic Cat. Mycopathologia 180(3-4), 281-287 PubMed.  Erratum in: Mycopathologia 180(3-4), 289.
  • Russell E B, Gunew M N, Dennis M M, Halliday C L (2016) Cerebral pyogranulomatous encephalitis caused by Cladophialophora bantiana in a 15-week-old domestic shorthair kitten. JFMS Open Rep 2(2), 2055116916677935 PubMed
  • Seyedmousavi S, Netea M G, Mouton J W, Melchers W J G, Verweij P E, de Hoog G S (2014) Black yeasts and their filamentous relatives: principles of pathogenesis and host defense. Clin Microbiol Rev 27, 527-542 PubMed.  
  • Sugahara G, Kiuchi A, Usui R, Usui R, Mineshige T, Kamiie J, Shirota K (2014) Granulomatous pododermatitis in the digits caused by Fusarium proliferatum in a cat. J Vet Med Sci 76(3), 43543-43548 PubMed
  • Miller R I (2010) Nodular granulomatous fungal skin diseases of cats in the United Kingdom: a retrospective review. Vet Dermatol 21(2), 130-135 PubMed
  • Quimby J M, Hoffman S B, Duke J, Lappin M R (2010) Adverse neurologic events associated with voriconazole use in 3 cats. J Vet Intern Med 24(3), 647-649 PubMed.  
  • Dye C, Johnson E M, Gruffydd-Jones T J (2009) Alternaria species infection in nine domestic cats.  J Feline Med Surg 11, 332-336 PubMed.
  • Abramo F, Bastelli F, Nardoni S, Mancianti F (2002) Feline cutaneous phaeohyphomycosis due to Cladophyalophora bantiana. J Feline Med Surg 4(3), 157-163 PubMed.    
  • Mariani C L, Platt S R, Scase T J et al (2002) Cerebral phaeohyphomycosis caused by Cladosporium spp. in two domestic shorthair cats. J Am Anim Hosp Assoc 38 (3), 225-230 PubMed.
  • Halaby T, Boots H, Vermuelen A, Van Der Ven A, Beguin H, Van Hooff H, Jacobs J (2001) Phaeohyphomycosis caused by Alternaria infectoria in a Renal Transplant Recipient. J Clin Microbio 1952-1955 PubMed
  • McKay J S, Cox C L & Foster A P (2001) Cutaneous alternariosis in a cat. J Small Anim Pract 42 (2), 75-78 PubMed.
  • Dhein C R, Leathers C W, Padhye A A, Ajello L (1988) Phaeohyphomycosis caused by Alternaria alternata in a cat. J Am Vet Med Assoc 193(9), 1101-1103 PubMed

Other Sources of Information

  • Miller W H, Griffin C E, Campbell K L (2013) Muller and Kirk’s Small Animal Dermatology. 7th edition. St Louis, MO: Elsevier Mosby, pp 244-245.
  • Reviews:
    • Lloret A, Hartmann K, Pennisi M G, Ferrer L, Addie D, Belák S, Boucraut-Baralon C, Egberink H, Frymus T, Gruffydd-Jones T, Hosie M J, Lutz H, Marsilio F, Möstl K, Radford A D, Thiry E, Truyen U, Horzinek M C (2013) Rare systemic mycoses in cats: blastomycosis, histoplasmosis and coccidioidomycosis: ABCD guidelines on prevention and management. J Feline Med Surg 15(7), 624-637 PubMed
    • Lloret A, Hartmann K, Pennisi M G et al (2013) Rare opportunistic mycoses in cats: phaeohyphomycosis and hyalohyphomycosis: ABCD guidelines on prevention and management. J Feline Med Surg 15 (7), 628-630 PubMed.
    • Grooters A M & Foil C S (2006) Miscellaneous fungal infections. In: Greene CE (ed). Infectious diseases of the dog and the cat. 3rd ed. St Louis.Saunders Elsevier. pp 637.

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