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Chromomykose/Chromoblastomykose

Zuletzt geändert von Thomas Brinkmeier am 2025/04/25 20:42

Chromomykose/Chromoblastomykose

Pg: Infektion durch verschiedene Spezies schwarzer Schimmelpilze über Hautverletzungen

Err: - Fonsecaea pedrosoi

Bed: Haupterreger

- Phialophora

- Exophalia

- Cladosporium carionii

- Wangiella dermatitidis

Vork: Tropen (ländliche Bezirke)

Lok: Prädilektionsstelle: untere Extremität

KL: verruköse krustöse Plaques oder bräunliche Knoten, die an der Oberfläche schwärzliche Pünktchen (Myzelklumpen mit Melaninbildung) aufweisen

Di: - Nativpräparat

Meth: Materialentnahme aus den o.g. schwarzen Pünktchen

- Pilzkultur

Hi: - Granulome mit Fremdkörperriesenzellen

- transepidermale Ausschleusung der Pilzelemente

Prog: meist Beschränkung auf Haut

Kopl: - Mutilationen sind häufig

- selten Dissemination in andere Organe

Lit:  

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Th: - Chirurgie

Altn: - Kryotherapie

- Wärmetherapie

Meth: 44-46 °C kontinuiertlich über mehere Wochen

- Laserbehandlung nach lokaler Hitzeapplikation

Lit: J Eur Acad Dermatol Venerol 2001; 16: 273-5

PT: CR

Co: manuelle oder apparative Lymphdrainage

- Itraconazol

Dos: 100-200 mg/Tag

Altn: - Amphotericin B

Co: 5-Fluorocytosin

Neg: ausgeprägte NW

- Terbinafin

  
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