Phycomycosis
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Phycomycosis is an uncommon condition of the gastrointestinal tract and
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different de ...
most commonly found in
dog The dog (''Canis familiaris'' or ''Canis lupus familiaris'') is a domesticated descendant of the wolf. Also called the domestic dog, it is derived from the extinct Pleistocene wolf, and the modern wolf is the dog's nearest living relative. Do ...
s and
horse The horse (''Equus ferus caballus'') is a domesticated, one-toed, hoofed mammal. It belongs to the taxonomic family Equidae and is one of two extant subspecies of ''Equus ferus''. The horse has evolved over the past 45 to 55 million yea ...
s. The condition is caused by a variety of
mold A mold () or mould () is one of the structures certain fungi can form. The dust-like, colored appearance of molds is due to the formation of spores containing fungal secondary metabolites. The spores are the dispersal units of the fungi. Not ...
s and
fungi A fungus ( : fungi or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms. These organisms are classified as a kingdom, separately from ...
, and individual forms include pythiosis, zygomycosis, and lagenidiosis. Pythiosis is the most common type and is caused by ''
Pythium ''Pythium'' is a genus of parasitic oomycetes. They were formerly classified as fungi. Most species are plant parasites, but ''Pythium insidiosum'' is an important pathogen of animals, causing pythiosis. The feet of the fungus gnat are frequen ...
'', a type of
water mould Oomycota forms a distinct phylogenetic lineage of fungus-like eukaryotic microorganisms, called oomycetes (). They are filamentous and heterotrophic, and can reproduce both sexually and asexually. Sexual reproduction of an oospore is the r ...
. Zygomycosis can also be caused by two types of
zygomycetes Zygomycota, or zygote fungi, is a former phylum, division or phylum of the kingdom Fungi. The members are now part of two Phylum, phyla: the Mucoromycota and Zoopagomycotina, Zoopagomycota. Approximately 1060 species are known. They are mostly t ...
, ''
Entomophthorales The Entomophthorales are an order of fungi that were previously classified in the class Zygomycetes. A new subdivision, Entomophthoromycotina, has recently been circumscribed for them. Most species of the Entomophthorales are pathogens of ins ...
'' (such as '' Basidiobolus'' and ''
Conidiobolus ''Conidiobolus'' is a genus of fungi in order Entomophthorales. Some species were defined in ''Conidiobolus'' but then moved into other genera such as ''Capillidium'' and ''Batkoa''. This genus can cause a human infection known as conidiobolomy ...
'') and ''
Mucorales The Mucorales is the largest and best studied order of zygomycete fungi. Members of this order are sometimes called pin molds. The term mucormycosis is now preferred for infections caused by molds belonging to the order Mucorales. Systematics ...
'' (such as ''
Mucor ''Mucor'' is a microbial genus of approximately 40 species of molds in the family Mucoraceae. Species are commonly found in soil, digestive systems, plant surfaces, some cheeses like Tomme de Savoie, rotten vegetable matter and iron oxide re ...
'', ''
Mortierella ''Mortierella'' species are soil fungi belonging to the order Mortierellales within the subphylum Mortierellomycotina (phylum: Mucoromycota). The widespread genus contains about 85 species. Taxonomy The genus name of ''Mortierella'' is in hon ...
'', ''
Absidia ''Absidia'' is a genus of zygote fungi in the family Cunninghamellaceae. ''Absidia'' species are ubiquitous in most environments where they are often associated with warm decaying plant matter, such as compost heaps. Some species in the genus ...
'', ''
Rhizopus ''Rhizopus'' is a genus of common saprophytic fungi on plants and specialized parasites on animals. They are found in a wide variety of organic substances, including "mature fruits and vegetables", jellies, syrups, leather, bread, peanuts, and ...
'', ''
Rhizomucor ''Rhizomucor'' is a genus of fungi A fungus ( : fungi or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms. These organisms are cla ...
'', and ''
Saksenaea ''Saksenaea'' is a genus of fungi in the Saksenaeaceae family. First described in 1953, the genus contains two pathogen In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is ...
''). The latter type of zygomycosis is also referred to as
mucormycosis Mucormycosis, also known as black fungus, is a serious fungal infection that comes under fulminant fungal sinusitis, usually in people who are immunocompromised. It is curable only when diagnosed early. Symptoms depend on where in the body the ...
. Lagenidiosis is caused by a ''
Lagenidium ''Lagenidium'' is a genus of Oomycota Oomycota forms a distinct phylogenetic lineage of fungus-like eukaryotic microorganisms, called oomycetes (). They are filamentous and heterotrophic, and can reproduce both sexually and asexually. Sexu ...
'' species, which like ''Pythium'' is a water mould. Since both pythiosis and lagenidiosis are caused by organisms from the class
Oomycete Oomycota forms a distinct phylogenetic lineage of fungus-like eukaryotic microorganisms, called oomycetes (). They are filamentous and heterotrophic, and can reproduce both sexually and asexually. Sexual reproduction of an oospore is the resul ...
s, they are sometimes collectively referred to as oomycosis.


Pythiosis

Pythiosis is caused by ''
Pythium insidiosum ''Pythium insidiosum'' is a species of ''Pythium'' and a member of the class oomycota. ''Pythium insidiosum'' is mainly found in standing water and occasionally soil. Unlike most ''Pythium'' species, which are generally pathogens of terrestrial ...
'' and occurs most commonly in dogs and
horse The horse (''Equus ferus caballus'') is a domesticated, one-toed, hoofed mammal. It belongs to the taxonomic family Equidae and is one of two extant subspecies of ''Equus ferus''. The horse has evolved over the past 45 to 55 million yea ...
s, but is also found in
cat The cat (''Felis catus'') is a domestic species of small carnivorous mammal. It is the only domesticated species in the family Felidae and is commonly referred to as the domestic cat or house cat to distinguish it from the wild members of ...
s,
cattle Cattle (''Bos taurus'') are large, domesticated, cloven-hooved, herbivores. They are a prominent modern member of the subfamily Bovinae and the most widespread species of the genus ''Bos''. Adult females are referred to as cows and adult ma ...
, and humans. In the United States it is most commonly found in the Gulf states, especially
Louisiana Louisiana , group=pronunciation (French: ''La Louisiane'') is a state in the Deep South and South Central regions of the United States. It is the 20th-smallest by area and the 25th most populous of the 50 U.S. states. Louisiana is borde ...
, but has been found in midwest and eastern states. It is also found in
southeast Asia Southeast Asia, also spelled South East Asia and South-East Asia, and also known as Southeastern Asia, South-eastern Asia or SEA, is the geographical south-eastern region of Asia, consisting of the regions that are situated south of mainlan ...
, eastern Australia,
New Zealand New Zealand ( mi, Aotearoa ) is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and over 700 smaller islands. It is the sixth-largest island count ...
, and
South America South America is a continent entirely in the Western Hemisphere and mostly in the Southern Hemisphere, with a relatively small portion in the Northern Hemisphere at the northern tip of the continent. It can also be described as the sout ...
. Pythiosis occurs in areas with mild winters due to the organism surviving in standing water that does not reach freezing temperatures. ''Pythium'' occupies swamps in late summer and infects dogs who drink water containing it. The disease is typically found in young, large breed dogs. It is suspected that pythiosis is caused by invasion of the organism into wounds, either in the skin or in the gastrointestinal tract. The disease grows slowly in the
stomach The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...
and small intestine, eventually forming large lumps of
granulation tissue Granulation tissue is new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process. Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any siz ...
. It can also invade surrounding lymph nodes. Symptoms include vomiting, diarrhea, depression, weight loss, and a mass in the abdomen. Pythiosis of the skin in dogs is very rare, and appears as
ulcer An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...
ated lumps. Primary infection can also occur in the bones and lungs. In horses, subcutaneous pythiosis is the most common form and infection occurs through a wound while standing in water containing the pathogen. The disease is also known as leeches, swamp cancer, and bursatti. Lesions are most commonly found on the lower limbs, abdomen, chest, and genitals. They are granulomatous and itchy, and may be ulcerated or
fistula A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...
ted. The lesions often contain yellow, firm masses of dead tissue known as kunkers. It is possible with chronic infection for the disease to spread to underlying bone. In humans it can cause
arteritis Arteritis is the inflammation of the walls of arteries, usually as a result of infection or autoimmune response. Arteritis, a complex disorder, is still not entirely understood. Arteritis may be distinguished by its different types, based on the o ...
,
keratitis Keratitis is a condition in which the eye's cornea, the clear dome on the front surface of the eye, becomes inflamed. The condition is often marked by moderate to intense pain and usually involves any of the following symptoms: pain, impaired e ...
, and
periorbital The periorbita is the area around the orbit. Sometimes it refers specifically to the layer of tissue surrounding the orbit that consists of periosteum The periosteum is a membrane that covers the outer surface of all bones, except at the articu ...
cellulitis Cellulitis is usually a bacterial infection involving the inner layers of the skin. It specifically affects the dermis and subcutaneous fat. Signs and symptoms include an area of redness which increases in size over a few days. The borders of ...
. In cats pythioisis is almost always confined to the skin as hairless and edematous lesions. It is usually found on the limbs,
perineum The perineum in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. The perineum is the region of the body between the pubic symphysis (pubic arch) and the coccyx (tail bone), includi ...
, and at the base of the tail. Lesions may also develop in the
nasopharynx The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and above the oesophagus and trachea (the tubes going down to the stomach and the lungs). It is found in vertebrates and invertebrates, though its struct ...
. ''Pythium insidiosum'' is different from other members of the genus in that human and horse hair, skin, and decaying animal tissue are chemoattractants for its
zoospore A zoospore is a motile asexual spore that uses a flagellum for locomotion. Also called a swarm spore, these spores are created by some protists, bacteria, and fungi to propagate themselves. Diversity Flagella types Zoospores may possess one or ...
s, in addition to decaying plant tissue.


Zygomycosis

Zygomycosis usually is a disease of the skin, but can also occur in the sinuses or gastrointestinal tract. In humans it is most prevalent in immunocompromised patients (
HIV/AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ...
, the elderly, SCID, etc) and patients in acidosis (diabetes, burns), particularly after barrier injury to the skin or mucus membranes. Zygomycosis caused by ''Mucorales'' causes a rapidly progressing disease of sudden onset in sick or
immunocompromised Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that a ...
animals. ''Entomophthorales'' cause chronic, local infections in otherwise healthy animals. The important species that cause entomophthoromycosis are ''Conidiobolus coronatus'', ''C. incongruous'', and ''
Basidiobolus ranarum ''Basidiobolus ranarum'' is a filamentous fungus with worldwide distribution. The fungus was first isolated by Eidam in 1886. It can saprophytically live in the intestines of mainly cold-blooded vertebrates and on decaying fruits and soil. The fu ...
''. ''Conidiobolus'' infections of the upper respiratory system have been reported in humans, sheep, horses, and dogs, and ''Basidiobolus'' has been reported less commonly in humans and dogs. Horses are one of the most common domestic animals to be affected by entomophthoromycosis. ''C. coronatus'' causes lesions in the nasal and oral mucosa of horses that may cause nasal discharge or difficulty breathing. ''B. ranarum'' causes large circular nodules on the upper body and neck of horses. ''Entomophthorales'' is found in soil and decaying plant matter, and specifically ''Basidiobolus'' can be contracted from insects and the feces of reptiles or amphibians. Zygomycosis of the sinuses can extend from the sinuses into the orbit and the cranial vault, leading to rhinocerebral mucormycosis.


Lagenidiosis

The best known species of ''Lagenidium'' is ''
Lagenidium giganteum ''Lagenidium'' is a genus of Oomycota. It includes the now deregistered biological control agent '' Lagenidium giganteum''. Certain species can cause lagenidiosis Lagenidiosis is a type of infectious disease. The best known species of '' Lagen ...
'', a parasite of ''mosquito'' larvae used in
biological control Biological control or biocontrol is a method of controlling pests, such as insects, mites, weeds, and plant diseases, using other organisms. It relies on predation, parasitism, herbivory, or other natural mechanisms, but typically also i ...
of mosquitoes. Two different species cause disease exclusively in dogs: ''L. caninum'' and ''L. karlingii''. ''Lagenidium'' is found in the southeastern United States in lakes and ponds. Lagenidiosis causes progressive skin and subcutaneous lesions in the legs, groin, trunk, and near the tail. The lesions are firm nodules or ulcerated regions with draining tracts. Regional lymph nodes are usually swollen. Spread of the disease to distant lymph nodes, large blood vessels, and the lungs may occur. An
aneurysm An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall. Aneurysms may be a result of a hereditary condition or an acquired disease. Aneurysms can also be a nidus ( ...
of a
great vessel Great vessels are the large vessels that bring blood to and from the heart. These are: * Superior vena cava * Inferior vena cava * Pulmonary arteries * Pulmonary veins * Aorta Transposition of the great vessels is a group of congenital A b ...
can rupture and cause sudden death. ''L. caninum'' is the more aggressive species and is more likely to spread to other organs than ''L. karlingii''.


Diagnosis and treatment

Diagnosis is through
biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a dise ...
or
culture Culture () is an umbrella term which encompasses the social behavior, institutions, and norms found in human societies, as well as the knowledge, beliefs, arts, laws, customs, capabilities, and habits of the individuals in these groups ...
, although an
ELISA The enzyme-linked immunosorbent assay (ELISA) (, ) is a commonly used analytical biochemistry assay, first described by Eva Engvall and Peter Perlmann in 1971. The assay uses a solid-phase type of enzyme immunoassay (EIA) to detect the presen ...
test has been developed for ''Pythium insidiosum'' in animals. Treatment is very difficult and includes surgery when possible. Postoperative recurrence is common.
Antifungal drug An antifungal medication, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as Cryptoc ...
s show only limited effect on the disease, but
itraconazole Itraconazole, sometimes abbreviated ITZ, is an antifungal medication used to treat a number of fungal infections. This includes aspergillosis, blastomycosis, coccidioidomycosis, histoplasmosis, and paracoccidioidomycosis. It may be given by mo ...
and terbinafine hydrochloride are often used for two to three months following surgery. Humans with ''Basidiobolus'' infections have been treated with
amphotericin B Amphotericin B is an antifungal medication used for serious mycosis, fungal infections and leishmaniasis. The fungal infections it is used to treat include mucormycosis, aspergillosis, blastomycosis, candida infections, candidiasis, coccidioidomy ...
and
potassium iodide Potassium iodide is a chemical compound, medication, and dietary supplement. It is a medication used for treating hyperthyroidism, in radiation emergencies, and for protecting the thyroid gland when certain types of radiopharmaceuticals are u ...
. For pythiosis and lagenidiosis, a new drug targeting water moulds called
caspofungin Caspofungin (INN) (brand name Cancidas) is a lipopeptide antifungal drug from Merck & Co., Inc. discovered by James Balkovec, Regina Black and Frances A. Bouffard. It is a member of a new class of antifungals termed the echinocandins. It wor ...
is available, but it is very expensive.
Immunotherapy Immunotherapy or biological therapy is the treatment of disease by activating or suppressing the immune system. Immunotherapies designed to elicit or amplify an immune response are classified as ''activation immunotherapies,'' while immunotherap ...
has been used successfully in humans and horses with pythiosis. The prognosis for any type of phycomycosis is poor.


References


External links


''Oomycosis: Pythiosis in the Dog, Horse and Cat and Lagenidiosis in the Dog''
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