Geotrichosis

Geotrichosis
Other names: Geotrichoses[1]
Top:Worldwide distribution of case reports or geotrichosis [2] Bottom:Geotrichum candidum
Specialty	Infectious disease
Symptoms	Symptoms vary depending on the affected area
Causes	Geotrichum candidum [2]
Diagnostic method	Skin scrapings[3][2]
Differential diagnosis	Tuberculosis, Cryptococcosis, Histoplasmosis,Blastomycosis[3]
Treatment	Amphotericin B, itraconazole, or topical nystatin [4] [5]

Geotrichosis is a mycosis caused by Geotrichum candidum. Geotrichum candidum is also a frequent member of the human microbiome, notably associated with skin, sputum and feces where it occurs in small to moderate percent of specimens. The fungus can cause an infection known as geotrichosis, affecting the oral, bronchial, skin and bronchopulmonary epithelia. The inoculum may arise from endogenous or exogenous sources. ^{[6][7]: 311 [8]}

Most cases affect the bronchopulmonary tree, although other sites can be involved, such as oral mucosa and vagina. Skin and gut infections are also known. Reported cases of geotrichosis have been characterized with symptoms of chronic or acute bronchitis. Exogenous geotrichosis may arise from contact with contaminated soil, fruits or dairy products.^[9][10]

Types

• Pulmonary geotrichosis is the most frequent form of geotrichosis. The symptoms appear to be secondary symptoms of pulmonary disease. This includes symptoms such as light, thick, sputum. Patients often have a cough that produces clear or yellow sputum. Another symptom of pulmonary geotrichosis includes fine to medium rales. The condition appears chronic with the presence of a little debilitation, fever and occasional wheezing can occur.^{[11][12][1][13]}
• Bronchial geotrichosis does not involve the lung instead the disease persists within the bronchial. Geotrichum candidum grows in the lumen of the bronchi. The disease is characterized as an endobronchial infection. Bronchial geotrichosis is similar to the allergic reaction of aspergillosis. Symptoms include prominent chronic cough, gelatinous sputum, lack of fever and medium to coarse rales. Patients with the bronchial condition their pulse and respiration are rarely elevated.Colonization of the bronchi can be associated with Candida albicans and usually occur with patients with chronic obstructive lung disease.^[14][15][16]
• Oral and vaginal geotrichosis is similar to thrush in its appearances and was often confused with this infection. The infected area forms a white plaque and patients usually report burning sensation in the affected areas. The vaginal geotrichosis is more common in pregnant women and is often associated with vaginitis.^{[17][1][2][18]}
• Gastrointestinal geotrichosis is a specific type of fungal infection that affects the digestive tract. It is caused by the yeast-like fungus Geotrichum candidum, which is a common inhabitant of the human gut as part of the normal flora,however under certain conditions, it can become pathogenic^[19]
• Cutaneous geotrichosis has two different types of variants which include superficial and deep infection. The superficial form the infection occurs on skin folds including submammary, inguinal, perianal and interdigital folds. The deep form develops nodules, and ulcers on legs, face and hands.^{[17] [2]}

Cause

Geotrichum candidum belongs to the Ascomycota division and typically forms white, flat, suede-like colonies. Microscopically, it produces hyaline, septate hyphae that fragment into chains of arthroconidia—its asexual spores.G. candidum is also an opportunistic pathogen^[20]

Diagnosis

The diagnoses of geotrichosis cannot be determined without using culture or microscopic measurements. The laboratory diagnosis of geotrichosis involves collected fungi samples areas of infections without contamination. Scraping of the mouth lesions and the ulcers can provide a sample of G. candidum. Samples can also be collected from pus and mucus can be obtained from the feces. Sputum can be searched for the mucoid-like white flakes for further examination. Culturing the cylindrical barrel-shaped or elliptical fungi in considerable numbers in oral lesions is an indicator that a patient may have geotrichosis.^{[3][2][21][15]}

X-rays or CT scans can be used to examine the lung tissue, however it can not be used to positively diagnose geotrichosis. X-rays or CT scans may show cavitation that is located the walls of the lungs tissues. The results of imaging of pulmonary geotrichosis presents smooth, dense patchy infiltrations and some cavities.^[3][12][3]

• 
  Geotrichum candidum culture
• 
  CT scan thorax revealed a soft-tissue mass with cavitation and surrounding consolidation at the right upper lobe

Differential diagnosis

In terms of the DDx we find that each type is different; however Pulmonary Geotrichosis is the most frequent form, therefore the following should be included:^[3][12][4]

• Tuberculosis
• Cryptococcosis
• Histoplasmosis
• Blastomycosis
• Coccidioidomycosis
• Bacterial pneumonias
• Nocardiosis

Prevention

As to prevention a few things can be done to help prevent Geotrichosis, they are:^[22]

• Clean and dry skin, especially in areas prone to moisture accumulation like skin folds
• Avoid prolonged exposure to humid environment

Treatment

There is no standard treatment for geotrichosis,there are several types of antimicrobial or antifungal compounds that can be used for geotrichosis treatment.Azole drugs including isoconazole and clotrimazole are used for geotrichosis treatment.^{[4] [5]}

Amphotericin B, clotrimazole and S-fluorocytosine have become more susceptible to G. candidum. Antimycotic resistance can appear due to repeated treatment.^[5]

Epidemiology

As to the epidemiology of Geotrichosis we find that it is geographically widespread, with indications that in the United States, Germany, and India have more reported cases^[2]

History

In 1847 Bennett described Geotrichum candidum causing a superinfection in the tuberculous cavity. Bennett was able to differentiate infection by Geotrichum candidum from candidiasis, and diagnose the first case of geotrichosis.^[23]

Notes

1.^ This is a case study(or case studies)

References

External links