Fungal Infections of Implantation (Chromoblastomycosis, Mycetoma, Lobomycosis, and Entomophthoromycosis)

The implantation or inoculation mycoses include a heterogeneous group of fungal diseases with subacute to chronic manifestations starting at the site of several types of transcutaneous traumas. They are also known as the subcutaneous mycoses, but this term seems imprecise as some of the implantation mycoses may also involve sites beyond the skin and the subcutaneous tissues, such as muscles, fascia, cartilage, and bones. Most of the implantation mycoses are neglected or orphan diseases and usually affect impoverished rural individuals living in tropical and subtropical low-income regions of Latin America, Asia, and Africa. To date, mycetoma and chromoblastomycosis were the only fungal infections officially recognized by the World Health Organization (WHO) as a neglected tropical disease (NTD). Although these infections do not cause disseminated or invasive disease, they have an important impact on public health, may be difficult to control, and often recur (Organization WHO, Mycetoma fact sheet, 2017; Department WHO, Diseases oCoNT. Sustaining the drive to overcome the global impact of neglected tropical diseases: second WHO report on neglected tropical diseases. Geneva; 2013).

The implantation mycoses covered in this chapter include chromoblastomycoses, eumycetoma, lobomycosis and entomophthoromycosis. Sporotrichosis, the most globally widespread and prevalent implantation mycoses, is covered in a separate chapter in this book (Chap. 22).