Detection of Fungi in the Palmar Aponeurosis in Patients with Dupuytren’s Contracture by Scanning Electron Microscopy

Abstract

The purpose of the study was to determine the capabilities of scanning electron and light microscopy in detecting fungi in surgical material from the patients with Dupuytren’s contracture. Material and Methods. The fragments of palmar aponeurosis from 27 patients with Dupuytren’s contracture were examined. Paraffin sections stained with hematoxylin-eosin and Periodic Schiff-Methenamine Silver were digitized using AxioScope.A1 microscope (Carl Zeiss Micro Imaging GmbH, Germany). For examination in JSM-840 scanning electron microscope (Jeol, Japan), the samples were dehydrated after fixation, soaked in camphene, dried, and silver sprayed in the IB-6 ionizer (Eiko, Japan). Results. In paraffin sections stained with methenamine-silver, the signs of mycotic microbiota were detected only in 2 (7.4%) of 27 patients, and with the use scanning electron microscopy — in 16 patients (59%). The morphological phenotypes and ultrastructure of intercellular contacts of yeast-like fungi were similar to Candida albicans. In all cases, the budding cells were detected. The destruction of the connective tissue of the palmar aponeurosis was observed in the form of loosening, stratification, and cavities formation (the zones of lysis). Conclusion. The scanning electron microscopy allowed to evaluate the ultrastructure of fungal cells and their interaction with surrounding tissues in the surgical material from the patients with Dupuytren’s contracture. A higher percentage of detection of fungal invasion compared to the Periodic Schiff-Methenamine staining was associated with a higher resolution and the ability of a larger area of tissue samples analysis.