Ann Dermatol.  2019 Oct;31(5):571-575. 10.5021/ad.2019.31.5.571.

A Case of Subcutaneous and Intranasal Phaeohyphomycosis Caused by Microsphaeropsis arundinis in an Immunocompromised Patient Misdiagnosed with Mucormycosis

Affiliations
  • 1Department of Dermatology, School of Medicine, Chosun University, Gwangju, Korea. chna@chosun.ac.kr

Abstract

Microsphaeropsis arundinis is a dematiaceous fungus capable of causing soft tissue infections known as phaeohyphomycosis, mostly in immunocompromised individuals. These infections arise from the traumatic inoculation of fungal materials into the subcutis, and can spread to adjacent subcutaneous tissues or via the lymphatics in a sporotrichoid manner. A 76-year-old man presented with diffuse erythematous plaques and swelling on both forearms and dorsal hands, and rhinalgia. He had been undergoing treatment for hypertension, angina pectoris, and diabetes. Histopathologic examinations of the skin, painful nasal septum, and molecular identification using internal transcribed spacer regions confirmed a diagnosis of subcutaneous and intranasal phaeohyphomycosis caused by M. arundinis. The patient was treated with oral itraconazole for over 5 months, and no recurrence was observed until the time of writing this manuscript. We report a rare case of subcutaneous and intranasal phaeohyphomycosis caused by M. arundinis and propose that confirmation of the causative strains is necessary, as it could affect the prognosis and treatment of the disease.

Keyword

Fungal infection; Microsphaeropsis arundinis; Phaeohyphomycosis

MeSH Terms

Aged
Angina Pectoris
Diagnosis
Forearm
Fungi
Hand
Humans
Hypertension
Immunocompromised Host*
Itraconazole
Mucormycosis*
Nasal Septum
Phaeohyphomycosis*
Prognosis
Recurrence
Skin
Soft Tissue Infections
Subcutaneous Tissue
Writing
Itraconazole
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