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Abstract

Infections are Achilles heel of kidney transplant recipients. Opportunistic fungal infections are increasingly recognized in these patients. We report a case of kidney transplant recipient with skin and soft tissue infection caused by Pyrenochaeta romeroi, a dematiaceous fungi. Infection by this organism is rare.

Subcutaneous phaeohyphomycosis from Medicopsis romeroi in a diabetic patient

“…Medicopsis romeroi is an emerging fungus causing subcutaneous phaeohyphomycosis. It has mostly been reported in immunocompromised patients receiving immunosuppressive drugs for hematologic malignancy [4], renal transplantation [5], rheumatoid arthritis [6], leprosy [7], and asthma [8]; however, there has been one report of a healthy, immunocompetent host [11], as shown in Table 2. Medicopsis romeroi has also reported in patients with type 2 diabetes mellitus who have poor glycemic control [9,10].…”

“…Medicopsis romeroi is an emerging fungus causing subcutaneous phaeohyphomycosis. Recent case reports have demonstrated that most patients with subcutaneous phaeohyphomycosis arising from Medicopsis romeroi have impaired immune systems [[4], [5], [6], [7], [8]], including patients with type 2 diabetes mellitus who have poor glycemic control [9,10]. Total surgical excision and debridement are the other options for eradicating the infection [1,2].…”

Recurrent Subcutaneous Phaeohyphomycosis Due to Medicopsis romeroi: A Case Report in a Dermatomyositis Patient and Review of the Literature

“…These 52 cases corresponded to 38 cases of PHM, including ours [ 1 , 2 , 3 , 4 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ] and 14 cases of eumycetoma [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. Two cases published as mycetoma by Thiyagarajan et al and Sum et al [ 20 , 21 ] were classified in this review as PHM, regarding the clinical presentation and the lack of grains and bone involvement.…”

“…One of them was cured only by surgery [ 25 ], and another one by a combination of surgery and antifungal treatment [ 26 ]. One case showed a progression despite antifungal treatment [ 27 ], while no outcome was available for the last one [ 28 ].…”

“…Subcutaneous PHM is, as shown in our literature review, the most frequently reported clinical presentation (65% of the literature review cases). It is responsible for nodulocystic subcutaneous lesions and abscesses affecting mostly immunocompromised patients with an immunosuppression course ranging from one month to many years [ 1 , 16 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 45 ]. In addition to this typical subcutaneous form of M. romeroi PHM, other presentations were rarely reported, including superficial, disseminated, ocular, and osteoarticular forms.…”