Case of chromoblastomycosis with pulmonary involvement

Abstract

Chromoblastomycosis is a slowly growing chronic cutaneous mycosis associated with a variety of cutaneous lesions. Extra-dermal involvement is rare. A 58-year-old man was admitted to the hospital with nausea, vomiting, weakness and a history of weight loss. On inspection, he had a large verrucous mass in the sacral region, and two large subcutaneous nodules in the anterior thoracic wall. He claimed the lesions were several years old. Biopsy and histological studies were positive for chromoblastomycosis. Routine chest radiography showed hilar enlargement, and a chest computed tomography was ordered. Pulmonary nodules were evident, and endoscopically acquired samples were also positive for chromoblastomycosis. Extra-dermal and systemic involvement in chromoblastomycosis is exceedingly rare and often associated with immunosuppression. There is only one other case of pulmonary chromoblastomycosis reported in the published work.

Chromoblastomycosis

“…Earlier literature reports referred to an involvement of deep organic sites such as brain and lungs as CBM, but such cases should be considered PHM (241)(242)(243). CBM affects mainly the skin and the subcutaneous tissue; dissemination to deeper organs is extremely rare (39,244). Several species of the Herpotrichiellaceae are related to the etiology of CBM, but no link with a specific type of lesion or mild to severe grades of this disease has been associated with any etiological agent.…”

First Reported Australian Case of Cladophilophora arxii: Features Consistent with Possible Primary Pulmonary Chromoblastomycosis

“…3 It is usually seen in otherwise healthy individuals, and extradermal spread is extremely rare. Cases have been described in the cornea, 8 liver, 9 lymph nodes, 10 and recently, lung 11 but usually, they are in the presence of skin lesions. Phaeohyphomycosis refers to clinical syndromes caused by melanized fungi that are not classified as eumycetoma or chromoblastomycosis.…”

“…11,12 The most recent case describes a malnourished, otherwise healthy man with both skin and pulmonary lesions positive for muriform cells on histological examination. Fungal culture was positive for F. pedrosoi, a known causative agent of chromoblastomycosis.…”

Chromoblastomycosis in a Diabetic Patient Without a History of Trauma

“…CBM involvement has been reported in the cerebrum, cornea, liver, lymph nodes, and lungs. 4 The infection initially presents as small papules and pustules on the lower extremities, which gradually transform into papillous hyperkeratotic lesions. Damage to the lymphatic system might be seen in some cases.…”

“…Admixed within the granulomatous inflammation were numerous neutrophils and scattered Medlar (sclerotic) bodies, which are characteristic for CBM (Figs. [2][3][4]. Periodic acid-Schiff, Gomori methenamine silver, and the Fontana-Masson special stains displayed the fungal organisms (Fig.…”