Disseminated Curvularia lunata Infection in a Football Player

Tiny keratotic brown lesions on the interdigital web between the toes of a healthy man caused by Curvularia species infection and a review of cutaneous Curvularia infections

“…Mahgoub (1973) described the first report of cutaneous Curvularia infection, caused by C. lunata. Thereafter, 25 reports of human skin infection cases in the English and Japanese literature were published (Mahgoub 1973;Rohwedder et al 1979;Barde and Singh 1983;Kiryu and Suenaga 1985;Duvic et al 1987;Gugnani et al 1990;Kamalam et al 1992;Grieshop et al 1993;Harris and Downham 1978;Lavoie et al 1993;Still et al 1993;Yvonne et al 1994;Agrawal and Singh 1995;Berg et al 1995;Torda and Jones 1997;Lopes and Jobim 1998;Fernandez et al 1999;Bonduel et al 2001;Tessari et al 2003;Tamaki et al 2006;Fan et al 2008;Garg et al 2008;Hiromoto et al 2008), including our patient (Table 2). Five species in the genus Curvularia were isolated from the skin lesions.…”

“…Three cases (Harris and Downham 1978;Rohwedder et al 1979;Tessari et al 2003) developed dissemination. One was a heart transplant recipient who was infected by C. lunata (Tessari et al 2003), and the others were immunocompetent patients (both football players) infected by C. lunata (Rohwedder et al 1979) and an unidentified Curvularia species (Harris and Downham 1978). The patient with a sternal wound infection caused by C. lunata was a neonate with congenital heart disease, who developed multiorgan failure and died (Yvonne et al 1994).…”

“…Those lesions were divided into two groups: the deep mycosis type and the superficial infected type. In the deep mycosis type, 16 cases were reported: abscess (mycetomas) (Mahgoub 1973), ulcer (Rohwedder et al 1979;Berg et al 1995, Torda andJones 1997;Hiromoto et al 2008), ecthyma gangrenosum-like lesion (Bonduel et al 2001), firm tender nodules and nodes (Tessari et al 2003;Garg et al 2008), papules (Kiryu and Suenaga 1985;Duvic et al 1987), macular lesion with central necrosis (Fernandez et al 1999), hemorrhagic bullous lesion (Lavoie et al 1993), and others [burn wound (Grieshop et al 1993;Still et al 1993), elevated hyperpigmented scaly lesion (Harris and Downham 1978), and surgical wound (Yvonne et al 1994)]. In the superficial infected type, 7 cases were reported: pigmented macules (Gugnani et al 1990;Agrawal and Singh 1995), scaling lesion (Lopes and Jobim 1998), and brown thick scales (present case) on the web between the toes and onychomycosis (Barde and Singh 1983;Kamalam et al 1992).…”

“…In 24 cases of Curvularia infection, all patients had skin lesions involving the upper or lower extremities, except for 1 case of fungal sternal wound infection in a neonate with congenital heart disease. Six cases involved subjects who worked or played outdoors (Mahgoub 1973;Harris and Downham 1978;Rohwedder et al 1979;Barde and Singh 1983;Agrawal and Singh 1995;Torda and Jones 1997;Garg et al 2008;Hiromoto et al 2008).…”

Optic atrophy due to Curvularia lunata mucocoele

“…On reviewing the published literature, this case was found to be the first in which Curvularia had caused optic neuropathy. There have been only five previously documented reports of Curvularia causing CNS infections [1][2][3][4][5][6]. This case demonstrates the importance of obtaining a tissue diagnosis together with appropriate surgical and medical management in the treatment of invasive fungal disease.…”