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

Abstract

Abstract. We describe the first case of possible pulmonary chromoblastomycosis in the absence of any identified cutaneous lesions in a relatively immunosuppressed man. The causative organism was Cladophialophora arxii, which is a rare pathogen that has only been described as causing human disease two times previously.

Combination of Amphotericin B and Terbinafine against Melanized Fungi Associated with Chromoblastomycosis

“…Cladophialophora carrionii is the predominant agent of the disease under arid desert-like climate conditions (10). Sporadic cases of CBM-like infections have also been reported for Cladophialophora arxii (11), Exophiala dermatitidis (12), Exophiala spinifera (13), Phialophora verrucosa (14), and Veronaea botryose (15), although attribution to this disease category has not been confirmed. CBM is extremely difficult to treat due to its recalcitrant nature, and there is no consensus regarding the treatment of choice (16).…”

The Role of Excision for Treatment of Chromoblastomycosis: A Cutaneous Fungal Infection Frequently Mistaken for Squamous Cell Carcinoma

“…6,13,15,16,21,23,24 The fungal bodies are described as dark, globe-shaped, brown cells that appear to be thick and septated. 3,8,13,14,18,22,26,30 Pseudoepitheliomatous hyperplasia can resemble squamous cell carcinoma. Histopathology examination also allows for the exclusion of other differential diagnoses, such as other deep mycoses and nonmelanoma skin cancers.…”

“…It has been proposed that combination therapies may improve outcomes. 2,3,5,6,8,16,19,23,26 The most common oral antifungals with documented clinical efficacy include itraconazole, terbinafine, flucytosine, and amphotericin B. 2,3,6,7,9,24,26 These oral antifungals can be used alone or in combination to achieve a synergistic effect.…”

“…2,3,5,6,8,16,19,23,26 The most common oral antifungals with documented clinical efficacy include itraconazole, terbinafine, flucytosine, and amphotericin B. 2,3,6,7,9,24,26 These oral antifungals can be used alone or in combination to achieve a synergistic effect. 7,19 Notably, recent literature has indicated itraconazole and terbinafine to be the most commonly used antifungals to date.…”

“…Chromoblastomycosis, also known as chromomycosis or chromohyphomycosis, is an uncommon fungal infection of the skin caused by a variety of dematiaceous fungal species. This cutaneous fungal infection is more frequently observed in tropical and subtropical regions, 1–3 particularly among adult men with a history of working in rural areas. 4–6 This is most likely because of occupational exposure with an increased risk of contracting chromoblastomycosis via traumatic implantation of fungus into the skin from splinters, thorns, or decaying plants.…”