Medicopsis romeroi infection presenting as disseminated nodules and sinuses in a patient with chronic rheumatoid arthritis

Bains, Anupama; Singh, Saurabh; Dutt, Naveen; Asfahan, Shahir; Vedant, Deepak; Nalwa, Aasma

doi:10.1111/jdv.16811

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…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.…”

Section: Methodsmentioning

confidence: 84%

“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Aljundi¹,

Brun

Akhoundi

et al. 2022

Microorganisms

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Medicopsis romeroi phaeohyphomycosis is increasingly reported in immunocompromised patients living in or originating from tropical and subtropical areas. We report a case of subcutaneous phaeohyphomycosis caused by M. romeroi in a 56-year-old Malian woman residing in France for 20 years. She developed a small nodule on her dominant hand’s ring finger 15 months after starting immunosuppressive medications for paraneoplastic dermatomyositis. A first surgical debridement was followed by a local recurrence. Despite a second surgical excision combined with posaconazole treatment, the infection recurred one year after antifungal therapy discontinuation. A wide excision was performed again, and antifungal therapy was resumed and maintained for six months, resulting in the absence of relapse during the 18 months following the surgery. This case highlighted the high risk of relapse in immunocompromised patients, suggesting the need for long-term follow-up and prolonged antifungal treatment following surgical excision in cases with sustained immunosuppression. The literature review was performed according to PRISMA guidelines and included 51 scientific publications. A noteworthy predominance of the subcutaneous phaeohyphomycosis presentation was found in immunocompromised patients, whereas eumycetoma had been reported in apparently healthy individuals. A combination of complete excision with antifungal treatment seemed to confer the best outcome.

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Section: Methodsmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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

Aljundi¹,

Brun

Akhoundi

et al. 2022

Microorganisms

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“…This case, however, has already been published yet included in our review due to matching dermatological presentation. 4 No organism could be cultured in any of the actinomycetoma cases. Thus microbiological isolation was possible in 13 of 38 cases (34.2%).…”

Section: Resultsmentioning

confidence: 99%

“…One case was of systemic mycoses but had discharging sinuses, and fungal identification using PCR amplification showed Medicopsis romeroi . This case, however, has already been published yet included in our review due to matching dermatological presentation 4 . No organism could be cultured in any of the actinomycetoma cases.…”

Section: Resultsmentioning

confidence: 99%

Clinical triad with multi‐biopsy histopathology as a reliable diagnostic marker of mycetomas: a retrospective review from a tertiary care center

et al. 2022

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Background Mycetoma is a neglected tropical infectious disease which runs a prolonged and protracted course. Microbiological confirmation is diagnostic yet unreliable due to poor sensitivity and variable availability of culture facilities in resource poor settings.Methods A retrospective review was performed on electronic records (histopathology, microbiology, and radiology) of all patients who underwent skin biopsies with mycetoma as one of the clinical differential diagnoses from year 2016 to 2020. ResultsOut of 73 patients biopsied with a differential of mycetoma, 42 fit the clinical triad of swelling-sinuses-granules. After clinical, microbiological, pathological, and radiological correlation, 31 cases were of eumycetoma and seven were of actinomycetoma. Mean patient age was 37.58 AE 13.8 years with a male to female ratio 2.45 : 1 and mean disease duration of 11.31 AE 10.9 years. Histopathological findings revealed fungal hyphae in 18 cases and gram-positive bacteria in six cases. Fungal culture was positive in 13 cases with the three commonest organisms being Madurella mycetomatis in five cases, Fusarium and Aspergillus nidulans in two cases each. X-ray changes of soft tissue, bones, and joints were seen in 25 cases, and "dot-in-circle" sign was seen in eight of nine MRIs. ConclusionEumycetoma was more common than actinomycetoma in our setup, ratio being 4.43 : 1. A clinical triad of swelling, multiple sinuses and grainy discharge with any one diagnostic support (histopathology/radiology) is sufficient to make a definitive diagnosis of mycetoma in the absence of microbiological identification. from drier regions, whereas Pseudallescheria boydii, Nocardia species, and Actinomadura pelletieri are more common in those areas with higher annual rainfall. 1 In India, actinomycetoma is more prevalent in drier areas, whereas eumycetoma is more common in sites with more rainfall. Within India, there is wide variation in the distribution of cases, as eumycetoma is common in Rajasthan, whereas other states, namely Andhra Pradesh, Punjab, Madhya Pradesh, Tamil Nadu, and West Bengal, report most cases of actinomycetoma. 2 Distribution also varies within the states; eumycetoma constitutes one-third of the total cases mainly reported from Uttar Pradesh (North India) and Central Rajasthan, while actinomycotic mycetoma is usually present in South India, South-East Rajasthan, and Chandigarh. 3 Mycetoma predominantly affects men as compared to women especially in rural areas, and it is mostly seen in patients who

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2021

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Medicopsis romeroi infection presenting as disseminated nodules and sinuses in a patient with chronic rheumatoid arthritis

Cited by 3 publications

References 5 publications

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

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

Clinical triad with multi‐biopsy histopathology as a reliable diagnostic marker of mycetomas: a retrospective review from a tertiary care center

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