Subcutaneous phaeohyphomycotic abscess caused byPleurophomopsislignicola

Abstract

A 41-year-old man with a past medical history of diabetes mellitus type II, AIDS (diagnosed 2 years earlier; CD4 count B/10), peripheral neuropathy, and pulmonary tuberculosis of 2 years duration was admitted to the hospital with abnormal liver function tests. There was a chronic hepatitis/cholestasis that had worsened while the patient was undergoing directly observed tuberculosis therapy. On admission, the patient complained of a painful swelling on his right arm. In the posterior aspect of the arm, there was a 3Á/4-cm subcutaneous mass that was fluctuant, mobile and tender. Incision of the mass released yellowish pus mixed with blood. Direct examination of the pus in KOH mounts and Gram-stained smears revealed subhyaline, septate, branched hyphae. When the pus was cultured on Sabouraud dextrose agar containing chloramphenicol, several velvety, olivaceous grey colonies grew after 7 days at 258C. When grown on oatmeal agar, the fungus produced subglobose, rostrate pycnidia with phialidic conidiogenous cells, and 1-celled cylindrical conidia. It was identified as Pleurophomopsis lignicola Petrak. This report describes the third known case of subcutaneous infection caused by P. lignicola in an immunocompromized patient.

Phaeohyphomycotic Soft Tissue Infections Caused by the Coelomycetous Fungus Microsphaeropsis arundinis

“…Infections usually are localized, following traumatic implantation, but may progress to invasive subcutaneous disease (2,4,5,7,9,11,17). Airborne transmission of these fungi is unlikely since they typically produce their conidia within enclosed structures known as conidiomata (16).…”