“…The light microscopy photographs of untreated B. alexandrina hemolymph showed two morphologically distinct types of hemocytes; granulocytes and hyalinocytes. This was agreed with Sminia and Van der Knaap (1987), Lie et al (1987), Barraco et al (1993) and Serrano et al (2002).…”
“…The light microscopy photographs of untreated B. alexandrina hemolymph showed two morphologically distinct types of hemocytes; granulocytes and hyalinocytes. This was agreed with Sminia and Van der Knaap (1987), Lie et al (1987), Barraco et al (1993) and Serrano et al (2002).…”
“…In high concentrations, hydrocortisone attenuates the cells of defense and delays the migration of phagocytic cells to the traumatized area by reducing vasodilatation and the subsequent vascular permeability. Other effects of steroids on fungi are growth stimulating, change in morphology favoring the change from yeast to hyphae, and resistance to antimycotics, making the fungus less vulnerable to osmotic stress in the presence of the antimycotic [12,13]. With all these described effects, the steroid may aggravate the clinical course of the infection.…”
Section: Discussionmentioning
confidence: 99%
“…The patient received amphotericin B treatment after diagnosis and was cured after ten months. Another eight cases of E. oligosperma infection were reported between 2007 and 2016 and showed global distribution, including Japan, Spain, India, and Taiwan [4,[13][14][15][16]. Most of the patients had immunosuppression status.…”
Herein, we report a case of subcutaneous infection caused by Exophiala oligosperma. A verrucous plaque was the major clinical feature. A histopathological examination revealed features of suppurative granuloma. Mycological and molecular identification revealed E. oligosperma as the etiologic agent. After eight months of treatment, the lesion showed worsening due to the use of self-medication with topical hydrocortisone. A second biopsy was performed with direct examination (KOH 10%) showing dark pigmented septate hyphae, yeast and multiple dark hyphae were highlighted in biopsy with Gomori methenamine silver (GMS) staining. We report this case to show the rise of this infection in an immunocompetent patient and the effects of steroids. The patient was treated with itraconazole and cryosurgery. Key words: Phaeohyphomycosis, Cutaneous, Verrucose, Exophiala oligosperma, Melanized fungi, Immunocompetent host, Itraconazole, Cryosurgery, Chromoblastomycosis
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