A case of mycetoma due to pseudallescheria boydii

Kim, Seong Jin; Won, Young Ho; Chun, Inn Ki

Abstract

Mycetoma is a clinical syndrome of localized, indolent, deforming, swollen lesions and sinuses, involving cutaneous and subcutaneous tissues, fascia, and bone. Its lesions. are composed of suppurat.ing abscesses, granulomata, and dra ning sinuses and the etiologic agents are wide variety of bacteria (actinomycotic mycetoma) and fungi(eumcotic mycetoma) from plant and soil. The patient was a 65-year-old female and a farnier. She was referred by the skin lesion loalized on the dorsum of her lefther left hand and wrist for three months. It showed multiple subcutaneclis nodules, abscesses, and discharging fitula based on the erythematous plaque. The skin biopsy frorn the lesion revealed the PAS positive hyphae in the granulocytic infiltration. Fungus cult,ure with a piece of tissue on sabouraud media shows hin, floccose, white colonies. Slide culture and biochemical idcrtification of pathogen led to the final diagnosis as Mycetoma caused by Pseudallescheria boydii(Monosporium apiospermum). The lesions disappeared gradualy following systemic oral administratior of Itraconazole 200mg daily for six weeks.