Korean J Lab Med.  2011 Jul;31(3):201-204. 10.3343/kjlm.2011.31.3.201.

Subcutaneous Phaeohyphomycosis Caused by Phaeoacremonium Species in a Kidney Transplant Patient: The First Case in Korea

• Choi J
• Lee Y
• Chung HS
• Koo JS
• Yong D
• Kim YS
• Lee K
• Chong Y

• KMID: 1735855
• DOI: http://doi.org/10.3343/kjlm.2011.31.3.201

Abstract

Phaeohyphomycosis is a subcutaneous infection caused by dark pigmented fungi, including fungi of the species Phaeoacremonium, Alternaria, Exophiala, and Pyrenochaeta. In August 2005, a 54-yr-old man who had received a renal transplant 5 yr ago was admitted to our hospital with a subcutaneous mass on the third finger of the right hand; the mass had been present for several months. He had been receiving immunosuppressive agents for several years. He underwent excision of the mass, which was followed by aspiration of the wound for bacterial and fungal cultures. Many fungal hyphae were observed on the histology slide treated with periodic acid-Schiff stain. A few white waxy colonies with a woolly texture grew on the Sabouraud dextrose agar at 30degrees C and changed to dark brown in color. Nucleotide sequencing of internal transcribed spacer regions revealed 100% homology to the Phaeoacremonium aleophilum anamorph and Togninia minima teleomorph (514 bp/514 bp). The patient completely recovered after wide surgical excision. Here, we report the first case of phaeohyphomycosis caused by Phaeoacremonium species in a kidney transplant patient in Korea.

Keyword

Subcutaneous phaeohyphomycosis; Phaeoacremonium species; Renal transplantation; Immunosuppressive agents

MeSH Terms

Antifungal Agents/therapeutic use
Ascomycota/genetics/*isolation & purification
Dermatomycoses/drug therapy/etiology/*microbiology
Fingers/surgery
Humans
Immunosuppressive Agents/adverse effects
*Kidney Transplantation
Male
Middle Aged
Republic of Korea
Sequence Analysis, DNA
Subcutaneous Tissue/microbiology

Figure

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  Fig. 1 (A) Subcutaneous lesion on the third finger of the right hand; (B) 6.5×3×1.2 cm-sized mass obtained after removal of the lesion.

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  Fig. 2 Periodic acid-Schiff stain showed many fungal hyphae under the microscope (×400).

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  Fig. 3 On the slide culture of the specimen, many fungal hyphae were septate, and conidiophores were observed to be short and usually unbranched (×400).

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