Tropical medicine rounds
First reported case of subcutaneous hyalohyphomycosis caused by Paecilomyces variotii
Article first published online: 17 MAY 2013
© 2013 The International Society of Dermatology
International Journal of Dermatology
Volume 52, Issue 6, pages 711–713, June 2013
How to Cite
Vasudevan, B., Hazra, N., Verma, R., Srinivas, V., Vijendran, P. and Badad, A. (2013), First reported case of subcutaneous hyalohyphomycosis caused by Paecilomyces variotii. International Journal of Dermatology, 52: 711–713. doi: 10.1111/j.1365-4632.2012.05761.x
Conflicts of interest: None.
- Issue published online: 17 MAY 2013
- Article first published online: 17 MAY 2013
Hyalohyphomycosis is a rare opportunistic fungal infection caused by saprophytes of genera such as Fusarium, Paecilomyces, Scedosporium, Penicillium, Scopulariopsis Acremonium, and similar fungi. The literature includes only one previous report of Paecilomyces variotii human infection and very few reports of subcutaneous mycosis caused by any of the hyalohyphomycosis group of fungi.
We report an instance of fungal infection in a 50-year-old woman, known to have diabetes, who presented with multiple raised lesions on the upper back of two years' duration. Dermatological examination revealed a 20 × 22-cm, swollen, indurated area on the upper back with multiple violaceous, exophytic nodules on the surface.
Microscopy from pus and tissue smear revealed septate branching fungi. Periodic acid Schiff (PAS) stain was positive for fungal elements. Culture on three occasions yielded P. variotii. Slide culture mounts showed septate hyaline hyphae of P. variotii with elongated phialides demonstrating bulbous bases and tapering apices attached to the conidiophores. The patient was treated with itraconazole, to which she responded well.
This is the first reported case of subcutaneous hyalohyphomycosis caused by P. variotii. It appears that this relatively rare fungal pathogen may be starting to assert itself as an important cause of infection in humans.