Mycotic granuloma caused by Phialophora repens

This is the first reported infection by the saprophytic fungus, Phialophora repens. The infection was a solitary granulomatous nodule in the scalp of a Zaïrian man with advanced lepromatous leprosy. The patient was being treated by long-term prednisolone therapy. In tissue sections there were nonpigmented microcolonies composed of irregularly branched septate hyphae. A darkly pigmented fungus was isolated on Sabouraud's medium. The mycologic features of the etiologic agent were typical of P. repens. The infection was treated successfully by excision of the nodule.