Lymphangitic chromoblastomycosis.

Area of Science:

• Mycology
• Dermatology
• Infectious Diseases

Background:

• Chromoblastomycosis (CM) is a chronic subcutaneous fungal infection caused by dematiaceous fungi, primarily Fonsecaea pedrosoi.
• It typically affects the lower extremities after traumatic inoculation and presents with various clinical patterns.

Observation:

• A rare case of chromoblastomycosis on the right lower limb is presented, exhibiting a sporotrichoid pattern.
• This unusual presentation is hypothesized to result from lymphatic spread of the fungus.
• Histopathology revealed characteristic intracellular and extracellular muriform (medlar) bodies within granulomatous inflammation.

Findings:

• Fungal culture confirmed the causative agent as Fonsecaea pedrosoi, identified by sporulating organisms of the Cladosporium and Rhinocladiella type.
• The specific sporotrichoid pattern observed is considered a rare manifestation of chromoblastomycosis.
• The patient's condition showed a positive response to itraconazole therapy.

Implications:

• This case highlights the importance of recognizing rare clinical presentations of chromoblastomycosis for timely diagnosis.
• Understanding the lymphatic spread mechanism in CM can refine diagnostic and treatment approaches.
• Successful treatment with itraconazole reinforces its efficacy in managing chromoblastomycosis, even in atypical forms.