Exophiala asiatica, a new species from a fatal case in China

We describe a new species, Exophiala asiatica, isolated from an infection of the pharynx in a 20-year-old, immunocompetent woman in Nanjing, China. The infection was initiated by a fishbone prick in the pharynx, soon developed with facial nodules but subsequently seemed to have disappeared. Tonsil ulceration with progressive soreness of the pharynx was observed 3 years later. Dysphagia, headache and paralysis occurred four years after first signs of infection. Hyphae and yeast-like cells were detected in tissue and a black fungus was recovered repeatedly from pharynx tissue. Despite antifungal therapy for more than one year, the patient died of apparent cerebral dissemination of the etiologic agent. On the basis of morphology, nutritional physiology, ribosomal small subunit DNA and ITS sequence data the strain could not be matched with any existing species. A new species, Exophiala asiatica, is therefore proposed.