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10:45
Deep Dermal Injection As a Model of Candida albicans Skin Infection for Histological Analyses
Published on: June 13, 2018
Cutaneous alternariosis microscopically mimicking blastomycosis.
Gregory W Osmond1, Robert W Walters, Puja K Puri
1Department of Pathology, Duke University Medical Center, Durham, NC, USA.
Journal of Cutaneous Pathology
|July 15, 2011
Summary
This case highlights Alternaria species mimicking blastomycosis in a heart transplant patient. Fungal cultures are crucial for accurate diagnosis of rare fungal infections.
Area of Science:
- Medical Mycology
- Dermatopathology
- Infectious Diseases
Background:
- Heart transplant recipients are immunocompromised and susceptible to opportunistic infections.
- Cutaneous manifestations of fungal infections can be diverse and challenging to diagnose.
- Blastomycosis is a deep fungal infection caused by Blastomyces dermatitidis, often presenting with skin lesions.
Observation:
- A 57-year-old man with a history of myocardial infarcts and heart transplantation developed a violaceous knee plaque.
- Biopsy revealed suppurative dermatitis with pseudocarcinomatous hyperplasia and eosinophilic organisms resembling Blastomyces.
- Special stains were negative for typical fungal elements, initially suggesting blastomycosis.
Findings:
- Fungal culture identified the causative agent as Alternaria species, not Blastomyces.
- The Alternaria species exhibited morphological features that closely mimicked blastomycosis in tissue.
- This represents a previously unreported striking similarity between alternariosis and blastomycosis.
Implications:
- Dermatopathologists must consider alternariosis in the differential diagnosis of suspected blastomycosis, particularly when hyphal forms are scarce.
- Accurate identification of fungal pathogens is essential for appropriate treatment, especially in immunocompromised patients.
- Fungal culture remains the gold standard for definitive classification of fungal infections.
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