Management of a Dermocutaneous Black Mold Abscess of the Finger with Flexor Sheath Involvement

Area of Science:

• Medical Mycology
• Infectious Diseases
• Surgical Case Report

Background:

• Black mold infections, caused by fungi in the genus Exophiala, are typically superficial.
• Previous hand infections by Exophiala have been limited to subcutaneous tissues.

Purpose of the Study:

• To report the first successful treatment of a flexor sheath infection caused by Exophiala jeanselmei.
• To describe the clinical presentation and management of this rare deep-seated fungal infection.

Main Methods:

• A 76-year-old male presented with a black mold infection of the index finger.
• The infection formed a granulomatous abscess that invaded the flexor sheath compartment.
• Treatment involved surgical excision of the abscess and drainage of the flexor sheath.

Main Results:

• The patient experienced an unremarkable recovery.
• Full digital function was maintained post-treatment.
• No recurrent infection was observed.

Conclusions:

• Exophiala jeanselmei can cause deep-seated infections, including flexor sheath involvement.
• Surgical management, including abscess excision and sheath drainage, is effective for this condition.
• This case expands the known spectrum of black mold hand infections.