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Subcutaneous entomophthoromycosis masquerading as soft tissue neoplasm in breastfeeding mother
Chaithra Gowthuvalli Venkataramana1, Murali Mohan Rama Krishna Reddy2, Harish Rao Kalbavi3
1Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Mangalore, Karnataka, India.
Abstract:
Subcutaneous entomophthoromycosis is an infection caused by saprophytic, ubiquitous and highly opportunistic fungal pathogens. Individuals with immune disorders are frequently susceptible to these infections. Entomophthoromycosis is a rare fungal infection that primarily affects children andmen, and is known to cause infection in healthy individuals. Diagnosis of the disease is by demonstration of fungal elements using special stains, and the disease responds well to oral antifungal agents. Long-term antifungal agents reduce the need for surgical intervention when the disease presents as a mass. We report a case of an immunocompetent nursing mother in her 20s who presented with a soft tissue mass in her right arm. It was diagnosed as subcutaneous entomophthoromycosis and treated with long-term fluconazole. The lesion showed a significant reduction in size following treatment for 2 months. Subcutaneous fungal infection presenting as a mass-forming lesion in extremities may mimic a neoplasm. Fungal infection should be ruled out in inflammatory cell-rich lesions seen on histopathological examination.
Insights
Subcutaneous entomophthoromycosis, a rare fungal infection, can affect healthy individuals. Long-term antifungal treatment, like fluconazole, effectively reduced a soft tissue mass in an immunocompetent patient.
Area of Science:
- Mycology
- Infectious Diseases
- Dermatology
Background:
- Subcutaneous entomophthoromycosis is a rare fungal infection caused by opportunistic pathogens.
- While often affecting immunocompromised individuals, it can also occur in healthy people.
- Early diagnosis and treatment are crucial for managing this infection.
Observation:
- A case of subcutaneous entomophthoromycosis presented as a soft tissue mass in the arm of an immunocompetent nursing mother.
- The lesion mimicked a neoplastic growth, highlighting the importance of considering fungal infections in differential diagnoses.
- Histopathological examination revealed fungal elements within an inflammatory cell-rich lesion.
Findings:
- The patient was treated with long-term oral fluconazole.
- Significant reduction in the soft tissue mass was observed after two months of treatment.
- This case demonstrates the efficacy of antifungal therapy in managing subcutaneous entomophthoromycosis.
Implications:
- Subcutaneous fungal infections presenting as masses require thorough histopathological evaluation to rule out malignancy.
- Long-term antifungal therapy can be effective in treating entomophthoromycosis, potentially avoiding surgical intervention.
- Raising awareness among clinicians about this rare fungal infection is important for timely diagnosis and management.
