An unusual subcutaneous mycosis due to Parathyridaria percutanea in an immunocompromised individual

Area of Science:

• Mycology
• Immunocompromised Host Infections
• Transplant Medicine

Background:

• Solid organ transplant recipients are highly susceptible to opportunistic infections due to immunosuppression.
• Subcutaneous mycoses, fungal infections of the skin and deeper tissues, pose significant morbidity in immunocompromised individuals.
• Penetrating injuries are common routes for fungal pathogen entry in this population.

Observation:

• A case of subcutaneous mycosis presented with multiple discharging sinuses on the left foot in a transplant recipient.
• The causative agent, Parathyridaria percutanea, is an emerging pathogen and challenging for phenotypic identification.
• Few cases of this specific fungal infection have been reported in the Indian subcontinent.

Findings:

• Parathyridaria percutanea was identified as the cause of subcutaneous mycosis.
• Genotypic methods proved crucial for accurate diagnosis when phenotypic identification was insufficient.
• Prompt diagnosis and targeted antifungal therapy are essential for managing such infections.

Implications:

• Early and accurate diagnosis of emerging fungal infections like subcutaneous mycosis is vital in immunocompromised patients.
• Genotypic identification methods are critical for diagnosing novel or difficult-to-identify fungal pathogens.
• Effective management can reduce patient morbidity, hospital stay, and financial burden.