Subcutaneous phaeohyphomycosis caused by Exophiala spinifera

Area of Science:

• Mycology
• Infectious Diseases
• Dermatology

Background:

• Subcutaneous fungal infections are uncommon, particularly those caused by dematiaceous fungi.
• Exophiala spinifera is a fungus typically found in soil and decaying plant material.
• Human infections are rare, with limited documented cases.

Observation:

• A case of subcutaneous infection in a US patient is presented.
• Diagnosis was confirmed through morphological analysis of fungal elements in tissue biopsy and cultured isolates.
• The patient presented with a subcutaneous infection.

Findings:

• Morphological identification confirmed the causative agent as Exophiala spinifera.
• Treatment involved a combination of ketoconazole and 5-fluorocytosine.
• The patient achieved a complete cure following the prescribed antifungal therapy.

Implications:

• This case expands the geographic and clinical spectrum of Exophiala spinifera infections in humans.
• Highlights the importance of accurate mycological diagnosis for effective treatment of rare fungal infections.
• Suggests ketoconazole and 5-fluorocytosine as a viable treatment regimen for Exophiala spinifera subcutaneous infections.