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Human subcutaneous pythiosis

J A Triscott1, D Weedon, E Cabana

  • 1Department of Anatomical Pathology, Royal Brisbane Hospital, Australia.

Journal of Cutaneous Pathology
|June 1, 1993
PubMed
Summary
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Two young, immunocompetent males developed subcutaneous Pythium infections, mimicking tumors. Prompt diagnosis and amphotericin B treatment were effective for this rare human pythiosis.

Area of Science:

  • Medical Mycology
  • Infectious Diseases

Background:

  • Pythium is a significant pathogen in horses, causing pythiosis.
  • Human subcutaneous pythiosis is rare, with limited documented clinical and histopathological features.

Observation:

  • Two cases of subcutaneous Pythium infection in young, immunocompetent males presented with rapid periorbital growth, clinically resembling tumors.
  • Exposure to swampy water or horses was noted in both cases.
  • Histopathology revealed a distinctive tissue reaction similar to equine pythiosis, with eosinophilic islands, macrophages, giant cells, fibrosis, and eosinophils.

Findings:

  • Hyphae were visualized using Grocott stain.
  • Immunoperoxidase techniques confirmed the Pythium organism.
  • Both patients showed a positive response to amphotericin B treatment.

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Implications:

  • This study details the clinical and histopathological characteristics of human subcutaneous pythiosis.
  • It highlights the importance of considering Pythium in cases of rapidly growing subcutaneous lesions, especially with relevant exposure history.
  • Effective treatment with amphotericin B is demonstrated for this rare fungal infection.