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Chromoblastomycosis caused by Exophiala spinifera
A A Padhye1, A A Hampton, M T Hampton
1Division of Bacterial and Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Summary
This study details the first US case of chromoblastomycosis from Exophiala spinifera, a fungus typically causing phaeohyphomycosis. Researchers observed a unique in vivo method of fungal propagation, leading to successful treatment with antifungal medication and heat therapy.
Area of Science:
- Mycology
- Dermatology
- Infectious Diseases
Background:
- Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue.
- Exophiala spinifera is a dematiaceous fungus known to cause phaeohyphomycosis.
- This report describes the second documented case of chromoblastomycosis caused by E. spinifera globally.
Observation:
- The first case of Exophiala spinifera-induced chromoblastomycosis in the United States is presented.
- Biopsied tissue revealed characteristic muriform cells (sclerotic bodies) within multinucleated giant cells in the dermis.
- A novel in vivo process of endoconidial formation and propagation of muriform cells was observed for the first time.
Findings:
- Exophiala spinifera can cause chromoblastomycosis, expanding its known pathogenic potential.
- The observed endoconidial formation offers new insights into fungal reproduction in vivo.
- Combined treatment with itraconazole, 5-fluorocytosine, and heat therapy led to significant clinical improvement.
Implications:
- This case highlights E. spinifera's ability to cause diverse infections, challenging previous classifications.
- Chromoblastomycosis and phaeohyphomycosis may represent a spectrum of disease caused by the same fungal agents.
- Findings contribute to understanding fungal pathogenesis and inform therapeutic strategies for dematiaceous fungal infections.