Severe Chromoblastomycosis-Like Cutaneous Infection Caused by Chrysosporium keratinophilum

Abstract

Chrysosporium species are saprophytic filamentous fungi commonly found in the soil, dung, and animal fur. Subcutaneous infection caused by this organism is rare in humans. We report a case of subcutaneous fungal infection caused by Chrysosporium keratinophilum in a 38-year-old woman. The patient presented with severe chromoblastomycosis-like lesions on the left side of the jaw and neck for 6 years. She also got tinea corporis on her trunk since she was 10 years old. Chrysosporium keratinophilum was isolated from the tissue on the neck and scales on the trunk, respectively. The patient showed satisfactory response to itraconazole therapy, although she discontinued the follow-up.

Keywords: Chrysosporium keratinophilum; cutaneous infection; diagnosis; fungal infection; treatment.

FIGURE 1

(A) Initial presentation: plaques and multiple verrucous nodules as a cauliflower-like appearance, superficial ulceration filled with pus on her left side of jaw and neck. (B) Scaling lesions spontaneously appeared on her trunk. (C,D) Direct examination of 10% Potassium hydroxide (KOH) wet mounts of exudates from surface plaque of neck and scales from the trunk revealed hyphae fractions (×400).

FIGURE 2

(A,B) Septate hyphae were present in the dermis. (PAS stain, ×100 and ×400).

FIGURE 3

(A) Aggravated lesion re-appeared on her neck. (B) Scaling lesions were also noticed on her trunk (arrows). (C) Lesions gradually disappeared after treatment.

FIGURE 4

(A) After incubating at 25°C for 2 weeks, colonies appeared yellowish white, fluffy, and dense, powdery at the center on potato dextrose agar (PDA). (B) Hyaline hyphae bearing conidia which were terminal or lateral, sessile or on short, cylindrical protrusions, thick-walled, obovoid to clavate with conspicuous basal scars (lactophenol solution, ×400).