Abstract
A large number of phaeoid fungi cause infection in humans and other animals which is characterized by the basic development of sclerotic body, dark-coloured filamentous hyphae as well as yeast-like cells in the invaded tissue. Two cases of subcutaneous mycosis in immunocompetent male patients aged 55 and 58 years attending Dermatology outpatient department of a tertiary care hospital in Assam, north-east India, are reported. The first case was diagnosed as chromoblastomycosis which was caused by Cladosporium cladosporioides. The patient clinically presented with a chronic verrucous and nodular growth of 32-year duration on the left foot and leg. Identification of the species was done by sequencing the D1/D2 region of LSU (large subunit 28S rDNA). The patient was treated with surgical resection and oral itraconazole which showed good clinical response and total regression of lesion after 9 months. The second case due to Bipolaris cynodontis presented as verrucous exophytic growth over the dorsum of the right foot of 1-year duration which was diagnosed as chromoblastomycosis. The identification of the species was done by sequencing the ITS region. The patient was started with oral itraconazole but was lost to follow-up. Chromoblastomycosis due to Cladosporium cladosporioides is rare. Bipolaris cynodontis is not yet reported as a cause of human infection. The aetiological role of this fungus was confirmed by repeated isolation of the fungus from the lesion and direct microscopy. Molecular identification methods can increase the spectrum of black moulds causing human infection in coming years. We are reporting these two cases with review of the available literature.
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References
Matsumoto T, Ajello L. Agents of phaeohyphomycosis. In: Collier L, editor. Topley and Wilson’s microbiology and microbial infections. 9th ed. New york: Oxford University Press; 1998. p. 503–4.
Schell WA. Agents of chromoblastomycosis and sporotrichosis. In: Collier L, editor. Topley & Wilson’s microbiology and microbial infections. 9th ed. New York: Oxford University Press; 1998. p. 315–23.
Gugnani HC, Sood N, Singh B, Makkar R. Subcutaneous phaeohyphomycosis due to Cladosporium cladosporioides. Mycoses. 2000;43:85–7.
De Hoog GS, Guarro J, Gené J, Figueras MJ. Atlas of clinical fungi. 2nd ed. Utrecht: Central Bureau Voor Schimmelcultures; 1995. p. 474.
Möller EM, Bahnweg G, Sandermann H, Geiger HH. A simple and efficient protocol for isolation of high molecular weight DNA from filamentous fungi, fruit bodies, and infected plant tissues. Nucleic Acid Res. 1992;20:6115–6.
Kurtzman CP, Robnett CJ. Identification of clinically important ascomycetous yeasts based on nucleotide divergence in the 5′ end of the large subunit (26S gene) ribosomal DNA gene. J Clin Microbiol. 1997;35:1216–23.
Chowdhary A, Randhawa HS, Singh V, Khan ZU, Ahmad S, Kathuria S, et al. Bipolaris hawaiiensis as etiologic agent of allergic bronchopulmonary mycosis: first case in a paediatric patient. Med Mycol. 2011;49:760–5.
Kwon-Chung KJ, Schwartz IS, Ryback BJ. A pulmonary fungus ball produced by Cladosporium cladosporioides. Am J Clin Pathol. 1975;64:564–8.
Kantarcioglu AS, Yucel A, de Hoog GS. Case report-Isolation of Cladosporium from cerebrospinal fluid. Mycoses. 2002;45:500–3.
Annesie G, Cimitan A, Zambruno G, Di silverio A. Cutaneous phaeohyphomycosis due to Cladosporium cladosporioides. Mycoses. 1992;35:243–6.
Drabick JJ, Gomatos PJ, Solis JB. Cutaneous cladosporiosis as a complication of skin testing in a man positive for human immunodeficiency virus. J Am Acad Dermatol. 1990;22:135–6.
Veira MR, Milheiro A, Pacheco FA. Phaeohyphomycosis due to Cladosporium cladosporioides. Med Mycol. 2001;39:135–7.
Pereiro R Jr, Jo-Chu J, Toribo J. Phaeohyphomycotic cyst due to Cladosporium cladosporioides. Dermatology. 1998;197:90–2.
Sang H, Zheng XE, Zhou WQ, He W, Lv GX, Shen YN, et al. A case of subcutaneous phaeohyphomycosis caused by Cladosporium cladosporioides and its treatment. Mycoses. 2011;55:195–7.
Duquia RP, de Almeida HL, Jr Vettorato G, Rocha NM, de Castro LA. Ecthyma-like phaeohyphomycosis caused by Cladosporium cladosporioides. Mycoses. 2010;53:541–3.
Bordoloi P, Nath R, Borgohain M, Huda MM, Barua S, Dutta D, et al. Subcutaneous mycoses: an aetiological study of 15 cases in a tertiary care hospital of Dibrugarh, North East India. Mycopathologia. 2015;179:425–35.
McGinnis MR, Rinaldi MG, Winn RE. Emerging agents of Phaeohyphomycosis: pathogenic species of Bipolaris and Exserohilum. J Clin Microbiol. 1986;24:250–9.
da Cunha KC, Sutton DA, Fothergill AW, Cano J, Gene J, Madrid H, et al. Diversity of Bipolaris species in clinical samples in the United States and their antifungal susceptibility profiles. J Clin Microbiol. 2012;50:4061–6.
de Hoog GS, Guarro J, Gené J, Figueras MJ. Atlas of clinical fungi. 2nd ed. Utrecht: Central bureau voor schimmelcultures; 2000.
Kuan CS, Yew SM, Toh YF, Chan CL, Ngeow YF, Lee KW, et al. Dissecting the fungal biology of Bipolaris papendorfii: from phylogenetic to comparative genomic analysis. DNA Res 2015; 27:dsv007 (Epub ahead of print).
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Nath, R., Barua, S., Barman, J. et al. Subcutaneous Mycosis Due to Cladosporium cladosporioides and Bipolaris cynodontis from Assam, North-East India and Review of Published Literature. Mycopathologia 180, 379–387 (2015). https://doi.org/10.1007/s11046-015-9926-x
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DOI: https://doi.org/10.1007/s11046-015-9926-x