Skip to main content

Advertisement

Log in

Subcutaneous Phaeohyphomycosis Caused by Pyrenochaeta romeroi in a Rheumatoid Arthritis Patient: A Case Report with Review of the Literature

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

Pyrenochaeta romeroi is a rare fungal agent of chronic, suppurative subcutaneous infections leading to mycetoma. It is an unusual cause of deep, non-mycetomatous infections. We herein present review of the literature along with a case of 61-year-old Indian female with rheumatoid arthritis who developed subcutaneous phaeohyphomycosis caused by Pyrenochaeta romeroi. It posed a diagnostic challenge, as the culture from fine-needle aspirate revealed a non-sporulating dematiaceous mould, which was the only supportive tool for its diagnosis and initiation of the therapy. However, it was the molecular sequencing which played the pivotal role in clinching the final aetiological diagnosis. To the best of our knowledge, this is the 20th case of Pyrenochaeta species infection occurring worldwide and first case report of subcutaneous phaeohyphomycosis caused by Pyrenochaeta romeroi in a rheumatoid arthritis patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Badali H, Chander J, Gulati N, Attri A, Chopra R, Najafzadeh MJ, et al. Subcutaneous phaeohyphomycotic cyst caused by Pyrenochaeta romeroi. Med Mycol. 2010;48:763–8.

    Article  CAS  PubMed  Google Scholar 

  2. van de Sande WW, Maghoub el S, Fahal AH, Goodfellow M, Welsh O, Zijlstra E. The mycetoma knowledge gap: identification of research priorities. PLoS Negl Trop Dis. 2014;8(3):e2667. doi:10.1371/journal.pntd.0002667.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Borelli D. Opportunistic fungi as producers of gray colonies and mycetomata. Dermatologica. 1979;159:168–74.

    Article  CAS  PubMed  Google Scholar 

  4. Girard C, Dereure O, Rispail P, Durand L, Guilhou JJ. Subcutaneous phaeohyphomycosis due to Pyrenochaeta romeroi in a patient with leprosy. Acta Derm Venereol. 2004;84:154–5.

    Article  PubMed  Google Scholar 

  5. Sutton DA, Rinaldi MG, Sanche SE. Demetiaceous fungi. In: Anaissie EJ, McGinnis MR, Pfaller MA, editors. Clinical mycology. 2nd ed. London: Churchill Livingstone Elsevier; 2009. p. 329–54.

    Chapter  Google Scholar 

  6. Andre M, Brumpt V, Destombes P, Segretain G. Fungal mycetoma with black grains due to Pyrenochaeta romeroi in Cambodia. Bull Soc Pathol Exot Filiales. 1968;61:108–12.

    CAS  PubMed  Google Scholar 

  7. Baylet R, Camain R, Chabal J, Izarn R. Recent contribution to the study of mycetoma in Senegal. Neotestudina rosatii, Pyrenochaeta romeroi, Aspergillus nidulans. Bull Soc Med Afr Noire Lang Fr. 1968;13:311–3.

    CAS  PubMed  Google Scholar 

  8. David-Chausse J, Texier L, Darrasse H, Moulinier C. Autochthonous mycetoma of the foot due to Pyrenochaeta romeroi. Bull Soc Fr Dermatol Syphiligr. 1968;75:452–3.

    CAS  PubMed  Google Scholar 

  9. Thammayya A, Sanyal M, Basu N. Pyrenochaeta romeroi causing mycetoma pedis in India. J Indian Med Assoc. 1979;73:66–7.

    CAS  PubMed  Google Scholar 

  10. English MP. Infection of the finger-nail by Pyrenochaeta unguishominis. Br J Dermatol. 1980;103:91–3.

    Article  CAS  PubMed  Google Scholar 

  11. Serrano JA, Pisano ID, Lopez FA. Black grain minimycetoma caused by Pyrenochaeta mackinnonii, the first clinical case of eumycetoma reported in Barinas state, Venezuela. J Mycol Med. 1998;8:34–9.

    Google Scholar 

  12. Mohanty JC, Mohanty SK, Sahoo A, Ghosh SK, Pattnaik KL. Eumycetoma caused by Pyrenochaeta romeroi: a case report. Indian J Dermatol. 2000;45:76–7.

    Google Scholar 

  13. Ferrer C, Perez-Santonja JJ, Rodriguez AE, Colom MF, Gene J, Alio JL, et al. New Pyrenochaeta species causing keratitis. J Clin Microbiol. 2009;47:1596–8.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Cerar D, Malallah YM, Howard SJ, Bowyer P, Denning DW. Isolation, identification and susceptibility of Pyrenochaeta romeroi in a case of eumycetoma of the foot in the UK. Int J Antimicrob Agents. 2009;34:617–8.

    Article  PubMed  Google Scholar 

  15. Verkley GJ, Gene J, Guarro J, Perez-Santonja JJ, Rodriguez AE, Colom MF, et al. Pyrenochaeta keratinophila sp. nov., isolated from an ocular infection in Spain. Rev Iberoam Micol. 2010;27:22–4.

    Article  PubMed  Google Scholar 

  16. Khan Z, Ahmad S, Kapila K, Ramaswamy NV, Alath P, Joseph L, et al. Pyrenochaeta romeroi: a causative agent of phaeohyphomycotic cyst. J Med Microbiol. 2011;60:842–6.

    Article  PubMed  Google Scholar 

  17. Thiyagarajan UM, Bagul A, Nicholson M. A nodulo-cystic eumycetoma caused by Pyrenochaeta romeroi in a renal transplant recipient: a case report. J Med Case Rep. 2011;5:460.

    Article  Google Scholar 

  18. Ocampo MA, Kanitakis J, Bienvenu AL, Chauvet C, Euvrard S. Phaeohyphomycosis caused by Pyrenochaeta romeroi mimicking a plantar wart in a kidney transplant recipient. Transpl Infect Dis. 2012;14:E173–4.

    Article  CAS  PubMed  Google Scholar 

  19. Hsiao YW, Chia JH, Lu CF, Chung WH. Molecular diagnosis and therapeutic experience of subcutaneous Pyrenochaeta romeroi infection: a case report and review of the literature. Int J Dermatol. 2013;52:1237–40.

    Article  PubMed  Google Scholar 

  20. Chan YY, Tan AL, Tan BH. Subcutaneous abscess due to Pyrenochaeta romeroi in a renal transplant recipient. Singapore Med J. 2014;55:e64–6.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Yadav S, Agarwal R, Singh S, Goel S. Pyrenochaeta romeroi causing subcutaneous phaeohyphomycotic cyst in a diabetic female. Med Mycol Case Rep. 2015;8:47–9.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Rinaldi MG. Phaeohyphomycosis. Dermatol Clin. 1996;14:147–53.

    Article  CAS  PubMed  Google Scholar 

  23. Badali H, Najafzadeh MJ, Van Esbroeck M, Van den Enden E, Tarazooie B, Meis JFGM, et al. The clinical spectrum of Exophiala jeanselmei, with a case report and in vitro antifungal susceptibility of the species. Med Mycol. 2010;48:318–27.

    Article  CAS  PubMed  Google Scholar 

  24. Chowdhary A, Meis JF, Guarro J, de Hoog GS, Kathuria S, Arendrup MC, et al. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi. Clin Microbiol Infect. 2014;20 (Suppl 3):47–75. doi:10.1111/1469-0691.12515.

    Article  CAS  PubMed  Google Scholar 

  25. Sharkey PK, Graybill JR, Rinaldi MC, Stevens DA, Tucker RM, Peterie JD, et al. Itraconazole treatment of phaeohyphomycosis. J Am Acad Dermatol. 1990;23:577–86.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Malini R. Capoor.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sharma, S., Capoor, M.R., Singh, M. et al. Subcutaneous Phaeohyphomycosis Caused by Pyrenochaeta romeroi in a Rheumatoid Arthritis Patient: A Case Report with Review of the Literature. Mycopathologia 181, 735–743 (2016). https://doi.org/10.1007/s11046-016-0022-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-016-0022-7

Keywords

Navigation