Our case may represent the rare primary cutaneous inoculation blastomycosis as lesions started on an area of previous trauma. Treatment with itraconazole was successful.
Eumycetoma is a chronic granulomatous infection of the skin, subcutaneous tissue, fascia, and bone caused by true fungi. Most commonly, it affects the foot or hand. Fungi commonly reported to cause eumycetoma are Madurella mycetomatis, Madurella grisea, Phialophora jeanselmei, Cephalosporium recifei, etc. There have been several previous reports of human invasive infections by Paecilomyces lilacinus causing endophthalmitis, keratitis, chronic sinusitis, skin and soft tissue infections, and catheter-related infections. We report a case of eumycetoma caused by P. lilacinus. To our knowledge, this is the first report of P. lilacinus causing eumycetoma of the foot in the English literature.
Our patient showed features identical to those of cases described by Hara and coworkers and assigned as a fourth type of tuberculide. As the lesions clinically resemble superficial thrombophlebitis, we propose the term "superficial thrombophlebitic tuberculide" rather than "nodular granulomatous phlebitis."
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