Phaeohyphomycosis caused by Diaporthe phaseolorum in an immunocompetent patient in Thailand: a case report

Abstract

Phaeohyphomycosis is caused by a large, heterogeneous group of darkly pigmented fungi. It is an infrequent infection in humans. However, the prevalence has been increasing in recent years especially in immunocompromised patients. Diaporthe phaseolorum is a common black fungal pathogen of plants, which rarely causes human infection. We report the first case of cutaneous infection caused by Diaporthe phaseolorum in an immunocompetent host and the first in Asia. Although, the review of the literature revealed two previous cases of cutaneous infection caused by this organism, both of them were in immunocompromised hosts. A slow-growing asymptomatic nodule was the major clinical feature. Histopathological examination showed granulomatous inflammation and pigmented septate hyphae and yeast-like cells. The fungal isolation was identified by morphological characteristics and DNA sequencing. The lesion was resolved after complete surgical excision and oral fluconazole for two months. This report highlights the potential role of Diaporthe phaseolorum as an emerging cause of infection in immunocompetent patients.

Molecular Identification of Fungi Causing Tissue Mycoses From Formalin Fixed Paraffin Embedded (FFPE) Archive Specimens

“…However, there are a few reports regarding Diaporthe spp. causing cutaneous, subcutaneous, and invasive mycoses (21)(22)(23)(24). This work also identified Pythium insidiosum and Rhizophus oryzae in two cases of acute fulminant fungal sinusitis.…”

Phylogenetic and Haplotype Network Analyses of Diaporthe eres Species in China Based on Sequences of Multiple Loci

“…The genus Diaporthe (asexual morph, Phomopsis ) represents a group of cosmopolitan species, including saprophytic, endophytic, and pathogenic ones on different plants [ 3 , 4 , 5 , 6 , 7 ]. Furthermore, Diaporthe species were also reported as the causal agents of many important diseases in humans, mammals, and insects [ 8 , 9 , 10 , 11 ]. To date, over 1020 names of “ Diaporthe ” and around 950 names of the asexual morph “ Phomopsis ” have been recorded in MycoBank lists ( (accessed on 15 July 2020), of which more than 100 Diaporthe and/or Phomopsis species have been reported in China [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ].…”

Black grain eumycetoma due to Diaporthe ueckerae. Taxonomical update of previous agents of infections due to Diaporthe spp.

“…( D. miriciae , D. ueckerae or D. rosae ). Thus, all the published D. phaseolorum human infection cases (until 2020) were in fact caused by D. rosae , D. miriciae or D. uekerae (Table 1) [ 8 , [10] , [11] , [12] , [13] , [14] ]. Remarkably, when our ITS sequence was blasted against the non-curated database it showed the highest identity with D. phaseolorum (99.48% identity).…”

“… Soft tissue infection dorsum of the right hand Surgery + FLC (200 mg/day 2 month)/cured. Thailand/2020 [ 12 ] Diaporte miriciae (MH268404) D. passifloricola (NR_147595.1/ 98 .74%) D. uakerae (NR_147543.1/98.00%) 59/female Poorly controlled diabetes Farmer/Ziziphus jujuba Soft tissue infection Left hand Surgery + TRB/cured Taiwan/2021 (13) Diaporthe uakerae (OL981188) 48/male Renal transplant recipient Farmer Mycetoma Left foot Surgery + ITC (200 mg/day 2 m a nth) switched to FLC (200 mg/day 4 month). Started a new ITC treatment (Nov. 2021)/not cured This work a Displayed species are those who had ≥99.00% identity or, failing that, the two species with the highest percentages of identity.…”