Two cases of multiple subcutaneous cystic phaeohyphomycosis in immunocompromised patients with a rare causative organism

Abstract

Phaeohyphomycosis comprises a spectrum of mycotic infectious diseases caused by heterogeneous group of phaeoid fungi. A subcutaneous cystic swelling with histological hallmark of pigmented hyphae in tissues accompanied by pyogenic granuloma is diagnostic of phaeohyphomycosis. We present two cases of phaeohyphomycosis in 65- and 55-year-old male agriculturalists, who presented with multiple, cystic soft-tissue masses involving extremities. Culture was done in one case and the specific organism was identified as Aureobasidium pullulans.

Polymorphous presentation of subcutaneous phaeohyphomycosis: a rare occurrence

“…Phaeohyphomycosis represents a wide spectrum of clinical diseases caused by dematiaceous fungi. It frequently appears as an opportunistic infection in immunosuppressed patients but can rarely affect immunocompetent individuals, as in our case . The characteristic presentation of phaeohyphomycosis is an asymptomatic, solitary, discrete, well encapsulated, subcutaneous nodule, cyst, or abscess commonly over the extremities .…”

Primary cutaneous non‐pigmented mycotic cyst contained in an epidermal inclusion cyst: Case report and review of the literature

“…True cysts such as epidermal inclusion cysts, by definition, require the presence of an epithelial lining. Mycotic cysts do not normally possess a true epithelial border and are instead surrounded by fibrocollagenous lining, hence classifying them as “pseudocysts.”…”

“…They are most commonly associated with dematiaceous fungi, which are a heterogeneous group of pigmented fungi that cause pheomycotic cysts with pigmented fungal walls . The most commonly implicated dematiaceous species include Exophiala, Wangiella, Alternaria, Bipolaris, Phialophora, Colletotrichum, Phialemonium , and Phoma species . They are commonly found in subtropical and tropical settings that contain moist environments such as decaying vegetation, bird nests, wood, and soil …”

Subcutaneous Fungal Abscess Mimicking an Implantation Dermoid- A Case Report

“…They result in asymptomatic, nodular or cystic lesion. 2 Subcutaneous fungal infections are more common in extremities. Their diagnosis is usually missed as fungal cyst are not commonly encountered and they mimic like other commonly encountered swellings.…”