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Chromoblastomycosis Due to Fonsecaea monophora in a Man with Nephritic Syndrome

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Abstract

Chromoblastomycosis is a chronic subcutaneous mycosis caused by dematiaceous fungi. Fonsecaea monophora, a new species segregated from F. pedrosoi, may be the most prevalent pathogen of chromoblastomycosis in southern China. Herein, we report a rare case of chromoblastomycosis in a man with nephritic syndrome. He presented with an asymptomatic red plaque on the back of his left wrist that had appeared and enlarged over a period of 1.5 years, without any prior trauma. He was initially diagnosed with sporotrichosis. However, he did not respond to a 6-month course of potassium iodide treatment. The lesion slowly enlarged and became verrucous instead. Concurrently, a similar maculopapule appeared on his left forearm. Histopathological examination of a biopsy specimen indicated the presence of sclerotic bodies in the dermis. The fungus was identified as Fonsecaea spp. based on the results of a slide culture; in addition, the agent was confirmed to be F. monophora by using molecular methods. The patient demonstrated marked improvement after receiving appropriate antifungal therapy for 3 months. To our knowledge, this is the first case of chromoblastomycosis caused by F. monophora in an immunosuppressed patient. The identification of the agent by molecular techniques is important for epidemiological purposes. Thus, we believe that combination therapy with itraconazole and terbinafine would be a suitable option for infections caused by F. monophora.

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Acknowledgment

Funding Sources — The National Natural Science Foundation of China (No. 81271771).

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Authors and Affiliations

  1. Department of Dermatology, Southwest Hospital of the Third Military Medical University, Chongqing, 400038, China

    Huan Tan, Yan Xu, Xue-mei Lan, Ya-guang Wu, Cun-jian Zhou & **-chuan Yang

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  1. Huan Tan
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  2. Yan Xu
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  3. Xue-mei Lan
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  4. Ya-guang Wu
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  5. Cun-jian Zhou
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Correspondence to Cun-jian Zhou or **-chuan Yang.

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Tan, H., Xu, Y., Lan, Xm. et al. Chromoblastomycosis Due to Fonsecaea monophora in a Man with Nephritic Syndrome. Mycopathologia 179, 447–452 (2015). https://doi.org/10.1007/s11046-014-9856-z

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  • DOI: https://doi.org/10.1007/s11046-014-9856-z

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