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Phaeoacremonium sphinctrophorum as a Novel Agent of Eumycetoma

Beatriz Bustamante, MD1; Sarah Abdalla Ahmed, PhD2,3,4; G. S. De Hoog, PhD2,3,5,6,7; Carlos Seas, MD1; Wendy W. J. Van De Sande, PhD8
[+] Author Affiliations
1Departamento de Enfermedades Infecciosas, Tropicales y Dermatologicas, Hospital Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt-Universidad Peruana Cayetano Heredia, Lima, Peru
2Centraalbureau voor Schimmelcultures KNAW Fungal Biodiversity Center, Utrecht, the Netherlands
3Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands
4Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
5Changzheng Hospital, Second Military Medical University, Shanghai, China
6Basic Pathology Department, Federal University of Paraná State, Curitiba, Paraná, Brazil
7Basic Pathology Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
8Erasmus MC, Department of Medical Microbiology and Infectious Diseases, Rotterdam, the Netherlands
JAMA Dermatol. 2016;152(9):1063-1065. doi:10.1001/jamadermatol.2016.1310.
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This case report describes a patient with eumycetoma caused by Phaeoacremonium sphinctrophorum.

Eumycetoma is a chronic granulomatous fungal disease of the subcutaneous tissues characterized by large tumorous masses and the production either black or white grains.1 As a result of the use of molecular diagnostic techniques, previously unrecognized causative agents of eumycetoma have been discovered. We report the first case to our knowledge of eumycetoma caused by Phaeoacremonium sphinctrophorum.

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Figure 1.
Clinical Appearance of the Eumycetoma Lesion and Histological Appearance of the White Grain

A, Eumycetoma of the right heel with white grains secreted from the sinus (inset). B, Hematoxylin-eosin–stained specimen of a white grain (original magnification ×100).

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Figure 2.
Fungal Colony Images

A, Cultured on oatmeal agar, the colony was reddish and velvety after 7 days of incubation. B, Type I phialides, short (3-9 µm; average length, 4 µm), occasionally wider at the base, with conidia (original magnification ×400). C, Type III phialides, longer (14-39 µm; average length, 22 µm), elongate-ampulliform or subcylindrical, and tapered at the apex (original magnification ×400).

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