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Pseudomycetoma caused by Microsporum canis in an immunosuppressed patient: a case report and review of the literature
Author(s) -
Berg Jena C.,
Hamacher Kirsten L.,
Roberts Glenn D.
Publication year - 2007
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.1600-0560.2006.00628.x
Subject(s) - microsporum canis , dermatophyte , pathology , dermatology , medicine , tinea capitis , trichophyton , grocott's methenamine silver stain , staining , antifungal
Background: A 65‐year‐old woman with a history of liver and kidney transplantation presented with a pruritic and tender rash of 2‐year duration on her left knee. Methods: The patient had a physical examination, and multiple skin biopsies were performed. Results: Examination showed a cluster of dome‐shaped, violaceous papules. A skin biopsy specimen showed multiple granules containing basophilic material within the superficial to mid dermis. The grains were embedded in an eosinophilic substance and surrounded by granulomatous inflammation. A Gomori methenamine silver stain showed abundant septate hyphae, and cultures grew colonies of Microsporum canis . A diagnosis of dermatophytic granuloma, or pseudomycetoma, was made. After considering the patient’s immune status, a prolonged course of fluconazole was initiated. Conclusion: Microsporum canis , a frequently encountered zoophilic dermatophyte associated with tinea capitis and tinea corporis, is rarely associated with a mycetoma‐like presentation, grain formation, or systemic infection. The medical literature describes only six cases of M. canis causing mycetoma‐like formations in immunocompromised and immunocompetent patients. This case report describes an unusual presentation of a common dermatophyte infection, and the literature review summarizes the importance of recognizing atypical presentations of dermatophyte infections. Such infections may warrant more aggressive treatment in immunocompromised patients.