Case Report: Coral Reef Pathogen Aspergillus sydowii Causing Black Grain Mycetoma

Am J Trop Med Hyg. 2021 Jan 4;104(3):871-873. doi: 10.4269/ajtmh.20-1352.

Abstract

Mycetoma is an infrequent subcutaneous infection caused by true fungi (eumycetoma) or aerobic actinomycetes (actinomycetoma). We report the case of a 62-year-old man with eumycetoma involving the left foot and ankle. Skin biopsy revealed black-brown grains, and in culture, a white colony fungus grew at day 8. Molecular sequencing using ITS1-ITS4 primers identified the species as Aspergillus sydowii. The patient was treated with itraconazole 200 mg twice daily and terbinafine 250 mg daily for 8 months, with complete response and no recurrence after 2.5 years of follow-up. Aspergillus sydowii is a saprotrophic fungus that rarely causes skin or nail disease. No cases of eumycetoma caused by this agent have been previously reported. As its geographic distribution continues to expand, it may increasingly be recognized as a cause of human disease.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Ankle / microbiology
  • Ankle / physiopathology*
  • Antifungal Agents / therapeutic use
  • Aspergillus / pathogenicity*
  • Female
  • Foot / microbiology
  • Foot / physiopathology*
  • Humans
  • Itraconazole / therapeutic use*
  • Male
  • Middle Aged
  • Mycetoma / diagnosis*
  • Mycetoma / drug therapy*
  • Mycetoma / physiopathology*
  • Terbinafine / therapeutic use*
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Itraconazole
  • Terbinafine