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Ann Lab Med. Nov 2012; 32(6): 438–441.
Published online Oct 17, 2012. doi:  10.3343/alm.2012.32.6.438
PMCID: PMC3486940
Subcutaneous Phaeohyphomycosis Caused by Exophiala salmonis
Young Ahn Yoon, M.D.,1 Kyung Sun Park, M.D.,1 Jang Ho Lee, M.T.,1 Ki-Sun Sung, M.D.,2 Chang-Seok Ki, M.D.,1 and Nam Yong Lee, M.D.corresponding author1
1Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
corresponding authorCorresponding author.
Corresponding author: Nam Yong Lee. Department of Laboratory Medicine and Genetics, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: +82-2-3410-2706, Fax: +82-2-3410-2719, micro.lee/at/samsung.com
Received June 18, 2012; Revised July 30, 2012; Accepted September 12, 2012.
Abstract
We report a case of subcutaneous infection in a 55-yr-old Korean diabetic patient who presented with a cystic mass of the ankle. Black fungal colonies were observed after culturing on blood and Sabouraud dextrose agar. On microscopic observation, septated ellipsoidal or cylindrical conidia accumulating on an annellide were visualized after staining with lactophenol cotton blue. The organism was identified as Exophiala salmonis by sequencing of the ribosomal DNA internal transcribed spacer region. Phaeohyphomycosis is a heterogeneous group of mycotic infections caused by dematiaceous fungi and is commonly associated with immunocompromised patients. The most common clinical manifestations of subcutaneous lesions are abscesses or cystic masses. To the best of our knowledge, this is the first reported case in Korea of subcutaneous phaeohyphomycosis caused by E. salmonis that was confirmed by molecular analysis and identification of morphological characteristics. This case suggests that E. salmonis infections are no longer restricted to fish.
Keywords: Phaeohyphomycosis, Exophiala, Soft tissue infection, Sequence analysis, Korea
Articles from Annals of Laboratory Medicine are provided here courtesy of
Korean Society for Laboratory Medicine