Oral phaeohyphomycosis

Phaeohyphomycosis of the Ankle Joint: A Case Report

Introduction

Fungal infection of the musculoskeletal system is very rare. We present a rare case of fungal infection in the ankle joint. Skeletal phaeohyphomycosis (PHM) has been reported only once before in the literature.

Case Report

A 56-year-old man presented with pain and swelling in his right ankle for 2 years. There was a diffuse swelling over the medial and lateral aspect of the ankle with restricted movements. Arthroscopic biopsy was done from the ankle and histopathological examination showed pigmented fungi with few phagocytosed fungal hyphae within multinucleated giant cells indicating PHM. The patient was treated with itraconazole. At 1-year follow-up, the patient is pain free and can do his routine activities comfortably.

Conclusion

Fungal infection is a rare condition and must be kept in mind while dealing with chronic foot and ankle swelling. Early diagnosis and treatment will give good functional results.

Oral phaeohyphomycosis in a patient with squamocellular carcinoma of the lip: second case report

This communication reports the second known case of oral phaeohyphomycosis in a patient with squamocellular carcinoma of the lip. The patient, an 82-year-old black woman, a former smoker (for more than 30 years), suffering from an ulcerous vegetative lesion in the middle third of the lower lip for approximately 12 months. The result of the histopathological analysis indicated carcinoma, with well-differentiated keratinized squamous cells and the presence of septate mycelial filaments. In the direct mycological examination, thick and dematiaceous septate mycelial filaments were observed. After the resection surgery, the patient did not need to use an antifungal drug to treat the phaeohyphomycosis, and no follow-up radiotherapy was needed to treat the squamocellular carcinoma. We stress that the presence of the squamocellular lesion of the lip was a possible contributing factor to the infection.

Cutaneous alternariosis in a renal transplant patient successfully treated with posaconazole: Case report and literature review

Cutaneous alternariosis is an uncommon fungal infection that most commonly presents in organ transplant patients on immunosuppressive therapy. There are no clinical trials or guidelines to guide treatment of this condition, however itraconazole is the most commonly used antifungal in published cases. Here we report on a case of cutaneous alternariosis in a renal transplant recipient treated with a newer antifungal, posaconazole. A review of published reports of cutaneous alternariosis since 2008 is also discussed.

Intraoral phaeohyphomycosis

Phaeohyphomycosis is an infection caused by pigment-producing saprophytic fungi. Systemic infections may occur in the immunocompromised patient. Infection in healthy individuals may result in subcutaneous abscess formation. Oral lesions appear to be rare. A case of intraoral phaeohyphomycosis presenting as a well-demarcated, painful nodule of the anterior hard palate in a 12-year-old healthy male is described. The mass was excised and the diagnosis was established following histopathologic examination of the tissue.