Liu Wentao, Xie Shuxia, Zhu Guoxing, Qin Shitong, Li Meirong, Yin Songchao, Lai Wei, Lu Chun, Chen Qiaoping, Feng Peiying
Department of Dermatology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Allergy, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
PLoS Negl Trop Dis. 2025 Sep 2;19(9):e0013484. doi: 10.1371/journal.pntd.0013484. eCollection 2025 Sep.
Chromoblastomycosis (CBM) and mycetoma, as implantation mycoses, have been listed as neglected tropical diseases (NTDs) by the World Health Organization. The concurrent occurrence of these two NTDs in a single patient is extremely rare. A 69-year-old female patient presented with papules on the dorsum of her left hand for over 5 months and nodules on the left lower limb accompanied by ulceration and pain for 20 days. Histopathological examination of the papule on the dorsum of the left hand revealed muriform cells and fungal culture of the tissue identified Fonsecaea monophora. Microscopic examination of the purulent secretion from the ulcer on the left lower calf revealed the presence of grains, and the tissue culture result was Scedosporium apiosperma complex, with metagenomic next-generation sequencing further identifying S. dehoogii as the predominant pathogen. The clinical diagnosis was CBM caused by F. monophora combined with eumycetoma due to S. dehoogii. The patient was treated with voriconazole at a dosage of 200 mg twice daily for 4 weeks, after which the papules on the dorsum of the left hand and the ulcer on the left lower calf showed gradual improvement. This case represents the first reported instance of concurrent CBM caused by F. monophora and eumycetoma due to S. dehoogii, providing a novel perspective on the clinical manifestations and early identification of neglected implantation mycoses.
着色芽生菌病（CBM）和足菌肿作为植入性真菌病，已被世界卫生组织列为被忽视的热带病（NTDs）。这两种NTDs同时出现在一名患者身上极为罕见。一名69岁女性患者左手背出现丘疹5个多月，左下肢出现结节并伴有溃疡和疼痛20天。左手背丘疹的组织病理学检查发现了砖格状细胞，组织真菌培养鉴定为单孢瓶霉。左小腿下部溃疡脓性分泌物的显微镜检查发现有颗粒，组织培养结果为阿利什霉属复合体，宏基因组下一代测序进一步确定德霍氏阿利什霉为主要病原体。临床诊断为单孢瓶霉引起的CBM合并德霍氏阿利什霉所致的真菌性足菌肿。患者接受伏立康唑治疗，剂量为每日两次，每次200mg，持续4周，之后左手背丘疹和左小腿下部溃疡逐渐好转。该病例是首例报告的由单孢瓶霉引起的CBM与德霍氏阿利什霉所致的真菌性足菌肿同时发生的病例，为被忽视的植入性真菌病的临床表现和早期识别提供了新的视角。
