title: Human phaeohyphomycotic osteomyelitis caused by the coelomycete Phomopsis saccardo 1905: criteria for identification, case history, and therapy.
abstract: The Sphaeropsidales, coelomycetous fungi producing asexual conidia within enclosed conidiomata (pycnidia), are saprobic on numerous vascular plants. Despite their ubiquitous nature, only a limited number of genera have been documented as causing human disease. We report what we believe to be the first human case of osteomyelitis due to a Phomopsis species in a chronically immunosuppressed female. The patient developed a subcutaneous abscess on the distal phalanx of the right fourth finger complicated by osteomyelitis. Operative specimens revealed fungal hyphae and a pure culture of mould. The patient was treated with a 6-month course of itraconazole. At 16 months of follow-up, she remained free of recurrence. Phomopsis species differ from the similar, more frequently reported Phoma species by having immersed, thick-walled, multiloculate conidiomata and by the production of alpha (short, ellipsoidal) and beta (long, filamentous) conidia.
authors.affiliation: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78284, USA. suttond@uthscsa.edu
authors.forename: D A
authors.initials: DA
authors.lastname: Sutton
authors.forename: W D
authors.initials: WD
authors.lastname: Timm
authors.forename: G
authors.initials: G
authors.lastname: Morgan-Jones
authors.forename: M G
authors.initials: MG
authors.lastname: Rinaldi
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001203:Ascomycota / Q000145:classification / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D009181:Mycoses / Q000150:complications* / Q000175:diagnosis; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D011241:Prednisone / Q000009:adverse effects; D011859:Radiography