title: Subcutaneous phaeohyphomycosis caused by Exophiala salmonis.
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.
authors.affiliation: Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Young Ahn
authors.initials: YA
authors.lastname: Yoon
authors.forename: Kyung Sun
authors.initials: KS
authors.lastname: Park
authors.forename: Jang Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Ki-Sun
authors.initials: KS
authors.lastname: Sung
authors.forename: Chang-Seok
authors.initials: CS
authors.lastname: Ki
authors.forename: Nam Yong
authors.initials: NY
authors.lastname: Lee
mesh_terms: D021903:DNA, Ribosomal Spacer / Q000235:genetics; D030541:Databases, Genetic; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology; D005093:Exophiala / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060446:Phaeohyphomycosis / Q000175:diagnosis* / Q000382:microbiology; D017422:Sequence Analysis, DNA
chemical_list: D021903:DNA, Ribosomal Spacer
keywords: Exophiala; Korea; Phaeohyphomycosis; Sequence analysis; Soft tissue infection