[Rhinofacial conidiobolomycosis associated with cervical, thoracic and brachial localizations: one clinical case in Nigeria].
We report here the clinical case of a Nigerian adult patient who received medical care during October 2010, at the Center for Diagnosis and Treatment of Buruli ulcer in Pobè (Benin). He presented a massive facial tumor associated with several subcutaneous (cervical, thoracic and upper limbs) nodules, evolving since several years. Tissue samples collected at Pobè medical center were addressed to the mycology and histology laboratories of Angers University Hospital (France), according to the medical exchange agreement between the two institutions about the diagnosis and treatment of Buruli ulcer disease. Histological examination showed a Splendore-Hoeppli phenomenon, consisting of a granulomatous reaction made of eosinophilic polynuclear cells surrounding rare, large and irregular, non-septate hyphae. A filamentous fungus was isolated by cultivation of the clinical samples, which was identified as Conidiobolus coronatus. The patient was treated orally with daily doses of ketoconazole (400 mg per day). After 4 months of treatment, a marked regression of the facial lesion was obtained. A first constructive facial surgery was achieved, but the patient did not attend the second step. This case report allows us to remind the mycological diagnosis of this exotic mycosis, but also to emphasize the main difficulties encountered in medical management in the developing countries.
Laboratoire de parasitologie-mycologie, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France.
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Twizeyimana
Centre de diagnostic et de traitement de l'ulcère de Buruli, Pobè, Bénin.
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A
Chauty
Laboratoire de parasitologie-mycologie, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France. Electronic address: mapihet@chu-angers.fr.
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M
Pihet
Centre de diagnostic et de traitement de l'ulcère de Buruli, Pobè, Bénin.
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MF
Ardant
Centre de diagnostic et de traitement de l'ulcère de Buruli, Pobè, Bénin.
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A
Adeye
Laboratoire d'anatomie pathologique, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France.
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Zidane
Laboratoire de parasitologie-mycologie, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France.
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L
de Gentile
Laboratoire d'anatomie pathologique, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France.
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JP
Saint-André
Laboratoire de parasitologie-mycologie, institut de biologie en santé, centre hospitalier universitaire, 4, rue Larrey, 49933 Angers cedex 9, France.
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Chabasse
D020092:Conidiobolus / Q000302:isolation & purification; D005145:Face / Q000382:microbiology; D005148:Facial Dermatoses / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D009668:Nose Diseases / Q000175:diagnosis* / Q000382:microbiology; D020096:Zygomycosis / Q000175:diagnosis* / Q000382:microbiology
Conidiobolomycose; Conidiobolomycosis; Conidiobolus coronatus; Entomophthoramycose rhinofaciale; Entomophthoromycose; Exotic mycosis; Ketoconazole; Kétoconazole; Mycose exotique; Nodules sous-cutanés; Phénomène de Splendore-Hoeppli; Rhinofacial entomophtoramycosis; Splendore-Hoeppli phenomenon; Subcutaneous nodules