Subcutaneous Phaeohyphomycosis Caused by Pyrenochaeta romeroi in a Rheumatoid Arthritis Patient: A Case Report with Review of the Literature.
Pyrenochaeta romeroi is a rare fungal agent of chronic, suppurative subcutaneous infections leading to mycetoma. It is an unusual cause of deep, non-mycetomatous infections. We herein present review of the literature along with a case of 61-year-old Indian female with rheumatoid arthritis who developed subcutaneous phaeohyphomycosis caused by Pyrenochaeta romeroi. It posed a diagnostic challenge, as the culture from fine-needle aspirate revealed a non-sporulating dematiaceous mould, which was the only supportive tool for its diagnosis and initiation of the therapy. However, it was the molecular sequencing which played the pivotal role in clinching the final aetiological diagnosis. To the best of our knowledge, this is the 20th case of Pyrenochaeta species infection occurring worldwide and first case report of subcutaneous phaeohyphomycosis caused by Pyrenochaeta romeroi in a rheumatoid arthritis patient.
Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Sonam
S
Sharma
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. malinircapoor@gmail.com.
Malini R
MR
Capoor
Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Mukul
M
Singh
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Deepti
D
Kiran
Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Ashish Kumar
AK
Mandal
D001172:Arthritis, Rheumatoid / Q000150:complications*; D001203:Ascomycota / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D044963:Biopsy, Fine-Needle; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D007194:India; D008828:Microbiological Techniques; D008853:Microscopy; D008875:Middle Aged; D060446:Phaeohyphomycosis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D011859:Radiography; D017422:Sequence Analysis, DNA; D012867:Skin / Q000473:pathology
D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer
Phaeohyphomycosis; Pyrenochaeta romeroi; Rheumatoid arthritis; Subcutaneous