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A Non-Mycetomatous Pseudallescheria boydii Skin Infection in An Immunocompromised Man
Jene-Kuen Wang, M. Ming-Long Hsu, J. Ju-Yun Lee
Dermatol Sinica 13: 93-102, 1995

Pseudallescheria boydii is an increasingly important cause of infection in debilitated and immunocompromised hosts. It causes infection of various organs. In skin, it usually manifests mycetoma. Non-mycetomatous skin infection is very rare. Only 3 cases were reported in the English literature. We report a new case with such infection. A 65-year-old man with diabetes mellitus and alcoholism was admitted for shortness of breath. He had upper GI bleeding and septic arthritis 20 days prior to the admission. Pulmonary nocardiosis and generalized dermatophytosis were diagnosed after admission. A progressively enlarging necrotic ulcer was noted on his left forearm for about 10 months. A biopsy specimen from ther ulcer revealed thrombosis and large aggregates of hyaline, septate hyphae in the dermis. P. boydii was isolated from the biopsy specimen. Despite aggressive treatment including ketoconazole, the general condition deteriorated. The patient was dicharged 10 days later due to continuous upper GI bleeding and multorgan failure.

   
   
 
 
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