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Chinese Journal of Mycology 2013, Vol. 8  Issue (6): 338-341.

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A case of cutaneous chromoblastomycosis caused by Fonsecaea monophora and laboratory study

WANG Run-chao, WAN Zhe, CHEN Wei, TU Ping, LI Ruoyu, WANG Ai-ping   

  1. Department of Dermatology and Venereology, Peking University First Hospital, Peking University Research Center for Medical Mycology, Beijing 100034, China
  • Received:2013-05-30 Online:2013-12-28 Published:2013-12-28

Abstract: Objective To report a case of chromoblastomycosis caused by Fonsecaea monophora and related laboratory investigation.Methods A 60-year-old woman was admitted with skin granulomatous lesions on the left hand for more than one year.Direct smear examination and fungal culture,Histopathologic examination, scanning electron microscope examination, PCR and ribosomal internal transcribed spacer(ITS)sequence analysis were performed for diagnosis.The antifungals susceptibility was tested according to M38-A2 published by CLSI.Results Sclerotic bodies were observed by direct smear examination.Histopat hologic examination showed chronic granuloma and round,thick-walled sclerotic bodies.Fungal culture produced olivaceous to black colonies.Rhinocladiella type and cladosporium type conidia were observed in the slide culture and scanning electron microscope examination. Ribosomal DNA ITS domains were amplified,and the product was sequenced, which was aligned with 100%sequential similarity to multiple sequences of F.monophora in the GenBank database. The MICs for itraconazole and terbinafine were 1.0 μg/mL and 0.015 6 μg/mL against this strain, After treatment with terbinafine (250 mg,QD) alone for 6 weeks, and itraconazole (200 mg, QD) combined with terbinafine (250 mg,QD)for 8 weeks,the patient was cured.Conclusions The case of cutaneous chromoblagtomycosis was caused by F.monophora identified by histopathology, mycology and molecular biology, Itraconazole with terbinafine has good effect.

Key words: Fonsecaea monophora, chromoblastomycosis, itraconazole, terbinafine

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