Abstract:

Objective To report the first case of hyalohyphomycosis caused by Sarocladium implicatum (Acremonium implicatum) in China.Methods A 69-year-old female patient came to us with an nodule on the left forearm for 9 months.Tissue was biopsied for microbiological and histopathological studies.Pathology showed inflammation,necrosis and granulation with fungal element in tissue.A positive fungus was recovered that was later identified as Sarocladium implican (Acremonium implicatum) according to morphology and DNA sequencing identification.Results This case was diagnosed as hyalohyphomycosis according to the finding of uncolored fungal elements in histopathological examination,with the positive fungal culture of the tissue.The isolate grown on culture was demonstrated belong to S. implicatum by DNA sequence analysis.She was cured after 3 months treatment with oral kalium iodidum solution and topical sertaconazole nitrate cream.Conclusion This is the first case of hyalohyphomycosis caused by S. implicatum in China confirmed both by culture and by pathological methods.Morphological characteristics and sequence of the ITS region of ribosomal DNA confirmed the identification of the isolate.Combination of kalium iodidum and sertaconazole is effective.

Key words: Sarocladium implicatum, Acremonium implicatum, hyalohyphomycosis, sertaconazole, kalium iodidum