Exophiala Jeanselmei Infection in a Patient with Two Primary Malignancies

Abstract

Background:

Dematiaceous fungi are emerging as an important pathogen, particularly in individuals on immunosuppressive medications. These fungi produce brown to black pigment and are responsible for a wide spectrum of diseases, including superficial infections of the skin and eye and, uncommonly, deep infections involving the central nervous system and internal organs.

Objective:

We present a male patient with localized, cutaneous Exophiala jeanselmei infection.

Methods:

We review the literature and present a brief discussion of phaeohyphomycotic infections, their clinical features, and their treatment modalities.

Results:

Workup of our patient revealed an underlying hepatic lymphoma and pulmonary squamous cell carcinoma.

Conclusions:

Phaeohyphomycotic infections, although uncommon, are increasingly recognized as important pathogens in patients who are immunologically compromised as a result of long-term steroid or other immunosuppressive therapy. Infections by these organisms in healthy-appearing individuals should prompt one to consider an immunodeficiency state and appropriate workup should be performed.