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    Tenosynovitis caused by Scedosporium apiospermum infection misdiagnosed as an Alternaria species: a case report.
    BMC Infect Dis 2017 Jan 14;17(1):72. Epub 2017 Jan 14.
    Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
    Background: Scedosporium apiospermum, which can usually be isolated from soil, polluted stream water and decaying vegetation, is increasingly recognized as an opportunistic dematiaceous fungus. The mortality rate of infection in immunocompromised hosts is over 50%. S. apiospermum is commonly responsible for dermal and epidermal infections (i.e., mycetoma) after traumatic penetration.

    Case Presentation: A 73-year-old woman was admitted to our hospital complaining of painful swelling and tenderness on the dorsum of the proximal left wrist and hand. The symptoms had persisted for approximately 2 months. A physical examination revealed a 4 x 3 cm, poorly defined, erythematous papule, which was fluctuant, with pustules and crusts on the dorsum of the left hand.

    Conclusions: We report a very rare case of tenosynovitis caused by S. apiospermum infection. We identified the infectious agent via molecular DNA sequencing. The infectious agent was initially misidentified as an Alternaria species by microscopic examination with lactophenol cotton blue (LPCB) staining. The infection was successfully treated with debridement and adjuvant fluconazole therapy.

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    Department of Dermatology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555, USA.
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    Scedosporium apiospermum is a ubiquitous filamentous fungus that may infect immunocompetent patients after trauma and may cause severe and often fatal infections in immunocompromised hosts. Here, we present the case of a 28-year-old female with S. apiospermum infection on the left forearm that had developed while she was on long-term immunosuppressant therapy. Read More
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    Service de Dermatologie, Hôpital Beauregard, 21, rue des Frères, 57126 Thionville Cedex.
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