Chromoblastomycosis in a Solomon Islander
Author: Shailendra Kapoor
Published online: 18 February 2013
To the Editor: I read with great interest the recent article by Knox and Marshall.1 Chromoblastomycosis may result in a number of rare systemic complications that may be associated with significant morbidity.
For instance, chromoblastomycosis may affect the cornea. This usually follows cataract surgery. Cladophialophora carrionii is the aetiological agent involved in corneal chromoblastomycosis.2 Keratitis occurs, resulting in ocular pain and decreased visual acuity. Topical and systemic antifungal therapy may be successful in treating the condition, but usually surgical procedures such as penetrating keratoplasty are required.
Rarely, malignancies such as squamous cell carcinomas may develop in the affected area. This is more common in the extremities and in men over the age of 60 years. Rarely, amputation may be required in this scenario. This complication usually affects patients with a 20–30-year history of chronic untreated or undertreated chromoblastomycosis.3
Chromoblastomycosis may also affect the genitalia, resulting in genital elephantiasis. Chromoblastomycosis may rarely affect the skeletal system, resulting in osteomyelitis.4 Septic arthritis has also been reported. Treatment requires arthrotomy and debridement followed by antimycotic therapy.
Chromoblastomycosis may also affect the central nervous system. For instance, mycotic granulomas in the medullary region of the brain have been reported.5 This is usually seen in intravenous drug users and may be fatal.
These examples clearly illustrate the necessity of identifying and treating chromblastomycosis in a timely manner.
Competing interests
References
- Knox J, Marshall C. Chromoblastomycosis in a Solomon Islander. Med J Aust 2012; 197: 350. 0_BABIGBAJ
- Lari HB, Mirani N, Chu DS. Corneal chromoblastomycosis caused by Cladophialophora carrionii after cataract surgery. J Cataract Refract Surg 2011; 37: 963-966. 0_i1142869
- Torres E, Beristain JG, Lievanos Z, Arenas R. Chromoblastomycosis associated with a lethal squamous cell carcinoma. An Bras Dermatol 2010; 85: 267-270. 0_CBBDCABA
- De Guzman L, Perlman DC, Hubbard CE. Septic arthritis and osteomyelitis due to the chromoblastomycosis agent Fonsecaea pedrosoi. Am J Orthop (Belle Mead NJ) 2012; 41: 328-331. 0_pgfId-2713476
- Kasantikul V, Shuangshoti S, Sampatanukul P. Primary chromoblastomycosis of the medulla oblongata: complication of heroin addiction. Surg Neurol 1988; 29: 319-321. 0_pgfId-2713568
Costs of Delivering the Hep B PAST Model of Care in Remote Australia: A Retrospective Pre–Post Study
Hoa Nguyen, Anh Le Tuan Nguyen, Paula Binks, Melita McKinnon, Emily Vintour-Cesar, Karen Wills, Nicola Stephens, Benjamin Cowie, Joshua S. Davis, Yuejen Zhao, Peter Nihill, Julie A. Campbell, Andrew J. Palmer, Jane Davies, Barbara de Graaff
Buruli Ulcer Acquired From Ringtail Possum Rescue
Daniel P. O'Brien, Naomi Clarke, Sara Bonnici, Mohammad A. Hussain
Q Fever Visceral Abscesses After Contact With Native Australian Marsupials
Samantha J. Laws, Enzo Binotto, James Stewart, Jennifer Ho, Trent Yarwood, Josh Hanson, Simon Smith
Hospital-Admitted Injection-Related Infections Among Incarcerated People Who Inject Drugs in Australia: A Retrospective Cohort Study
Andrew Palmer, Matthew Carter, Jeremy Yeo, Cecilia Shim, Jason Connor, Jeremy Hayllar, Gerald Holtmann, Naomi Moy, Elliott G. Playford, Naomi Runnegar, Paul J. Clark
The Live Attenuated Influenza Vaccine in Australia: An Additional Tool for Influenza Prevention
Cyra Patel, Alexis Pillsbury, Tran Nguyen, Xia Wang, Helen E. Quinn, Clayton K. Chiu, Allen C. Cheng, Katie L. Flanagan, Zhicheng Wang
Reflex Testing for Hepatitis D Infection: A Unique Opportunity to Reduce Hepatitis D-Related Chronic Liver Disease Deaths in Australia
Jessica Howell, Lauren Andersson, Miriam T. Levy, James O'Beirne, Leon Adams, Katharine Irvine, Avik Majumdar, Golo Ahlenstiel, Kathy Jackson, Krispin Hajkowicz, Joseph Doyle, Jane Davies, Sarah Cherian, Wayne Dimech, Alexander J. Thompson