Subcutaneous phaeohyphomycotic abscess caused by Pleurophomopsis lignicola.

A 41-year-old man with a past medical history of diabetes mellitus type II, AIDS (diagnosed 2 years earlier; CD4 count < 10), peripheral neuropathy, and pulmonary tuberculosis of 2 years duration was admitted to the hospital with abnormal liver function tests. There was a chronic hepatitis/cholestasis that had worsened while the patient was undergoing directly observed tuberculosis therapy. On admission, the patient complained of a painful swelling on his right arm. In the posterior aspect of the arm, there was a 3-4-cm subcutaneous mass that was fluctuant, mobile and tender. Incision of the mass released yellowish pus mixed with blood. Direct examination of the pus in KOH mounts and Gram-stained smears revealed subhyaline, septate, branched hyphae. When the pus was cultured on Sabouraud dextrose agar containing chloramphenicol, several velvety, olivaceous grey colonies grew after 7 days at 25 degrees C. When grown on oatmeal agar, the fungus produced subglobose, rostrate pycnidia with phialidic conidiogenous cells, and 1-celled cylindrical conidia. It was identified as Pleurophomopsis lignicola Petrak. This report describes the third known case of subcutaneous infection caused by P. lignicola in an immunocompromized patient.

Molecular relatedness within the "Ascochyta pinodes-complex".

The morphological, molecular and pathological characters of 34 isolates identified as Ascochyta pinodes, A. phaseolorum, and Phoma medicaginis var. pinodella were determined. Initial molecular findings, based on PCR fragment size and RFLPs of sections of the mitochondrial genome, the rRNA gene cluster and the beta-tubulin gene complex, were further investigated by sequencing of the total rRNA ITS regions. Isolates were homogenous for all characteristics determined, with the exception of conidial size and septation, and RFLPs of AT rich (presumptive mitochondrial) DNA. The results suggest that the isolates represent host preferential forms of a single taxon, and this finding is discussed in relation to the known teleomorphs and reference material of the species studied.

Maxillary sinusitis caused by Pleurophomopsis lignicola.

An immunocompetent 59-year-old man developed sinusitis over a 6- to 8-month period after cutting down a rotted maple tree (Acer sp.). A polypoid obstruction with a bloody drainage was evident in his right nasal cavity. A computed tomographic scan showed an opacification of the maxillary sinus. Surgery was performed to remove a fungus ball that had extended into the patient's medial sinus cavity. Sections of the sinonasal mucosa revealed marked acute and chronic sinusitis with inflammation, congestion, and hemorrhage. Sections from the pasty brown to black debrided material revealed a fungus ball consisting of an extensive network of brown-pigmented, septate, profusely branched hyphae. When grown on oat agar, the phaeoid fungus produced pycnidia and was identified as Pleurophomopsis lignicola. The genus Pleurophomopsis includes seven species, which are all known from plant material. This report documents for the first time a coelomycetous fungus, P. lignicola, causing sinusitis in an immunocompetent patient.

Sphaeropsis subglobosa keratomycosis--first reported case.

Recurrent keratomycosis is reported due to the coelomycete Sphaeropsis subglobosa, which has not been recognised previously as a human pathogen. Infection followed corneal injury by a frayed bamboo cane with implantation of its splinters. Initial successful therapy with 2% clotrimazole topically, to which it was sensitive, was followed by recurrent infection after 39 months, initially a keratitis but progressing to an endophthalmitis. Penetrating keratoplasty was necessary to eradicate the infection. Further isolation of the fungus showed that it had not developed resistance to clotrimazole but had survived dormant, deep in the corneal stroma. S. subglobosa should be considered in bamboo-associated and horticultural injuries.

Liver infection caused by Coniothyrium fuckelii in a patient with acute myelogenous leukemia.

A case of liver infection caused by Coniothyrium fuckelii is described in a patient with acute myelogenous leukemia. This fungus is found in the soil and can be a pathogen of plants. Coniothyrium spp. are members of the order Sphaeropsidales, an order composed of fungi whose conidiomata are usually pycnidia with the conidiogenous hymenium lining the walls of the locule. Coniothyrium spp. must be differentiated from Phoma spp. and Hendersonula spp., the two most commonly isolated members of the Sphaeropsidales.