Primary Cutaneous Adiaspiromycosis: A Case Report and Review of the Literature.

Abstract

Aim: To document a case of primary cutaneous Adiaspiromycosis.

Introduction: Adiaspiromycosis is a rare emerging fungal infection caused by Chrysosporium Parvum var Crescens now called as `Emmonsia Crescens` belonging to the genus Emmonsia, order Onygenales, family Ajellomycetes.

Case report: A 38-year-old male presented with an ulcerated nodule over the infra-axillary region with itching for 3 months. The lesion began as small nodule slowly growing to attain the present size. His routine investigations were within normal limits. Serological tests such as HBsAg and HIV were nonreactive. Fine needle aspiration cytology showed `suppurative granulomatous` inflammation. The nodule was excised and sent for histopathological examination. Histopathology showed numerous noncaseating granulomas and suppuration. Amidst suppuration, as well as inside the giant cells and within granulomas, numerous varying sized, thick-walled, round to oval `adiaspores` were seen. There was no evidence of budding or septation or endosporulation. They were PAS and GMS positive. He was treated with topical luliconazole and oral fluconazole. There was no recurrence on follow up of one years.

Conclusion: Adiaspiromycosis is a rare fungal infection and primary cutaneous involvement is a rare distinct entity. Detailed morphological assessment in histopathology is essential for its identification as the organisms are difficult to isolate in fungal culture from human clinical material.