An unusual subcutaneous mycosis due to Parathyridaria percutanea in an immunocompromised individual

Solid Organ transplant recipients are at risk of opportunistic infections due to immunosuppressed state, prolonged hospital stay and exposure to multiple antibiotics. Subcutaneous mycoses are heterogenous group of fungal infections affecting dermis and subcutaneous tissue due to penetrating injury. Subcutaneous mycosis in immunocompromised individual causes significant morbidity in the form of chronic discharging sinuses and systemic spread. Parathyridaria percutanea is an emerging cause of subcutaneous mycosis in transplant patients and is difficult to identify phenotypically. It is relatively novel pathogen and only few cases are reported in Indian population. Here we present a case of subcutaneous mycosis who presented with multiple discharging sinuses over left foot. Timely identification of implicating pathogen and initiation of targeted anti-fungal therapy plays important role in decreasing hospital stay and overall financial burden to patient. Present case also highlights importance of genotypic methods in diagnosing emerging fungal infection in immunocompromised individuals, when phenotypic identification fails.