Chromoblastomycosis: A case series from Eastern China

PLoS Negl Trop Dis. 2022 Sep 26;16(9):e0010800. doi: 10.1371/journal.pntd.0010800. eCollection 2022 Sep.

Abstract

Chromoblastomycosis (CBM) is a chronic fungal infection of the cutaneous and subcutaneous tissues caused by brown pigmented fungi. Fonsecaea monophora is one of the most common pathogens of CBM in China. Most formal cases have been reported from Southern China, however, the infection is not uncommon in Eastern China where very few case series are available. To describe the clinical aspects of CBM, we report a series of 11 cases between 2018 and 2021 at a single medical center in Eastern China. The patients were predominately male (n = 9) and the disease duration ranged from 3 months to 20 years. Plaque type lesions were the most common clinical manifestations. There were 7 cases of mild forms and 3 cases of severe forms. Among the 3 severe cases, one case gave up treatment due to economic poverty; one case did not respond to a 1-year systemic treatmen; one case was cured by combination therapy of 10 months. Other cases were cured by treatment with antifungal agents. All cases of direct mycological examination were positive. All isolates were identified by morphology and sequencing of the the ITS regions of ribosomal DNA, Ten were F. monophora and 1 was Cladophialophora carrionii. All cases had been evaluated at other clinics, where 8 cases were misdiagnosed as other diseases. As a neglected tropical disease (NTD), CBM is still a major challenge in the field of dermatology, especially in its severe clinical forms. As an effective and simple diagnostic method of CBM, direct microscopic examination should be further promoted in rural hospitals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents / therapeutic use
  • China
  • Chromoblastomycosis* / diagnosis
  • Chromoblastomycosis* / drug therapy
  • Chromoblastomycosis* / microbiology
  • DNA, Ribosomal
  • Humans
  • Male
  • Skin / pathology

Substances

  • Antifungal Agents
  • DNA, Ribosomal

Grants and funding

This work was supported by a grant from the Hangzhou Science and Technology Bureau (http://kj.hangzhou.gov.cn) grant 202004A17 to ZHL. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.