Phaeohyphomycosis caused by Exophiala spinifera in a patient with systemic lupus erythematosus

VernacularTitle:系统性红斑狼疮伴棘状外瓶霉所致暗色丝孢霉病一例
Author: Yingping LIN ; Wenming HUANG ; Wen LI ; Yanping YANG ; Hongwei GUO ; Yiming FAN
Publication Type:Journal Article
Keywords: Lupus erythematosus,systemic; Phaeohyphomycosis; Exophiala spinifera
From: Chinese Journal of Dermatology 2011;44(8):552-555
CountryChina
Language:Chinese
Abstract: A 27-year-old woman who suffered from a 2-year history of systemic lupus erythematosus (SLE) presented with a 6-month history of nodules and ulcer on the right lower extremity. Direct microscopic examination of the pus showed branched and septate hyphae and spores in a chain-like arrangement.Histopathological examination revealed yellowish brown hyphae and spores. Dark green velvety colony grew on Sabouraud dextrose agar (SDA). Slide culture showed branched, septate hyphae and spine-like annellated conidiophores. The isolate was identified as Exophiala spinifera by DNA sequence analysis. The strain was unable to liquefy gelatin, could grow at 25 ℃ to 39 ℃, and was sensitive to itraconazole, amphotericin B and terbinafine. Animal test revealed that the infection induced by Exophiala spinifera in immunocompromised mice was more severe than that in normal controls. Based on the clinical features, histopathological, fungal culture and DNA sequencing results, the patient was diagnosed with systemic lupus erythematosus accompanied by subcutaneous phaeohyphomycosis caused by Exophiala spinifera.