Journal
JOURNAL OF CLINICAL MICROBIOLOGY
Volume 53, Issue 8, Pages 2674-2685Publisher
AMER SOC MICROBIOLOGY
DOI: 10.1128/JCM.00637-15
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Funding
- Brazilian government fellowship
- Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES)
- National Counsel of Technological and Scientific Development (CNPq)
- Coordination for the Improvement of Higher Education Personnel (CAPES), Brasilia, Brazil
- National Council for Scientific and Technological Development (CNPq), Brasilia, Brazil
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We report a fatal case of a chromoblastomycosis-like infection caused by a novel species of Fonsecaea in a 52-year-old immunocompetent Caucasian male from an area of chromoblastomycosis endemicity in Brazil. The patient had a 30-year history of slowly evolving, verrucous lesions on the right upper arm which gradually affected the entire arm, the left hemifacial area, and the nose. Subsequent dissemination to the brain was observed, which led to death of the patient. The internal transcribed spacer (ITS) and partial large subunit (LSU), BT2, and CDC42 genes of the isolates recovered from skin and brain were sequenced, confirming the novelty of the species. The species is clinically unique in causing brain abscesses secondary to chromoblastomycosis lesions despite the apparent intact immunity of the patient. Histopathologic appearances were very different, showing muriform cells in skin and hyphae in brain.
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