Journal of Medical Sciences1682-44741812-5727Asian Network for Scientific Information10.3923/jms.2014.201.205Pseudallescheria boydi with Black Discharge: A Case Report]]>AlgarniAbdullah AlawfiAbdusalam AidaroosAmal Y. Al DonesaJocelyn ParvezSarwat 42014144Pseudallescheria boydii could cause lethal infections involving brain,
lung, eyes and other deep tissue infections both in immune-compromised and immune-competent
patients. Mycetoma and wound infection are also caused by this fungus. Pseudallescheria
boydii usually reported as resistant to Amphotericin B in vivo. Pseudallescheria
boydii, have been implicated as potentially emerging human and veterinary
pathogen. Mycetoma and mycetomatous infections have been reported in both immuno-compromised
and immuno-competent patient caused by Pseudallescheria boydii and by
its asexual state Scedosporium apiospermum. Hence a timely diagnosis
is essential as the organism is often resistant to many antifungal drugs. A
nine year old, healthy girl who was presented with history of trauma, due to
falling down on the tiled floor, incurring a 2 mm wound on her right forearm
at school. Subsequently, the swelling was increasing dramatically in size with
a large amount of black discharge over a short period of time without any foul
smell. The black discharge was collected and sent to Microbiology Laboratory.
Culture and microscopy for bacteria were negative while potassium hydroxide
(KOH) microscopy reported positive for fungal element with septate mycelium.
Fungal culture yielded Pseudallescheria boydii. It was treated successfully
with surgical debridement under general anesthesia and systemic antifungal therapy.
Patient was initially started with liposomal Amphotericin B and shifted to voriconazole
after identification of fungus. Patient was discharged home on oral voriconazole
and showed no complications on follow up. The report is a pointer to the fact
that P. boydii can cause mycetoma, hence, an early diagnosis and treatment
of infection could avert the dangerous outcome. A late diagnosis after formation
of mycetoma could make clinical treatment a difficult task and resulted in failure
and amputation. To the best of our knowledge this is the first reported case
of Pseudallescheria boydii causing wound infection in Saudi Arabia.]]>Berzina, I., N.S. Trumble, T. Novicki and L.C. Sharkey,2011Scedosporium apiospermum infection in a horse.]]>408488Bibashi, E., G.S. de Hoog, E. Kostopoulou, M. Tsivitanidou, J. Sevastidou and P. Geleris,2009Pseudallescheria boydii in an immunocompetent patient.]]>13184186Buzina, W., G. Feierl, D. Haas, F.F. Reinthaler and A. Holl et al.,2006Scedosporium apiospermum (teleomorph Pseudallescheria boydii) after a near-drowning incident: Case report and review of the literature.]]>44473477Kravitz, J.N., L.L. Steed and M.A. Judson,2011Pseudallescheria angusta pulmonary mycetomas in fibrocystic sarcoidosis.]]>49198201Larone, D.H.,2011Leechawengwongs, M., S. Milindankura, A. Liengudom, K. Chanakul, K. Viranuvatti and P. Clongsusuek,2007Scedosporium apiospermum brain abscesses after near-drowning successfully treated with surgery and long-term voriconazole: A case report.]]>50512516Lindsley, M.D., J. Guarro, R.N. Khairy, J. Williams, N. Iqbal and P. Pancholi,2008Pseudallescheria fusoidea, a new cause of osteomyelitis.]]>4621412143Ong, A., C.C. Blyth, R. Bency, M. Vicaretti and A. Harun et al.,2011Scedosporium and Pseudallescheria infection.]]>4920672071Ouchi, T., T. Sato, N. Yoshizawa, M. Sugiura, K. Nagao, T. Yaguchi and Y. Hata,2008Pseudallescheria boydii infection caused by trauma].]]>49119123 (In Japanese)Tammer, I., K. Tintelnot, R.C. Braun-Dullaeus, C. Mawrin, C. Scherlach, D. Schluter and W. Konig,2011Pseudallescheria/Scedosporium species in patients with advanced HIV disease: A diagnostic and therapeutic challenge.]]>15e422e429