Exophiala Jeanselmei Infection in a Patient with Two Primary Malignancies

Abstract

Background: Dematiaceous fungi are emerging as an important pathogen, particularly in individuals on immunosuppressive medications. These fungi produce brown to black pigment and are responsible for a wide spectrum of diseases, including superficial infections of the skin and eye and, uncommonly, deep infections involving the central nervous system and internal organs. Objective: We present a male patient with localized, cutaneous Exophiala jeanselmei infection. Methods: We review the literature and present a brief discussion of phaeohyphomycotic infections, their clinical features, and their treatment modalities. Results: Workup of our patient revealed an underlying hepatic lymphoma and pulmonary squamous cell carcinoma. Conclusions: Phaeohyphomycotic infections, although uncommon, are increasingly recognized as important pathogens in patients who are immunologically compromised as a result of long-term steroid or other immunosuppressive therapy. Infections by these organisms in healthy-appearing individuals should prompt one to consider an immunodeficiency state and appropriate workup should be performed.