Chromoblastomycosis caused by Fonsecaea: clinicopathology, susceptibility and molecular identification of seven consecutive cases in southern China

• Published in: Clinical microbiology and infection Vol. 19; no. 11; pp. 1023 - 1028
• Main Authors: Yang, Y.-P., Li, W., Huang, W.-M., Zhou, Y., Fan, Y.-M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2013; Elsevier Limited
• Subjects: Administration, Oral; Aged; Aged, 80 and over; Antifungal Agents - pharmacology; Antifungal Agents - therapeutic use; Ascomycota - classification; Ascomycota - drug effects; Ascomycota - isolation & purification; China; Chromoblastomycosis; Chromoblastomycosis - diagnosis; Chromoblastomycosis - microbiology; Chromoblastomycosis - pathology; DNA, Fungal - chemistry; DNA, Fungal - genetics; Female; Fonsecaea; Fonsecaea monophora; Fonsecaea pedrosoi; Hospitals, Teaching; Humans; Itraconazole - pharmacology; Itraconazole - therapeutic use; Male; Microbial Sensitivity Tests; Middle Aged; Molecular Sequence Data; Naphthalenes - pharmacology; Naphthalenes - therapeutic use; Pyrimidines - pharmacology; Sequence Analysis, DNA; strain identification; susceptibility test; Treatment Outcome; Triazoles - pharmacology; Voriconazole; China; susceptibility test; Chromoblastomycosis; Fonsecaea pedrosoi; strain identification; Fonsecaea monophora
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1111/1469-0691.12067

The clinicopathological and microbiological features of chromoblastomycosis caused by Fonsecaea pedrosoi or Fonsecaea monophora are summarized. Four F. monophora and three F. pedrosoi strains were isolated from seven consecutive chromoblastomycosis patients and identified by genetic analysis between 2004 and 2012 in a teaching hospital in southern China. Six strains were sensitive to voriconazole, itraconazole and terbinafine using E-test and Neo-Sensitabs. Six patients healed after oral itraconazole or terbinafine, and one was lost to follow up. Internal transcribed spacer sequence is sufficient for species delimitation of Fonsecaea, and the Neo-Sensitabs test and E-test are comparable in their susceptibility testing. Itraconazole and/or terbinafine may be the preferred treatment for this chromoblastomycosis.