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Phaeohyphomycosis

المؤلف:  Stefan Riedel, Jeffery A. Hobden, Steve Miller, Stephen A. Morse, Timothy A. Mietzner, Barbara Detrick, Thomas G. Mitchell, Judy A. Sakanari, Peter Hotez, Rojelio Mejia

المصدر:  Jawetz, Melnick, & Adelberg’s Medical Microbiology

الجزء والصفحة:  28e , p689

2026-02-12

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Phaeohyphomycosis is a term applied to infections characterized by the presence of darkly pigmented septate hyphae in tissue. Both cutaneous and systemic infections have been described. The clinical forms vary from solitary encapsulated cysts in the subcutaneous tissue to sinusitis to brain abscesses. Over 100 species of dematiaceous molds have been associated with various types of phaeohyphomycotic infections. They are all exogenous molds that normally exist in nature. Some of the more common causes of sub cutaneous phaeohyphomycosis are Exophiala jeanselmei, Phialophora richardsiae, Bipolaris spicifera, and Wangiella dermatitidis. These species and others (eg, Exserohilum rostratum, Alternaria species, and Curvularia species) may be implicated also in systemic phaeohyphomycosis. The incidence of phaeohyphomycosis and the range of pathogens have been increasing in recent years in both immunocompetent and compromised patients.

In tissue, the hyphae are large (5–10 µm in diameter), often distorted and may be accompanied by yeast cells, but these structures can be differentiated from other fungi by the melanin in their cell walls (Figure 1). Specimens are cultured on routine fungal media to identify the etiologic agent. In general, itraconazole or flucytosine is the drug of choice for subcutaneous phaeohyphomycosis. Brain abscesses are usually fatal, but when recognized, they are managed with amphotericin B and surgery. The leading cause of cerebral phaeohyphomycosis is C. bantiana.

Fig1. Phaeohyphomycosis. Melanized hyphae are observed in the tissue. 400×.