Exophiala jeanselmei causing subcutaneous phaeohyphomycosis in a healthy adult in Sri Lanka: A case report

Phaeohyphomycosis is a chronic infection caused by filamentous dematiaceous fungi and it embraces a wide range of clinical presentations. Subcutaneous phaeohyphomycosis is caused by traumatic implantation of aetiological fungi in subcutaneous tissue and is usually reported in agricultural workers in the tropics. Subcutaneous phaeohyphomycosis presents with various skin manifestations and is often misdiagnosed by clinicians. Exophiala sp is a common aetiological agent of post traumatic subcutaneous phaeohyphomycosis.

We present a middle aged farmer who presented with a subcutaneous nodule in his dominant hand. This swelling was initially diagnosed as a ganglion but turned out to be an abscess caused by Exophiala jeanselmei and the patient was cured by complete surgical excision without antifungal therapy. This case report aims to contribute to knowledge on this uncommon entity, in order to help practitioners to correctly diagnose and treat subcutaneous phaeohyphomycosis.