Two cases of subcutaneous scedosporiosis, caused by Scedosporium apiospermum, are reported. Both patients had lesions localized in the forearm: a solitary ulceration in one and a sporotrichoid-like lesion in the other. The literature is reviewed
Scedosporium apiospermum; Subcutaneous scedosporiosis; Subcutaneous mycosis
| Case (ref.) | Age, sex | Subcutaneous lesions | Underline condition | Diagnosis | Treatment; outcome |
| 1 (12) | 76, M | Soft tissue painful, erythematous swelling of the 4th and 5th finger; in one year, involved the hand, wrist and forearm. X-ray did not reveal bone lesions. | None | Culture of synovia and synovium | Amphotericin B and miconazole; relapse |
| 2 (26) | 76, M | Nodules (1 mm to 4 cm) from the dorsum of the 5th finger along the ulnar margin of the right forearm; arthritis and osteitis of the wrist, disclose by X-ray and 99mTc bone scan. | Prednisone, bronchitis, hypertension, temporal arteritis | Pus (direct, smears PAS); biopsy (Grocott) Culture of the pus | Ketoconazole; death: heart failure |
| 3 (3) | 59, F | Non tender, swollen, erythematous induration, covered by many pustular lesions on the righ leg 2 months duration. | Diabetes Cushings disease | Biopsy (PAS). Culture of the pus and biopsied fragments | Miconazole. Control of immunosuppression |
| 4 (25) | 46, M | Infected surgical wound resulting from partial hemilaminectomy. | None | Culture of infected tissue | Surgical debridement |
| 5 (25) | 64, M | Infected axillo femoral graft. | Diabetes | Culture of the graft | Graft resection |
| 6 (10) | 24, M | Purulent material draining from a craniotomy wound. | Dexamethazone | Culture of the pus | Miconazole |
| 7 (16) | 45, F | Ulceration (2 × 5 cm) covered by adherent slough on the dorsum of right ankle. | None | Direct and culture of slough biopsy | Surgical debridement and skin graft |
| 8 (17) | 64, M | Painless tumefaction and ulceration (1 cm) with erythematous border, covered by a necrotic scar and draining a yellowish pus, 3 month duration. | Waldenstroms disease Corticotherapy Cytotoxic drugs | Pus (direct), biopsy (Grocott), culture | Ketoconazole |
| 9 (8) | 38, M | Tumefaction of the right malleolar region with a fistula draining purulent material. | None | Culture of the pus | Surgical extraction of a rubber fragment |
| 10 (11) | 45, M | One painless, tender, flutuant nodule (2 cm) in the left knee 4 month duration. | Diabetes, renal transplantation | Biopsy (Grocott and culture) and corticotherapy | Surgery Itraconazole |
| 11 (4) | 73, M | Subcutaneous nodules distributed on the foot, tibial crest and tigh (0.5 to 3 cm), 4 month duration. | Hortons disease Corticotherapy | Biopsy (Grocott) Culture of the pus | Itraconazole |
| This report | |||||
| Case 1 | 73, F | Ulceration (1 × 2 cm) on the flexor surface of the forearm. | Carcinoma of the breast Cytotoxic drugs corticotherapy |
Direct and culture | None; death: pulmonary failure |
| Case 2 | 66, F | Three painfull nodules on the flexor surface of the left forearm. | None | Direct, smears (Grocott) and culture | Itraconazole; cured. |
