Clinical Microbiology Subcutaneous Phaeohyphomycosis Caused by Exophiala

We report a case of subcutaneous infection in a 55-yr-old Korean diabetic patient who presented with a cystic mass of the ankle. Black fungal colonies were observed after cul-turing on blood and Sabouraud dextrose agar. On microscopic observation, septated ellip-soidal or cylindrical conidia accumulating on an annellide were visualized after staining with lactophenol cotton blue. The organism was identified as Exophiala salmonis by se-quencing of the ribosomal DNA internal transcribed spacer region. Phaeohyphomycosis is a heterogeneous group of mycotic infections caused by dematiaceous fungi and is com-monly associated with immunocompromised patients. The most common clinical mani-festations of subcutaneous lesions are abscesses or cystic masses. To the best of our knowledge, this is the first reported case in Korea of subcutaneous phaeohyphomycosis caused by E. salmonis that was confirmed by molecular analysis and identification of mor-phological characteristics. This case suggests that E. salmonis infections are no longer re-stricted to fish