Fonsecaea

• Includes Fonsecaea pedrosoi (most common), F. monophora, F. nubica

Clinical Presentation

• Most common agent causing human chromoblastomycosis
• Infection likely occurs as a result of direct traumatic inoculation of plant debris into a wound i.e. coconut shells
• Chronic localized fungal infection of the skin and subcutaneous tissue that produces raised, scaly lesions, usually in the lower extremities
• Lesions are warty, cauliflower-like

Diagnosis

• Culture
  • Microscopy:
  • Septate hyphae with poorly formed cylindrical conidiophores producing short chains of conidia
    • Pathognomonic muriform cells (copper penny) found on histology

Management

• Surgery + itraconazole + terbinafine for severe cases has been suggested