Abstract
A 78-year-old male was admitted to our hospital because of fever, sputum and cough. Chest X-ray showed infiltrative shadows in the right lung field. Smears of his sputum were positive for acid-fast bacilli. We found multiple subcutaneous abscesses on the right distal forearm. Microscopic examination of skin biopsy specimens revealed granulation tissues with the proliferation of epitheloid cells with the scattering infiltrations of neurophils, giant cells and histiocytic cells. The examination of the PAS stained specimen revealed fungal elements and a black fungus, Exophiala jeanselmei, was isolated by the cultures of pus from the abscess. He was diagnosed as pulmonary tuberculosis complicated with subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei and was successfully treated with anti-tuberculosis drugs and anti-fungal agent, 5-fluorocytosine.
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