Infection sous-cutanée disséminée par Scytalidium (Neoscytalidium) dimidiatum

Abstract

S.dimidiatum (recently reclassified as N.dimidiatum) is a fungus that causes nail and/or superficial skin infection. It may also cause subcutaneous and deep infection, chiefly in immunocompromised patients. An 87-year-old male treated with oral corticosteroids for sarcoidosis consulted for violaceous cutaneous nodules on the back of his hands. Histopathological examination revealed epithelioid cell granulomas with numerous mycelial filaments and multiple spores. Culture of a biopsy sample resulted in growth of numerous colonies of S.dimidiatum and the patient was treated with intravenous amphotericin B. This organism is transmitted by direct or indirect contact with contaminated soil or plants. It mainly causes superficial skin and nail infections, and may result in deeper infections on rare occasions. We report a case of subcutaneous infection with S.dimidiatum in an immunocompromised patient (due to general steroid therapy) that was successfully treated using amphotericin B.