SUBCUTANEOUS ZYGOMYCOSIS PRESENTING WITH MULTIPLE SWELLINGS

Abstract

Subcutaneous mycoses are a heterogenous group of fungal infections of the dermis and subcutis. They affect population in rural communities, often in humid, tropical, or subtropical regions of developing countries. They are directly inoculated into the dermis or subcutaneous tissue through a penetrating injury from vegetative materials.30 year old homemaker presented with two discrete painful hyperpigmented swellings with no surrounding satellite lesions, gradually increasing in size, on right thigh of six months duration. There was a history of penetrating trauma. No comorbidities were present .Histopathology showed septal and lobular panniculitis with foreign body granuloma. Fungal stains showed broad hyphae and Basidiobolus species growth was observed in Sabaroud dextrose agar. A diagnosis of subcutaneous zygomycoses was made and treatment with Itraconazole and potassium iodide was started, to which she responded well within 3 months of therapy. Histopathological examination is reliable and less time consuming. But culture is the gold standard investigation for conrming the diagnosis. The positivity in culture ranges from 40 to 60%, hence histopathology is the main tool for diagnosis. Treatment with itraconazole and potassium iodide has produced excellent results.