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Abstract: TH-PO868

When the Diagnosis Is Skin Deep: A Case of Cutaneous Chromoblastomycosis in a Patient with Kidney Transplant

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Gardner, Maryn, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Shawar, Saed, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Introduction

Chromoblastomycosis, caused by fungi from the Herpotrichiellaceae family, primarily affects skin and soft tissues. Although it's prevalent in tropical and subtropical regions, U.S. cases have been reported. The disease presents various dermatologic lesions and can, in rare cases, affect lungs, bones, and brain. Treatment includes physical interventions, antifungal therapy, and is notoriously difficult due to frequent relapses and possible bacterial infections.

Case Description

A 67-year-old male kidney transplant recipient with a history of end-stage kidney disease from hypertension presented with a persistent, expanding skin lesion on his right anterior leg. Despite being non-pruritic, non-painful, and without any surrounding inflammation, his interest in gardening raised suspicion. A skin biopsy confirmed the diagnosis of chromoblastomycosis. The patient began itraconazole treatment, resulting in slow lesion improvement.

Discussion

Melanized fungal infections, such as chromoblastomycosis, are infrequent, particularly in temperate climates, making diagnosis challenging. This case illustrates the necessity of an early skin biopsy for accurate diagnosis. Immunocompromised patient, are at an elevated risk of disseminated disease. Thus, early diagnosis and treatment are critical to reduce potential morbidity and mortality.

Picture 1: Right Anterior Leg, Skin Lesion