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Journal of Clinical Microbiology, March 1999, p. 807-811, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Human Phaeohyphomycotic Osteomyelitis Caused by the Coelomycete Phomopsis Saccardo 1905: Criteria for Identification, Case History, and Therapy

Deanna A. Sutton,1,* William D. Timm,2 Gareth Morgan-Jones,3 and Michael G. Rinaldi1,4

Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio,1 and Audie L. Murphy Division, South Texas Veterans Health Care System,4 San Antonio, Texas 78284; Infectious Disease Specialists of Southeastern Wisconsin, S.C., Milwaukee, Wisconsin 532102; and Auburn University, Auburn University, Alabama 368493

Received 13 July 1998/Returned for modification 30 September 1998/Accepted 28 November 1998

The Sphaeropsidales, coelomycetous fungi producing asexual conidia within enclosed conidiomata (pycnidia), are saprobic on numerous vascular plants. Despite their ubiquitous nature, only a limited number of genera have been documented as causing human disease. We report what we believe to be the first human case of osteomyelitis due to a Phomopsis species in a chronically immunosuppressed female. The patient developed a subcutaneous abscess on the distal phalanx of the right fourth finger complicated by osteomyelitis. Operative specimens revealed fungal hyphae and a pure culture of mould. The patient was treated with a 6-month course of itraconazole. At 16 months of follow-up, she remained free of recurrence. Phomopsis species differ from the similar, more frequently reported Phoma species by having immersed, thick-walled, multiloculate conidiomata and by the production of alpha (short, ellipsoidal) and beta (long, filamentous) conidia.

* Corresponding author. Mailing address: Fungus Testing Laboratory, Department of Pathology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78284-7750. Phone: (210) 567-4131. Fax: (210) 567-4076. E-mail: suttond{at}uthscsa.edu.

Journal of Clinical Microbiology, March 1999, p. 807-811, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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