A rare complication of ear piercing: a case of subcutaneous phaeohyphomycosis caused by Veronaea botryosa in China

Med Mycol. 2011 Apr;49(3):296-302. doi: 10.3109/13693786.2010.513340. Epub 2010 Sep 21.

Abstract

We present the third case of phaeohyphomycosis caused by Veronaea botryosa in China and the tenth case worldwide. A 16-year-old Chinese girl developed crusted, verrucous lesions, initially on the left ear and later on the left buttock, within 2-5 months of receiving an ear piercing. Histopathological examination of biopsy specimens confirmed diagnosis of subcutaneous phaeohyphomycosis. Microscopic examination of the colonies recovered in culture from a portion of the biopsy specimen resulted in the identification of Veronaea botryosa based primarily on the presence of two-celled, brownish pigmented, cylindrical conidia produced sympodially from erect conidiogenous cells. The lesions significantly improved with daily oral treatment with itraconazole 400 mg and adjuvant thermotherapy for 6 months. A maintenance therapy with low dose itraconazole was prescribed in order to achieve clinical and mycological cure. A two-year follow-up didn't reveal any recurrence of infection. Our case is the first report of V. botryosa infection associated with a cosmetic procedure, which suggests that skin piercing could precipitate V. botryosa or other dematiaceous, as well as opportunistic fungal infections.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antifungal Agents / administration & dosage
  • Ascomycota / isolation & purification*
  • Biopsy
  • Body Piercing / adverse effects*
  • China
  • Female
  • Histocytochemistry
  • Humans
  • Hyperthermia, Induced
  • Itraconazole / administration & dosage
  • Microscopy
  • Mycoses / diagnosis*
  • Mycoses / pathology*
  • Mycoses / therapy
  • Subcutaneous Tissue / pathology
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Itraconazole