Abstract
We report on the first case of eumycetoma caused by the organism Leptosphaeria tompkinsii to be diagnosed and possibly acquired within the United Kingdom. Conventional culture of fungal grains and surgical tissue specimens was negative and the diagnosis was achieved using panfungal polymerase chain reaction and sequencing technology. Despite limited surgical resection and prolonged antifungal therapy with voriconazole, the patient developed progressive disease with mycetoma bone involvement. This case highlights the usefulness of molecular diagnostic techniques in eumycetoma where organisms may fail to grow with conventional culture or be difficult to identify morphologically. It also reminds us that eumycetoma is a difficult infection to treat and despite optimism regarding the efficacy of the newer triazole antifungals in this condition, treatment failures may still occur.
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Acknowledgments
We would like to acknowledge all of the clinical staff involved in the care of this patient and the laboratory staff who were involved in the processing of the samples. In particular we would like to give thanks to Hemu Patel for her assistance in the identification of the fungal species and to Dr Mark Bamford for his assistance in preparing the photomicrographs.
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Cartwright, K.E., Clark, T.W., Hussain, A.M. et al. Eumycetoma of the Hand Caused by Leptosphaeria tompkinsii and Refractory to Medical Therapy with Voriconazole. Mycopathologia 172, 311–315 (2011). https://doi.org/10.1007/s11046-011-9432-8
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DOI: https://doi.org/10.1007/s11046-011-9432-8