Foot mycosis caused by fusarium solani mimicking tinea pedis in pediatric patient
Keywords:
Foot mycosis, Fusarium solani, Tinea pedisAbstract
Background. Foot mycoses are mainly caused by dermatophytes, sometimes yeasts, and uncommonly and rare conditions by non-dermatophyte molds (NDMs). It is uncommon in women and children. Fusarium species are ubiquitous and may be found in the soil, air and plants. Some predisposition factors could be related with this disease including barefoot, wearing occlusive shoes, sweating of the feet. Trauma is the major risk factor for localized Fusarium infection. Case: A 11-year-old boy, complained itching and red patches on right and left feet since 1 year ago. Patient used to play barefoot, usually on the ground, in the fields and often played when it was raining. Patient also had a history of being stabbed by a twig. Patients used to wear socks for a long time at school. On Physical examination at right and left plantar pedis regions showed multiple erythematous macules with firm margins,covered with thin scales on top, plaques with yellowish crusts on top, erosions,no pus and no pustules. Potassium hydroxide 20% examination revealed fungal hyphae, and white and cotton macroscopic fungi were found from fungal culture examination. Pink or violet center, and becoming bluish-brown are present sporoconidia. Microscopically, it showed sickle or canoe shaped thin-walled macroconidia with 3–4 septa, microconidia,chlamydospore.Showed concordance with the feature of spesies namely Fusarium solani. Patients was received itraconazole 100 mg twice a day for 1 month and cetirizine 10 mg once a day, clinical cure was noted and mycological cure was obtained after 1 month of treatment. Conclusion: Foot mycosis due to non-dermatophyte species, namely Fusarium solani is a rare case. Clinical manifestation might be mimicking dermatophyte foot mycosis. A detail history and physical examination, supported by identification of etiology will lead to correct diagnosis and prompt treatment. Education to patient how to prevent reccurency by avoiding predisposition factor of the disease is the most important point of care.References
Hay, R. J., 2007. Fusarium infections of the skin. School of Medicine and Dentistry, Queens University Belfast, Belfast, UK, 20(3), pp. 115-117
Batista, B.G., Chaves, M. A., Reginatto, P., Saraiva, O. J., Fuentefria, A.N., 2020. Human fusariosis: An emerging infection that is difficult to treat, Journal of the Brazilian Society of Tropical Medicine, 53(0013), pp.1-7
Schwartz, K.L., Sheffield, H., Richardson, S.E., Sung, L., Morris, S.K., 2015. Invasive Fusariosis: A Single Pediatric Center 15-Year Experience, Journal of the Pediatric Infectious Diseases Society, 4(2), pp.163-170
Kuruvilla TS, Dias M., 2012. Fusarium solani: A causative agent of skin and nail infections. Indian J Dermatol,57 (4), pp.308-309.
Hof, H. , 2020..The medical relevance of fusarium spp. J fungi, 6(3) pp.1–11
Sariguzel, F.M., Koc, N.A., Yagmur, G., Berk, E., 2014. Interdigital foot infections: Corynebacterium minutissimum and agents of superficial mycoses, Brazilian Journal of Microbiology 45(3), pp.781-784.
Homa M., Galgóczy L., Manikandan P., Narendran V., Sinka R., Csernetics Á., Vágvölgyi C., Kredics L. and Papp T., 2018. South Indian Isolates of the Fusarium solani Species Complex From Clinical and Environmental Samples: Identification, Antifungal Susceptibilities, and Virulence. Front. Microbioll, 9(1052), pp.1-14
Lu, L.Y., Ou, J.H., Hui, R.C.Y., Chuang, Y.H., Fan, Y.C., Sun, P.L., 2023. High Diversity of Fusarium Species in Onychomycosis: Clinical Presentations, Molecular Identification, and Antifungal Susceptibility. J. Fungi , 9(534), pp. 1-13.
Diongue, K., Diallo, M.A., Ndiaye, M., Seck, M.C., Badiane, A.S., Ndiyane, D. 2018. Interdigital tinea pedis resulting from Fusarium spp. in Dakar, Senegal, Journal de Mycologie Médicale, 28(1), pp.227-31
Guptaa, A. K., Baranb, R., Summerbellc, R.C., 2007. Fusarium infections of the skin. Curr opin infect dis, 20(2), pp.115–117
Tullio, V., Banche, G. & Allizond, V., 2010. Non-dermatophyte moulds as skin and nail foot mycosis agents: Phoma herbarum, Chaetomium globosum and Microascus cinereus. British mycological society, 1, pp. 345-349.
Tahir, m., iftikhar, n. & sheikh, z. I., 2011. Diagnostic accuracy of plain potassium hydroxide mount and. Pak armed forces med j, 61(2), pp. 262-265.
Richardson, M. D. & Warnock, D. W., 2012. Dermatophytosis. In: M. D. Richardson & D. W. Warnock, eds. Fungal Infection Diagnosis and Management. UK: Wiley-Blackwell., pp. 91-263.
