Abstract

Introduction: The phaeohyphomycosis are mycotic infections, occurring specially in immunocompromised patients, producing many clinical manifestations. Histopathology, cultures, and molecular biology studies are among the diagnosis approach. The treatment includes the combination of systemic antimycotic therapy with surgical interventions.

Case presentation: male patient, 61 years old, diabetic and with kidney transplant; has a history of an ulcered wound over his right knee, unpainful and with secretion, since the last year. On skin biopsy there were observed dematiaceous hyphae, making the presumptive diagnosis of phaeohyphomycosis. After poor clinical evolution using itraconazole and developing systemic symptoms and deep collections, he required the use of amphotericin B and surgical management, obtaining Cladophialophora spp in the culture, confir­ming the diagnosis. At the time he is receiving voriconazole with satisfying recovery.

Conclusions: we present the case of a tumor-like phaeohyphomycosis in an immunocompromised patient, with poor improvement using systemic therapy only, requiring combination with surgical management.