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Chromoblastomycosis after a leech bite complicated by myiasis: a case report

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Author(s): Slesak Günther | Inthalad Saythong | Strobel Michel | Marschal Matthias | Hall Martin | Newton Paul

Journal: BMC Infectious Diseases
ISSN 1471-2334

Volume: 11;
Issue: 1;
Start page: 14;
Date: 2011;
Original page

ABSTRACT
Abstract Background Chromoblastomycosis is a chronic mycotic infection, most common in the tropics and subtropics, following traumatic fungal implantation. Case presentation A 72 year-old farmer was admitted to Luang Namtha Provincial Hospital, northern Laos, with a growth on the left lower leg which began 1 week after a forefoot leech bite 10 years previously. He presented with a cauliflower-like mass and plaque-like lesions on his lower leg/foot and cellulitis with a purulent tender swelling of his left heel. Twenty-two Chrysomya bezziana larvae were extracted from his heel. PCR of a biopsy of a left lower leg nodule demonstrated Fonsecaea pedrosoi, monophora, or F. nubica. He was successfully treated with long term terbinafin plus itraconazole pulse-therapy and local debridement. Conclusions Chromoblastomycosis is reported for the first time from Laos. It carries the danger of bacterial and myiasis superinfection. Leech bites may facilitate infection.
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Tango Jona
Tangokurs Rapperswil-Jona