Primary cutaneous infection due to Microascus cirrosus: a case report

BACKGROUND: Microascus cirrosus, the teleomorph of Scopulariopsis spp., is a saprobic species with a worldwide distribution and rarely causes human infection. In the present paper, we present the first case of primary cutaneous M. cirrosus infection in a Chinese female. CASE PRESENTATION: A 17-year-old female presented with tender ulceration on her left ankle for three months. Histology revealed multiple branching, septate hyphae and moniliform fungal elements in the dermis. Tissue culture grew M. cirrosus, the teleomorph of Scopulariopsis spp., characterized by intercalary and ballooned, chlamydospore-like structures, annellidic and ampulliform conidiogenous cells along with truncated, bullet-shaped, smooth conidia and globose perithecial ascomata with cylindrical necks. Further molecular sequencing confirmed the identification. A diagnosis of primary cutaneous infection due to M. cirrosus was made. Treatment with itraconazole 200 mg per day for 10 weeks achieved significant improvement of the skin lesions. CONCLUSIONS: This case of uncommon mycotic cutaneous infection highlights the importance of mycological examination that help to recognize rare pathogenic fungi.