Pythiosis presenting with chronic swelling and painful subcutaneous lesion at right deltoid

Athitaya Luangnara; Mati Chuamanochan; Siri Chiewchanvit; Nuttaya Pattamapaspong; Parichat Salee; Romanee Chaiwarith

doi:10.1016/j.idcr.2023.e01873

Pythiosis presenting with chronic swelling and painful subcutaneous lesion at right deltoid

IDCases. 2023 Aug 7:33:e01873. doi: 10.1016/j.idcr.2023.e01873. eCollection 2023.

Authors

Athitaya Luangnara¹, Mati Chuamanochan², Siri Chiewchanvit², Nuttaya Pattamapaspong³, Parichat Salee¹, Romanee Chaiwarith¹

Affiliations

¹ Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
² Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
³ Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Abstract

Pythiosis is a fatal disease which has high incidence in tropical regions. In contrast with vascular pythiosis, cutaneous and subcutaneous pythiosis are both uncommon. Here, we report a case of subcutaneous pythiosis in a pregnant farmer manifested with a progressively larger and more painful mass at right deltoid. The tissue culture and molecular test were negative for fungi. The diagnosis was supported by the positivity of serum immunochromatographic test (ICT) for pythiosis. Patients responded well to the combination therapy of itraconazole, terbinafine and azithromycin.

Keywords: Cutaneous pythiosis; Pythiosis; Subcutaneous pythiosis.

Publication types

Case Reports