Doctors detect rare fungal infection in Pimpri woman

PUNE: Fungal infection! That is nothing to worry about is what most doctors will tell you. And perhaps this is what a 35-year-old Pimpri woman would have thought before the infection in her skin progressed, leaving her almost bed-ridden and dispirited.

It all started about a year ago when the woman developed pea-sized nodules over her neck and chest. These nodules, which resembled cutaneous tuberculosis, kept on increasing in size and spreading on her body to later rupture with pus-like discharge.

The woman’s brother brought her to the DY Patil Medical College and Hospital in Pimpri fearing that his children might contract the infection. At the hospital, doctors did extra investigations on her condition to find that she was infected by an extremely rare fungus, known as exophiala spinifera.

“When she was brought to the hospital in September, she could barely walk and had swelling on her face. She was not talking and would refuse to eat. She had lost 7-8kg in weight and her menstrual cycle had stopped for three months. She used to just stare blankly into space,” Shrea Kapoor, a resident doctor of DY Patil Medical College and Hospital in Pimpri. told TOI. Kapoor, along with another resident doctors Sakshi Sitaniya, played a vital role in relieving the woman of her agony.

The resident doctors, both pursuing their post-graduation (MD) in dermatology, said the woman had a lot of dark-coloured nodules that were rupturing and oozing pus without any pressure or movement. “Before being brought to the hospital, she had consulted several general practitioners and had taken oral medicines and injectable, but to no avail,” they said.

Dermatologist Ajay Kumar, associate professor with the hospital, said, “After her skin test came negative for skin TB, we did a thorough investigation of other bacterial and fungal infections, which lasted for three weeks. Pus drained from a discharging lesion was sent to the department for culture and sensitivity. After due investigation, microbiologists managed to isolate exophiala spinifera from the woman’s skin samples.”

The doctors also confirmed the finding using molecular sequencing with the help of the experts at the National Culture Collection of Pathogenic Fungi at the Postgraduate Institute of Medical Education and Research (PGIMER) in Chandigarh.

“The causative fungus, exophiala spinifera, occurs relatively rare in humans and its detection up to the level of subspecies is extremely rare,” microbiologists Kalpana Angadi and Shahzad Mirza said.

Once the diagnosis was confirmed, the woman was put on oral antifungals, which quickly subsided the lesions within months. “The patient is now able to do household chores and her quality of life has improved tremendously,” the doctors said.

But how the woman contracted the infection. When asked, expert said she used to carry plants and wood on her shoulders and may have got it from them. “However, it is difficult to ascertain the source,” they added.