Pythiosis presenting with chronic swelling and painful subcutaneous lesion at right deltoid
Athitaya Luangnara,
Mati Chuamanochan,
Siri Chiewchanvit,
Nuttaya Pattamapaspong,
Parichat Salee,
Romanee Chaiwarith
Affiliations
Athitaya Luangnara
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Mati Chuamanochan
Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Siri Chiewchanvit
Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Nuttaya Pattamapaspong
Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Parichat Salee
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Romanee Chaiwarith
Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Correspondence to: 110 Intavaroros Road, Sri Phum, Muang, Chiang Mai 50200, Thailand.
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.
