Multiple Subcutaneous Nodules Caused by Plant Fungus Thyridium flavostromatum in an Immunocompromised Patient

Thyridium flavostromatum is a newly discovered species of plant fungus identified from the host plant Phyllostachys pubescens. It is a type of ascomycetes that has yellowish stromata and gets the name "flavostromatum." Immunocompromised patients are infected with rare and opportunistic fungal infections. We here present a case of multiple subcutaneous tender nodules caused by T. flavostromatum in a man with rheumatoid arthritis on immunosuppressants. Aspirate from the nodules revealed yeast-like cells with chlamydospores that were not identified in the matrix-assisted laser desorption ionization/time of flight mass spectrometry database. Additional DNA sequencing analysis identified the plant fungus T. flavostromatum. He was treated successfully with voriconazole. To our knowledge, this is the first reported case of the plant fungus Thyridium causing nodules on human skin.