Cutaneous phaeohyphomycosis with the recently described fungus Gloniopsis leucaenae: first case report

Background Fungi of genus Gloniopsis are plant pathogens within class Dothideomycetes, rarely described to cause human infection. Species Gloniopsis leucaenae ( G. leucaenae ) was first isolated in 2019 and previously reported only in plant matter in Thailand. Case presentation A 68-year-old male landscaper on vedolizumab for Crohn’s disease, living in Florida with no travel history, presented with a swelling on dorsal aspect of hand. Pathology from excisional biopsy showed a subcutaneous phaeohyphomycosis nucleated by plant matter, and broad-range PCR identified G. leucaenae. After excision without antifungal treatment, a second lesion arose and was excised, with hyphae again demonstrated on histology, but culture and PCR negative. Treatment was started with empiric itraconazole. Conclusions This case report, in contradistinction to a prior case report of a related Gloniopsis species that caused disseminated disease in an immunocompromised host, demonstrates the capacity of G. leucaenae to cause local infection in relatively immunocompetent individuals. It also highlights that a pathogen described on one continent may cause an infection on another continent, even without identifiable travel. Global trade networks and climate change require broadening of the differential diagnosis for fungal infections.