Kerion-like scalp disease in a child with a culture isolate reported as Aspergillus lentulus

A 7-year-old boy presented with kerion-like inflammatory alopecia. Direct microscopy demonstrated fungal hyphae, and a cultured mould was reported as Aspergillus lentulus by mass spectrometry. Treatment comprised oral terbinafine for 3 months and oral prednisone for 2 months. Fungal examination was negative and Wood lamp examination was normal at 3 months; hair regrowth was gradually recovering at the 6-month follow-up. This case illustrates the need to interpret an unusual mould isolate alongside clinical findings before assigning causation.