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MUCOCUTANEOUS ENTOMOPHTHORAMYCOSIS ACQUIRED BY CONJUNCTIVAL INOCULATION OF THE FUNGUS

Entomophthoramycoses are classified into subcutaneous, mucocutaneous, and primary visceral forms. The mucocutaneous form, also known as rhinoentomophthoramycosis, involves the mucosa and subcutaneous tissues of the nose and is caused by Conidiobolus coronatus (Entomophthora coronata). In this report, we describe the first case of mucocutaneous entomophthoramycosis acquired by introduction of the fungus through the conjunctival mucosa as a consequence of trauma involving contamination with soil. The patient was a 37-year-old man with no other complaints. The lesion was tumoral and extended into the ethmoidal and maxillary sinuses. The histopathologic appearance of the lesion was characteristic of this infection with a granulomatous process rich in eosinophils and with hyphae surrounded by an eosinophilic, periodic acid–Schiff stain–positive halo (Splendore-Hoeppli phenomenon). To the best of our knowledge, this case constitutes the first report of mucocutaneous entomophthoramycosis acquired by ocular contamination.

Received May 16, 2006. Accepted for publication June 21, 2006.

Acknowledgment: The American Committee on Clinical Tropical Medicine and Travellers’ Health (ACCTMTH) assisted with publication expenses.

^* Address correspondence to Achiléa L. Bittencourt, Serviço de Anatomia Patológica, Hospital Universitário Professor Edgard San-tos, Rua Dr. Augusto, Viana s/n° Canela, CEP 40.110-060, Salvador, Bahia, Brazil. E-mail: achilea{at}uol.com.br

Authors’ addresses: Achiléa L. Bittencourt and Livia M. B. Nossa, Department of Pathology, School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil. Roberto Marback, Department of Ophthalmology, School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil.