, Volume 181, Issue 7–8, pp 555–560 | Cite as

Superficial Phaeohyphomycosis Caused by Aureobasidium melanogenum Mimicking Tinea Nigra in an Immunocompetent Patient and Review of Published Reports

  • Wan-Ting Chen
  • Mei-Eng Tu
  • Pei-Lun Sun


Aureobasidium pullulans is a ubiquitous black yeast-like fungus belonging to order Dothideales. It was regarded as a contaminant, but is now considered a pathogen causing a wide range of human infections. We report a case of superficial phaeohyphomycosis in an immunocompetent patient with clinical presentations mimicking tinea nigra. On microscopic examination of lesion scales, multiple thick-walled, pigmented oval spores with septa were noted. A fungus with black mucoid colonies was repeatedly isolated from the lesions during the treatment course. This fungus was identified as A. melanogenum on the basis of morphological characteristics and subsequently confirmed by sequencing internal transcribed spacers of ribosomal DNA. The clinical presentations and microscopic findings of lesion scales were considerably similar to those of tinea nigra. However, fungal culturing proved that the causative pathogen was A. melanogenum rather than Hortaea werneckii. The patient might have acquired this infection during gardening activities. We also reviewed reported cases of cutaneous A. pullulans infection.


Aureobasidium melanogenum Skin Phaeohyphomycosis Tinea nigra 


Compliance with Ethical Standards

Conflict of interests

The authors declare no conflict of interests.


  1. 1.
    Zalar P, Gostincar C, de Hoog GS, Ursic V, Sudhadham M, Gunde-Cimerman N. Redefinition of Aureobasidium pullulans and its varieties. Stud Mycol. 2008;61:21–38.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Larone DH. Medically important fungi. Washington DC: ASM Press; 2002.Google Scholar
  3. 3.
    Sun PL, Hsieh HM, Ju YM, Jee SH. Molecular characterization of dermatophytes of the Trichophyton mentagrophytes complex found in Taiwan with emphasis on their correlation with clinical observations. Br J Dermatol. 2010;163:1312–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Tamura K, Stecher G, Peterson D, Filipski A, Kumar S MEGA6: molecular evolutionary genetics analysis, version 6.0.; 2013.Google Scholar
  5. 5.
    Arranz Sanchez DM, de la Calle MC, Martin-Diaz MA, Flores CR, Gonzalez-Beato MJ, Pinto PH, Diaz Diaz RM. Subcutaneous mycosis produced by Aureobasidium pullulans in a renal transplant recipient. J Eur Acad Dermatol Venereol. 2006;20:229–30.CrossRefPubMedGoogle Scholar
  6. 6.
    Fletcher H, Williams NP, Nicholson A, Rainford L, Phillip H, East-Innis A. Systemic phaeohyphomycosis in pregnancy and the puerperium. West Indian Med J. 2000;49:79–82.PubMedGoogle Scholar
  7. 7.
    Joshi A, Singh R, Shah MS, Umesh S, Khattry N. Subcutaneous mycosis and fungemia by Aureobasidium pullulans: a rare pathogenic fungus in a post allogeneic BM transplant patient. Bone Marrow Transpl. 2010;45:203–4.CrossRefGoogle Scholar
  8. 8.
    Paredes CJ, Del Gordo EC, Torrado E, Restrepo Suarez JF, Rodriguez G, Canas CA, Gamarra AI. Chronic septal panniculitis caused by phaeohyphomycosis. J Clin Rheumatol. 1998;4:323–7.PubMedGoogle Scholar
  9. 9.
    Redondo-Bellon P, Idoate M, Rubio M, Ignacio Herrero J. Chromoblastomycosis produced by Aureobasidium pullulans in an immunosuppressed patient. Arch Dermatol. 1997;133:663–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Pikazis D, Xynos ID, Xila V, Velegraki A, Aroni K. Extended fungal skin infection due to Aureobasidium pullulans. Clin Exp Dermatol. 2009;34:e892–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Chander J, Sharma A. Prevalence of fungal corneal ulcers in northern India. Infection. 1994;22:207–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Chawla B, Sharma N, Titiyal JS, Nayak N, Satpathy G. Aureobasidium pullulans keratitis following automated lamellar therapeutic keratoplasty. Ophthal Surg Lasers Imaging. 2010;42:1–3.Google Scholar
  13. 13.
    Gupta V, Chawla R, Sen S. Aureobasidium pullulans scleritis following keratoplasty: a case report. Ophthalmic Surg Lasers. 2001;32:481–2.PubMedGoogle Scholar
  14. 14.
    Venugopal PL, Venugopal TL, Gomathi A, Ramakrishna ES, Ilavarasi S. Mycotic keratitis in Madras. Indian J Pathol Microbiol. 1989;32:190–7.PubMedGoogle Scholar
  15. 15.
    Koppang HS, Olsen I, Stuge U, Sandven P. Aureobasidium infection of the jaw. J Oral Pathol Med. 1991;20:191–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Morais OO, Porto C, Coutinho AS, Reis CM, Teixeira Mde M, Gomes CM. Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum. Braz J Infect Dis. 2011;15:288–92.CrossRefPubMedGoogle Scholar
  17. 17.
    Tan HP, Wahlstrom HE, Zamora JU, Hassanein T. Aureobasidium pneumonia in a post liver transplant recipient: a case report. Hepatogastroenterology. 1997;44:1215–8.PubMedGoogle Scholar
  18. 18.
    Clark EC, Silver SM, Hollick GE, Rinaldi MG. Continuous ambulatory peritoneal dialysis complicated by Aureobasidium pullulans peritonitis. Am J Nephrol. 1995;15:353–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Salkin IF, Martinez JA, Kemna ME. Opportunistic infection of the spleen caused by Aureobasidium pullulans. J Clin Microbiol. 1986;23:828–31.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Bolignano G, Criseo G. Disseminated nosocomial fungal infection by Aureobasidium pullulans var. melanigenum: a case report. J Clin Microbiol. 2003;41:4483–5.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Girardi LS, Malowitz R, Tortora GT, Spitzer ED. Aureobasidium pullulans septicemia. Clin Infect Dis. 1993;16:338–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Hawkes M, Rennie R, Sand C, Vaudry W. Aureobasidium pullulans infection: fungemia in an infant and a review of human cases. Diagn Microbiol Infect Dis. 2005;51:209–13.CrossRefPubMedGoogle Scholar
  23. 23.
    Huang YT, Liaw SJ, Liao CH, Yang JL, Lai DM, Lee YC, Hsueh PR. Catheter-related septicemia due to Aureobasidium pullulans. Int J Infect Dis. 2008;12:e137–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Kaczmarski EB, Liu Yin JA, Tooth JA, Love EM, Delamore IW. Systemic infection with Aureobasidium pullulans in a leukaemic patient. J Infect. 1986;13:289–91.CrossRefPubMedGoogle Scholar
  25. 25.
    Mershon-Shier KL, Deville JG, Delair S, Fothergill AW, Wickes B, de Hoog GS, Sutton DA, Lewinski MA. Aureobasidium pullulans var. melanigenum fungemia in a pediatric patient. Medical Mycol. 2011;49:80–3.CrossRefGoogle Scholar
  26. 26.
    Taborda CP, da Silva MB, Nosanchuk JD, Travassos LR. Melanin as a virulence factor of Paracoccidioides brasiliensis and other dimorphic pathogenic fungi: a minireview. Mycopathologia. 2008;165:331–9.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Kwon-Chung KJ. Tinea nigra. In: Kwon-Chung KJ, Bennett JE, editors. Medical mycology. Pennsylvania: Lea & Febiger; 1992. p. 191–7.Google Scholar
  28. 28.
    Li DM, de Hoog GS, Saunte DM, van den Ende AH, Chen XR. Coniosporium epidermidis sp. nov., a new species from human skin. Stud Mycol. 2008;61:131–6.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Khan ZU, Ahmad S, Joseph L, Chandy R. Cutaneous phaeohyphomycosis due to Neoscytalidium dimidiatum: first case report from Kuwait. Journal de Mycologie Médicale. 2009;19:138–42.CrossRefGoogle Scholar
  30. 30.
    Rakeman JL, Bui U, Lafe K, Chen YC, Honeycutt RJ, Cookson BT. Multilocus DNA sequence comparisons rapidly identify pathogenic molds. J Clin Microbiol. 2005;43:3324–33.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Gostinčar C, Ohm RA, Kogej T, Sonjak S, Turk M, Zajc J, Zalar P, Grube M, Sun H, Han J, et al. Genome sequencing of four Aureobasidium pullulans varieties: biotechnological potential, stress tolerance, and description of new species. BMC Genom. 2014;15:549.CrossRefGoogle Scholar
  32. 32.
    Najafzadeh MJ, Sutton DA, Keisari MS, Zarrinfar H, de Hoog GS, Chowdhary A, Meis JF. In vitro activities of eight antifungal drugs against 104 environmental and clinical isolates of Aureobasidium pullulans. Antimicrob Agents Chemother. 2014;58:5629–31.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Queiroz-Telles F, Esterre P, Perez-Blanco M, Vitale RG, Salgado CG, Bonifaz A. Chromoblastomycosis: an overview of clinical manifestations, diagnosis and treatment. Med Mycol. 2009;47:3–15.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  1. 1.Department of DermatologyMackay Memorial HospitalTaipeiTaiwan
  2. 2.Department of DermatologyChang Gung Memorial HospitalTaoyuanTaiwan
  3. 3.College of MedicineChang Gung UniversityTaoyuanTaiwan

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