Case Number : Case 3008 - 17 January 2022 Posted By: Dr. Mona Abdel-Halim

Fungal infection, probably by dermatophyte.

Yes.  Given the deep and granulomatous nature of the reaction I guess Majocchi's granuloma would be a reasonable term to use here.

Granulomatous dermatitis, maybe Candida. 

Tissue invasion by non pigmented,  septate hyphae and the chronic granulomatous infiltrate suggest a deep fungal infection of hyalohyphomycosis type. The identification of the causative fungus will need culture and help of a microbiologist. 

Underlying CARD9 mutation needs to be ruled out because of the invasive fungal infections

On 20/01/2022 at 08:59, Krishnakumar subramanian said:

Underlying CARD9 mutation needs to be ruled out because of the invasive fungal infections

Yes, this was a case of deep dermatophytosis

Repeated cultures revealed Epidermophyton floccosum

We think the patient has CARD9 mutation, still trying to see if testing for it is available in Egypt or not

Thank you all!

On 20/01/2022 at 06:59, Krishnakumar subramanian said:

Underlying CARD9 mutation needs to be ruled out because of the invasive fungal infections

Great diagnosis