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Subcutaneous abscess caused by Phoma sp. resembling Pyrenochaeta romeroi: unique fungal infection occurring in immunosuppressed recipient of renal allograft.

A species of Phoma closely resembling, but distinct from, Pyrenochaeta romeroi was the sole agent repeatedly cultured from a cold subcutaneous abscess occurring in an immunosuppressed recipient of a transplanted cadaveric kidney. Yeast-like and septate hyphal elements were present in histologic sections of the subcutaneous tissues exhibiting acute necrotizing and granulomatous inflammation. This case is believed to be the first in which human infection as opposed to colonization by Phoma sp. has been clearly documented. The present fungus is compared with previously described species of Phoma as well as Pyrenochaeta romeroi . Features which distinguish the present isolate from Pyrenochaeta romeroi include brown mycelium without grains in vivo, and ostiolated pycnidia lacking setae and pycnidiophores in vitro .