Subcutaneous granuloma caused by Phialophora richardsiae: case report and review of the literature.

A phaeomycotic cyst in a 47-year-old man, caused by Phialophora richardsiae, was treated successfully by excision. A critical review of the literature indicates that the pathological course of P. richardsiae infections usually follows a similar pattern to that of the present case, viz. generation of a well-defined and limited nodule following traumatic subcutaneous introduction of the fungus. The nodule typically accumulates a viscous yellow fluid. The infection remains localized, often being encapsulated by a fibrous layer; adenopathy is not observed. Concomitant bacterial infections are also common; in the present case Pseudomonas stutzeri was identified. Neither bacterial nor fungal infection recurred after surgery.