Infections due to Wangiella dermatitidis in humans: report of the first documented case from the United States and a review of the literature.

Wangiella dermatitidis, a normally saprophytic dematiaceous fungus, has rarely been reported as a cause of disease in humans. A review of the worldwide literature yielded eight validly documented cases of W. dermatitidis infections. Reported herein is a subcutaneous knee infection due to W. dermatitidis in a diabetic man with impaired T-cell function and cutaneous anergy. Repeated cultures of the lesion were positive for W. dermatitidis despite therapy with amphotericin B. It is believed that this represents the first well-documented case of infection due to W. dermatitidis in North America, although the fungus has previously been isolated from nature in several states. The current state of knowledge of this organism, based on previously reported cases and isolations from nature, are discussed. No curative medical therapy is known for this infection, but surgical excision seems to be the treatment of choice for circumscribed W. dermatitidis infections.