Question

A woodworker presented with chronic localized infection of the skin on his lower legs and feet which were irregular, rough, cauliflower-like lesions. Microscopy of the biopsy shows copper penny-muriform cells and branched air bodies, the etiological agent is:

• A. Chromoblastomycosis
• B. Phaeohyphomycosis
• C. Chromomycosis
• D. Rhinosporidiosis

Hint:

Chromoblastomycosis is commonly seen in individuals who have occupational exposure to soil or wood, especially in tropical and subtropical areas.

Answer 1

The Correct Option is A

The question is about identifying the etiological agent responsible for the chronic localized infection with specific characteristics such as irregular, rough, and cauliflower-like lesions on the skin, along with copper penny-muriform cells seen in microscopy.

To solve this question, let's analyze the options and see which one fits the described symptoms and microscopy findings:

1. Chromoblastomycosis:
   • This is a chronic fungal infection of the skin and subcutaneous tissue.
   • It presents as verrucous (warty), nodular lesions, often described as "cauliflower-like".
   • Microscopy of a lesion in chromoblastomycosis shows characteristic "copper penny" or "sclerotic" bodies, which are brownish, thick-walled, and muriform (having a particular layered wall structure).
2. Phaeohyphomycosis:
   • Another fungal infection but characterized mainly by hyphae, not muriform cells.
   • Typically presents as cystic infections and does not usually have the cauliflower-like appearance.
3. Chromomycosis:
   • This is synonymous with Chromoblastomycosis and not a separate entity.
4. Rhinosporidiosis:
   • Caused by Rhinosporidium seeberi and is characteristically an infection leading to polypoid masses within mucous membranes, such as nasal passages.
   • Does not have the described "copper penny" form bodies.

Based on the information provided and the analysis above, the option that perfectly fits the description of the symptoms and findings is Chromoblastomycosis.

Therefore, the correct answer is Chromoblastomycosis. It presents the described lesions and microscopic findings of copper penny-muriform cells.