An Unusual Deep Fungal Infection With Nigrospora Sphaerica In Hiv Positive Patient

A 34-year-old HIV positive male with a CD4+ cell count of 133 cell/mm(3) presented with multiple crusted and hemorrhagic ulcers on the face, scalp, trunk, and limbs for 3 months. Skin biopsies showed granulomatous inflammation with microabscesses and lots of hyphae and spores. PCR identified the fungus as Nigrospora sphaerica. This is mainly a plant pathogen which rarely causes opportunistic infections in humans. After a thorough literature search we found very few reported cases of human infection by this fungus worldwide but none in Africa. We therefore report the first case of human infection by Nigrospora sphaerica in the African continent.