Clinicopathological analysis of fungal lesions with unique presentations in immunocompetent adults - A case series from a tertiary care hospital in North Karnataka

Introduction: Fungal infections are mostly an opportunistic infection in immunocompromised patients and posttraumatic in immunocompetent adults. However, there has been a recent increasing trend of cases among immunocompetent adults with no history of trauma. Very few case series describing the clinicopathological picture of prevalent fungi are available from the various regions of India. Aims and Objectives: The present study aims to analyze clinicopathological features of various cases of fungal etiology with unique or rare presentations. Materials and Methods: This study included a clinicopathological analysis of surgical specimens received for histopathological examination at our hospital with special emphasis on cases with rare or unique presentations during the 1-year period from June 2019 to June 2020. Results: A total of 11 cases of fungal lesions with rare or unique clinicopathological presentations were selected for analysis. Majority of the patients were male, and most of them were from a rural background. There were four cases of aspergillosis, two cases of fungal keratitis, one case of renal aspergillosis, and one case of a subcutaneous swelling with discharging sinus. There were three cases of chromoblastomycosis, which presented as subcutaneous swellings with no lesion of overlying skin. There was an incidental finding of Candida sp. in two esophageal endoscopic biopsies, which primarily revealed esophageal adenocarcinoma. There was one case each of eumycetoma and mucormycosis. However, the mucormycosis case occurred in the setting of fungal abscess with osteomyelitis of the left mandible. Conclusion: Fungal lesions have revealed an increasing trend of infections in immunocompetent individuals in recent years, with various unique clinicopathological presentations. Therefore, there is a need for increased vigilance and analysis of such cases.