A patient with chromoblastomycosis (warty plaque on foot) has biopsy showing thick-walled, dark brown, muriform (sclerotic) bodies dividing by fission in multiple planes ('copper pennies'). The most common causative species in India is which of the following?

• A Cladophialophora carrionii
• B Phialophora verrucosa
• C Fonsecaea pedrosoi ✓
• D Rhinocladiella mackenziei

Explanation

Fonsecaea pedrosoi is the most common causative agent of chromoblastomycosis worldwide, including India, accounting for 80–90% of cases. It is a dematiaceous (melanised) fungus that produces the characteristic muriform (sclerotic) bodies in tissue. C. carrionii is more common in arid regions (Venezuela, Australia). P. verrucosa can also cause chromoblastomycosis and is characterised by phialide-type sporulation. R. mackenziei causes cerebral phaeohyphomycosis with near 100% fatality. Treatment of chromoblastomycosis involves itraconazole ± terbinafine with cryotherapy adjunct.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

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