A coffee plantation worker from Kerala presents with a slowly enlarging warty, verrucous plaque over the lower leg of 4 years duration. Biopsy shows suppurative granulomas containing round, thick-walled, brown pigmented cells that resemble copper pennies and divide by internal transverse and vertical septation. What are these structures called?

• A Sclerotic granules
• B Muriform cells (medlar bodies) ✓
• C Cigar-shaped yeast cells
• D Spherules containing endospores

Explanation

Chromoblastomycosis follows traumatic implantation of dematiaceous fungi such as Fonsecaea pedrosoi or Cladophialophora carrionii. The hallmark in tissue is muriform cells, also called Medlar bodies or copper penny cells, which are brown, thick-walled and divide by planar septation in two planes without budding. Sclerotic granules occur in mycetoma, cigar bodies in sporotrichosis and endosporulating spherules in coccidioidomycosis, so each distractor maps to a different disease.

Reference: Jagdish Chander, Textbook of Medical Mycology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.