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Naganishia albidus Causing Perioral Cutaneous Infection: A Rare Case Easily Misdiagnosed

Summary

A 37-year-old construction worker developed unusual scaling and itchy sores around his mouth that worsened despite treatment for eczema. Doctors eventually discovered the infection was caused by a rare yeast fungus called Naganishia albidus, which is almost never seen in healthy people. Using advanced laboratory tests and antifungal medications taken by mouth and applied to the skin, the infection completely cleared within six weeks.

Background

Naganishia albidus is a rare saprophytic yeast that uncommonly causes human infections, typically affecting immunocompromised individuals. Cutaneous naganishiosis is exceptionally rare in immunocompetent individuals, and perioral localization has not been previously reported in the literature.

Objective

To report a rare case of perioral cutaneous infection caused by N. albidus in an immunocompetent individual and highlight the diagnostic challenges and clinical management of this atypical presentation.

Results

N. albidus was confirmed through multiple diagnostic modalities including direct fluorescent staining, fungal culture, MALDI-TOF MS analysis, and molecular sequencing. The patient was successfully treated with oral itraconazole 0.2 g twice daily and topical fluconazole cream twice daily for six weeks, resulting in complete lesion resolution.

Conclusion

Perioral cutaneous infection caused by N. albidus is exceptionally rare and poses significant diagnostic challenges due to atypical presentation mimicking common dermatological conditions. Advanced diagnostic modalities combined with appropriate antifungal therapy can achieve excellent clinical outcomes, emphasizing the importance of maintaining high clinical suspicion for uncommon fungal pathogens.
  • Published in:Infection and Drug Resistance,
  • Study Type:Case Report,
  • Source: PMID: 40919006, DOI: 10.2147/IDR.S514483
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