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

Summary

A 37-year-old man developed an unusual fungal skin infection around his mouth caused by Naganishia albidus, a rare yeast. He was initially misdiagnosed with eczema and his condition worsened with wrong treatment. Advanced fungal testing techniques helped identify the correct organism, and after six weeks of antifungal medication (both oral and topical), his skin completely cleared. This case shows why doctors need to consider rare fungal infections when skin problems don’t respond to typical treatments.

Background

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

Objective

To report a unique case of perioral cutaneous infection caused by N. albidus in an immunocompetent individual and highlight the diagnostic challenges and treatment approaches for this rare fungal infection.

Results

Fungal identification confirmed N. albidus through multiple diagnostic modalities. Histopathology showed infectious granulomatous inflammation. Laboratory findings ruled out systemic involvement and immunodeficiency. 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. Advanced diagnostic modalities including molecular and proteomic tools facilitate accurate identification. Timely diagnosis and appropriate combination antifungal therapy can lead to excellent clinical outcomes even in rare fungal infections.
  • Published in:Infection and Drug Resistance,
  • Study Type:Case Report,
  • Source: 10.2147/IDR.S514483, PMID: 40919006
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