An unusual skin lesion caused by lasiodiplodia theobromae

Lasiodoplodia theobromae is a common plant pathogen of tea and fruiting plants from the Coelomycetes family. It is a rare plant pathogen in both immunocompetent and immunocompromised hosts with infections reported including sinusitis, keratitis, pneumonia and cutaneous lesions. We describe a case of subcutaneous infection as a result of traumatic implantation caused by the fungus Lasiodiplodia theobromae. It was isolated in multiple swabs from the foot of an active healthy male following a penetrating sea water injury. Following the trauma, the patient used wild aloe vera plant leaf to promote wound healing and this was thought to be a potential source of inoculation. Identification was performed by traditional mycology culture methods with sporulation occurring only with cornmeal agar at 28 days. Identification was confirmed by DNA sequencing. The patient was successfully treated with voriconizole.