# Microsurgical Debridement for Persistent Ulcers Due to Rare Fungus Infection: Case Report and Literature Review

## TL;DR

A patient with a persistent fungal ulcer was successfully treated with microsurgical debridement after other methods failed.

## Contribution

This case highlights the effectiveness of radical microscopic debridement for treating rare fungal infections.

## Key findings

- Chronic fungal ulcer due to Scopulariopsis brevicaulis was unresponsive to multiple antifungal agents and debridement.
- Radical microscopic debridement eradicated fungal conidiospores and prevented recurrence for 2 years.
- Multidrug resistance in rare fungal infections may require surgical intervention for successful treatment.

## Abstract

A patient suffered from chronic ulcer due to recalcitrant fungal infection for 3.5 years. Five antifungal agents and 40 times of debridement—all failed. Finally, radical microscopic debridement was performed for eradication of fungal conidiospores. Since then, there was no recurrence at 2 years of follow-up.
Scopulariopsis brevicaulis
is one of the rarest pathogens of cutaneous fungal infections, for which multidrug resistance increased the complexity and difficulty of treatment. Radical excision, especially microscopic debridement, was the key for eradication of fungal conidiospores in this case.