We present the case of a 76-year-old man with a black mold infection of the index finger. This granulomatous abscess uncharacteristically invaded the flexor sheath compartment, threatening proximal spread. Treatment consisted of excision of the abscess and drainage of the flexor sheath. The patient recovered unremarkably, maintaining digital function without recurrent infection.
The members of the fungal genus Exophiala are dark-pigmented mycoses commonly termed “black mold.” Previously reported atraumatic black mold infections of the hand have been limited to subcutaneous involvement. To our knowledge, this is the first report of the successful treatment of a flexor sheath infection caused by the species E. jeanselmei.