Describe the clinical features of phaeohyphomycosis.

The spectrum of clinical infections is broad. The most typical presentation is a subcutaneous cyst or abscess at the site of trauma and Exophiala jeanselmei is the most common organism. The primary lesion is a painless nodule. The nodule evolves into a fluctuant abscess. Immunocompromised patients present with multiple nodules. Dissemination is rare; however, the incidence has increased over the past 10 years. Scedosporium proliferans (42% cases), Bipolaris spicifera (8%), and Wangiella dermatitidis (7%) are the most common causes of disseminated disease. The primary risk factor is decreased host immunity, especially prolonged neutropenia. The outcome is poor, despite antifungal therapy, with an overall mortality rate of 79%. Cerebral phaeohyphomycosis acquired through inhalation and hematogenous dissemination is most commonly seen in immunocompetent persons with no obvious risk factors.