Primarily seen in oakleaf hydrangea kept under poor drainage conditions. Wilting of the foliage is the first symptom of the disease. The leaves may turn yellow, shed, and the plants will be stunted depending upon the root-colonization. The feeder roots are brittle, and brown in color compared to normal off-white color in healthy plants.

The stem can have a brown discoloration below the bark extending above the soil line. The causal agent is P. nicotiana is usually introduced into a nursery on unrooted or rooted cuttings, and container stocks.