A Case of Cutaneous Exophiala spinifera Infection.

Abstract

like, septate and dark brown conidiophores with annellides. (lactophenol cotton blue stain. 1000), d; Scanning electron microscopic view of E. spinifera showing an elongated tip with many annellations on a hypha.

Case Study: Posaconazole Treatment of Disseminated Phaeohyphomycosis Due toExophiala spinifera

“…The combination of a triazole antifungal agent (e.g., itraconazole or fluconazole) and flucytosine therapy, with or without surgical excision, has been used successfully to treat subcutaneous dematiaceous infection in adult patients [2,5,7,10,11,14,17,18]. In vitro susceptibility studies of antifungal agents have shown that fungi of the Exophiala genus are susceptible to azoles, terbinafine, and flucytosine [19][20][21].…”

“…Its morphological and culture characteristics are very similar to those of Exophiala jeanselmei. In recent years, several new cases of phaeohyphomycosis caused by E. jeanselmei and E. spinifera have been reported, both in humans and cats, and have exhibited a variety of clinical patterns, including subcutaneous pseudocystic lesions, peritonitis, and systemic infections [1,[6][7][8][9][10][11][12][13][14][15]. A report of 5 serious cases caused by dematiaceous fungi noted not only that infection due to this group of organisms is increasing, but also that species such as E. jeanselmei are exhibiting unusual manifestations [16].…”

Concurrent double infections of the skin: Phaeohyphomycosis and nocardiosis in a patient with idiopathic thrombocytopenic purpura

“…There is only one other well-documented case of E spinifera infection in Japan. 13 The authors thank Dr Yuzuru Mikami (Research Center for Pathogenic Fungi and Microbial Toxicosis, Chiba University, Japan) for performing morphologic and physiologic studies for identification of N asteroides. …”

“…9 Although the clinical manifestation did not seem typical of fungal infection, we were able to execute appropriate and immediate examinations because of the presence of the apparent infectious disease on the right hand. Human infections by E spinifera have been described in 18 cases, [10][11][12][13] which can be divided into disseminated infections in children and adolescents and localized cutaneous and/or subcutaneous infections in adults, generally with an underlying disease. 11 This case should be considered as belonging to the group of localized infections in adults with underlying disease.…”

A case of subcutaneous phaeohyphomycotic cyst due to Exophiala jeanselmei complicated with systemic lupus erythematosus

“…Four species of Exophiala are known: E. jeanselmei, E. dermatitidis, E. moniliae, and E. spinifera. 1 Exophiala jeanselmei is widely distributed in the natural world; and in the everyday living environment it has been isolated from bathtubs and water pipes of home bathrooms, as well as from bathtubs of public baths. 2 We report a case of phaeohyphomycosis caused by E. jeanselmei as a complication of systemic lupus erythematosus (SLE), together with statistics and an examination of the literature.…”