Clinical spectrum of phaeohyphomycosis in solid organ transplant recipients

Tirico, Maria Claudia Carvas Passarelli; Neto, Cyro Festa; Cruz, Lana L.; Mendes-Sousa, Antonio Ferreira; Valkinir, Desirée Esther J.; Spina, Ricardo; Oliveira, Walmar Roncalli Pereira de

doi:10.1016/j.jdcr.2016.09.009

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…Infection can be either mucocutaneous or disseminated. The wide variety of mucocutaneous lesions range from papules, plaques, pustules, nodules, cysts, abscesses, sporotrichoid lesions, and kaposiform lesions [2, 4, 8, 9]. They are usually asymptomatic and could be solitary or multiple [2].…”

Section: Discussionmentioning

confidence: 99%

Phaeohyphomycosis caused by Diaporthe phaseolorum in an immunocompetent patient in Thailand: a case report

Laosakul

Youngchim

Chuamanochan

et al. 2020

Access Microbiology

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Phaeohyphomycosis is caused by a large, heterogeneous group of darkly pigmented fungi. It is an infrequent infection in humans. However, the prevalence has been increasing in recent years especially in immunocompromised patients. Diaporthe phaseolorum is a common black fungal pathogen of plants, which rarely causes human infection. We report the first case of cutaneous infection caused by Diaporthe phaseolorum in an immunocompetent host and the first in Asia. Although, the review of the literature revealed two previous cases of cutaneous infection caused by this organism, both of them were in immunocompromised hosts. A slow-growing asymptomatic nodule was the major clinical feature. Histopathological examination showed granulomatous inflammation and pigmented septate hyphae and yeast-like cells. The fungal isolation was identified by morphological characteristics and DNA sequencing. The lesion was resolved after complete surgical excision and oral fluconazole for two months. This report highlights the potential role of Diaporthe phaseolorum as an emerging cause of infection in immunocompetent patients.

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Section: Discussionmentioning

confidence: 99%

Phaeohyphomycosis caused by Diaporthe phaseolorum in an immunocompetent patient in Thailand: a case report

Laosakul

Youngchim

Chuamanochan

et al. 2020

Access Microbiology

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“…36 Patients who underwent SOT much more frequently developed cutaneous disease that may or may not involve multiple organ sites. [70][71][72] Fever is common but not universal, and may be accompanied by respiratory or neurologic symptoms, skin manifestations such as nodular rash, or ulcerative lesions, and, rarely, frank sepsis. 18,50 Marked eosinophilia may be observed and is associated with Curvularia, the most common causes of allergic disease.…”

Section: Disseminated Diseasementioning

confidence: 99%

Phaeohyphomycosis

Arcobello

Revankar

2020

Semin Respir Crit Care Med

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Phaeohyphomycosis refers to infections due to a large group of heterogenous organisms called “dematiaceous” or “melanized” fungi. These fungi are distinguished by the predominance of melanin in their cell walls, which likely acts as a virulence factor. Virtually, everyone is exposed to dematiaceous fungi through inhalation, as they are ubiquitous in the environment, although the development of infection is extremely uncommon. Invasive disease is rare but remains important due to the ability to cause serious disease in immunocompetent and immunocompromised hosts, unlike other fungal infections such as aspergillosis. A large variety of invasive manifestations can be caused by these organisms, including deep local infections, pulmonary infection, cerebral infection, and disseminated disease, which is associated with high mortality. While advances in molecular techniques are promising, they have still not replaced histology and culture as the primary diagnostic tools. Therapy is not standardized and is based primarily on clinical experience from descriptive case reports.

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“…2 The incidence in this population has been rising, however, as recent advances in immunosuppressive therapies have increased posttransplant survival. 3 Subcutaneous phaeohyphomycosis can present with nodules, cysts, tumors, and/or verrucous plaques, and the diagnosis almost always requires clinicopathologic correlation. 3 Rapid diagnosis can be made when septate brown hyphae and/or yeast forms are observed on hematoxylin and eosin stain.…”

Section: Practice Pointsmentioning

confidence: 99%

“…3 Subcutaneous phaeohyphomycosis can present with nodules, cysts, tumors, and/or verrucous plaques, and the diagnosis almost always requires clinicopathologic correlation. 3 Rapid diagnosis can be made when septate brown hyphae and/or yeast forms are observed on hematoxylin and eosin stain. Rarely, patients present with disseminated infection, characterized by fungemia; central nervous system involvement; and/or infection of multiple deep structures including the eyes, lungs, bones, and sinuses.…”

Section: Practice Pointsmentioning

confidence: 99%

“…6 The latter is a particularly important consideration when managing phaeohyphomycosis in organ transplant recipients, as azoles are known cytochrome P450 3A4 inhibitors that can affect serum levels of common immunosuppressive medications including calcineurin inhibitors and mammalian target of rapamycin inhibitors. 3 Local recurrence is common regardless of whether azole therapy is pursued, 7 and dissemination of localized Exophiala infections is exceedingly rare. 8 There is a strong argument to be made for our patient's decision to forgo antifungal therapy.…”

Section: Practice Pointsmentioning

confidence: 99%

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