Exophiala dermatitidis pneumonia successfully treated with long-term itraconazole therapy

Mukai, Yutaka; Nureki, Shin-ichi; Hata, Masahiro; Shigenaga, Takehiko; Tokimatsu, Issei; Miyazaki, Eishi; Kadota, Jun‐ichi; Yarita, Kyoko; Kamei, Katsuhiko

doi:10.1016/j.jiac.2014.02.006

Cited by 17 publications

(21 citation statements)

References 17 publications

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“…Most of the non-CF cases were from Asia, where CF is rare, and the patients were more often female and had bronchiectasis. 3 , 6 , 7 …”

Section: Discussionmentioning

confidence: 99%

Sinobronchial Syndrome Patients with Suspected Non-Tuberculous Mycobacterium Infection Exacerbated by Exophiala dermatitidis Infection

Watanabe¹,

Sano²,

Konno³

et al. 2022

IDR

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Background Exophiala dermatitidis is an environmental black fungus that rarely causes respiratory infections, yet its pathophysiological features and treatment regimens have not been established. Case Series Two cases of exacerbations of chronic bronchitis and sinusitis due to E. dermatitidis infection in Japan are presented. Both patients were women, and non-tuberculous Mycobacterium (NTM) infection was suspected based on chest radiological findings, but E. dermatitidis was detected from bronchial lavage fluid and nasal mucus, respectively. Both cases were successfully treated by antifungal agents such as liposomal amphotericin B, voriconazole, and itraconazole, but clarithromycin, rifampicin, ethambutol, and sitafloxacin for NTM were not effective. Conclusion E. dermatitidis can become a respiratory pathogen, especially in patients with chronic sinobronchial syndrome.

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“…Most of the non-CF cases were from Asia, where CF is rare, and the patients were more often female and had bronchiectasis. 3 , 6 , 7 …”

Section: Discussionmentioning

confidence: 99%

Sinobronchial Syndrome Patients with Suspected Non-Tuberculous Mycobacterium Infection Exacerbated by Exophiala dermatitidis Infection

Watanabe¹,

Sano²,

Konno³

et al. 2022

IDR

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“…Patients with CARD-9 deficiency have defective neutrophils, which are involved in the intracellular killing of the yeast Candida, and severely reduced levels of circulating Th17 cells and TNF-α [1]. The patient in the present case recovered from lymph node fungal infection but not from CNS E. dermatitidis infection; different outcomes were observed due to different infection sites and fungal species [11]. Despite the in vitro susceptibility to antifungal agents, the infection may relapse and can be potentially fatal.…”

Section: Discussionmentioning

confidence: 64%

A fatal case of Exophiala dermatitidis meningoencephalitis in an immunocompetent host: A case report and literature review

Yang

et al. 2021

Journal of Infection and Chemotherapy

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Background: Central nervous system (CNS) infection due to Exophiala dermatitidis is rare and fatal, and primarily reported in immunocompromised patients or those with caspase recruitment domain-containing protein 9 deficiency. Herein, we describe a case of an otherwise healthy person (without underlying disease or gene deficiency) diagnosed with Exophiala dermatitidis meningoencephalitis. The patient achieved clinical remission under high-dose antifungal therapy in the first 14 months but died after 2 years of the therapy. Case presentation: A 15-year-old student with headache and fever was admitted to our department. Lumbar puncture showed increased cerebrospinal fluid (CSF) pressure, moderately high CSF protein levels and cell counts, and a remarkable decrease in CSF glucose and chloride. Magnetic resonance imaging of the brain revealed multiple lesions and cerebral pia mater enhancement. CSF culture confirmed E. dermatitidis infection. We administered 4-week antifungal therapy of amphotericin B, but his CSF culture remained positive. After receiving the 12-week standard dose of voriconazole (200 mg q12h), the patient's CSF culture became negative, but his condition deteriorated with intracranial lesion enlargement. We administered a high-dose voriconazole therapy (600-800 mg per day) for 12 months, which led to clinical remission. The voriconazole dose was reduced due to adverse effects including hepatic dysfunction and hypokalemia, and the disease progressed with high intracranial pressure and epileptic seizures. Conclusions: CNS infection caused by E. dermatitidis is fatal and the most serious form of fungal infection. Initially, high-dose and long-term antifungal therapy could be effective. Gene defect and related antifungal immunodeficiency may be the most important pathogenic and lethal factor.

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“…Exophiala infection is a rare diagnosis but is being identified more frequently, likely related to increases in immunosuppression related to solid organ transplantation [1] . Infection is commonly limited to cutaneous involvement, but disseminated disease can occur and affect the lungs, digestive tract, and central nervous system [5] . Review of the literature suggests that most reported cases of Exophiala pneumonia are present in patients who are immunocompromised or have underlying lung disease, such as cystic fibrosis or chronic bronchiectasis [5] , [3] .…”

Section: Discussionmentioning

confidence: 99%

Exophiala pneumonia requiring pneumonectomy in a post-renal transplant patient

Gonzales

Shin

et al. 2022

IDCases

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Exophiala dermatitidis pneumonia successfully treated with long-term itraconazole therapy

Cited by 17 publications

References 17 publications

Sinobronchial Syndrome Patients with Suspected Non-Tuberculous Mycobacterium Infection Exacerbated by Exophiala dermatitidis Infection

Sinobronchial Syndrome Patients with Suspected Non-Tuberculous Mycobacterium Infection Exacerbated by Exophiala dermatitidis Infection

A fatal case of Exophiala dermatitidis meningoencephalitis in an immunocompetent host: A case report and literature review

Exophiala pneumonia requiring pneumonectomy in a post-renal transplant patient

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