Unusual presentation of chromoblastomycosis due to<i>Cladophialophora carrionii</i>in a renal and pancreas transplant recipient patient successfully treated with posaconazole and surgical excision

Dupont, Christian; Duong, Tu-Anh; Mallet, Serge; Mamzer-Bruneel, Marie-France; Thervet, Éric; Bougnoux, Marie‐Elisabeth; Dupont, B.

doi:10.1111/j.1399-3062.2009.00477.x

Cited by 17 publications

(7 citation statements)

References 14 publications

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“…Recommendations for refractory cases are combination antifungal therapy including cryotherapy or surgery when possible (recommendation BIII) . Based on experimental and in vitro studies the new triazole drug posaconazole is promising and could be useful when other therapy has failed (recommendation BIII) .…”

Section: Recommendations By Clinical Entitiesmentioning

confidence: 99%

ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi

Chowdhary

Meis

Guarro

et al. 2014

Clinical Microbiology and Infection

297

253

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The aetiological agents of many invasive fungal infections are saprobes and opportunistic pathogens. Some of these fungi are darkly pigmented due to melanin production and traditionally have been named 'dematiaceous'. The melanized fungi cause a wide array of clinical syndromes ranging from superficial to deep-seated infections. Diagnosis relies on histopathological examination of clinical specimens and on examination of cultures. Sequencing is recommended for accurate species identification, especially for unusual or newly described pathogens. In cases of mycetoma and chromoblastomycosis, pathognomonic histological findings are useful and the Fontana-Masson stain, specific for melanin, usually confirms the diagnosis. There are no standardized therapies but voriconazole, posaconazole and itraconazole demonstrate the most consistent in vitro activity against this group of fungi. Oral itraconazole has been considered the drug of choice, given the extensive clinical experience with this drug. However, voriconazole may presumably be superior for central nervous system infections because of its ability to achieve good levels in the cerebrospinal fluid. Posaconazole is a well-tolerated alternative drug, backed by less clinical experience but with excellent salvage treatment results after failure of other antifungals. Amphotericin B has been useful as alternative therapy in some cases. Combination antifungal therapy is recommended for cerebral abscesses when surgery is not possible and for disseminated infections in immunocompromised patients.

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Section: Recommendations By Clinical Entitiesmentioning

confidence: 99%

ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi

Chowdhary

Meis

Guarro

et al. 2014

Clinical Microbiology and Infection

297

253

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“…For instance, there is some evidence in India that CBM may be acquired during manual work in black tea cultivation at the Gardens of Assam, northeast region, and also in rubber plantations in the central districts of Kerala and nearby Western Ghats (155). Less frequently, CBM has been observed in immunosuppressed hosts, usually in solid-organ transplant recipients and in association with neoplastic diseases (156). Similarly to implantation mucormycosis after natural disasters, several cases of CBM were reported in the United States after Hurricane Ike (157,158).…”

Section: Demographics and Risk Factorsmentioning

confidence: 99%

Chromoblastomycosis

et al. 2017

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SUMMARY Chromoblastomycosis (CBM), also known as chromomycosis, is one of the most prevalent implantation fungal infections, being the most common of the gamut of mycoses caused by melanized or brown-pigmented fungi. CBM is mainly a tropical or subtropical disease that may affect individuals with certain risk factors around the world. The following characteristics are associated with this disease: (i) traumatic inoculation by implantation from an environmental source, leading to an initial cutaneous lesion at the inoculation site; (ii) chronic and progressive cutaneous and subcutaneous tissular involvement associated with fibrotic and granulomatous reactions associated with microabscesses and often with tissue proliferation; (iii) a nonprotective T helper type 2 (Th2) immune response with ineffective humoral involvement; and (iv) the presence of muriform (sclerotic) cells embedded in the affected tissue. CBM lesions are clinically polymorphic and are commonly misdiagnosed as various other infectious and noninfectious diseases. In its more severe clinical forms, CBM may cause an incapacity for labor due to fibrotic sequelae and also due to a series of clinical complications, and if not recognized at an early stage, this disease can be refractory to antifungal therapy.

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“…It is characterized by scaly papules that may progress to verrucous nodules or ulcerating plaques that may be treated with itraconazole or posaconazole. In difficult cases, the diagnosis requires histopathology and isolation of colonies of the dematiaceous mold in culture [60].…”

Section: Infectionsmentioning

confidence: 99%

“…It is caused by pigmented fungi that are common saprophytes growing in soil, vegetation, and wood. Several cases of cutaneous chromomycosis have been reported in transplant recipients [58–60]. It is characterized by scaly papules that may progress to verrucous nodules or ulcerating plaques that may be treated with itraconazole or posaconazole.…”

Section: Infectionsmentioning

confidence: 99%

Nonneoplastic mucocutaneous lesions in organ transplant recipients

Ponticelli¹,

Bencini²

2011

Transplant International

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Nonneoplastic cutaneous or mucosal complications are frequent in organ transplant recipients. In a systematic overview made in Leiden, 591 nonmalignant skin diseases were registered in 1768 (33%) organ transplant recipients followed over 13 years [1]. Smaller series reported that the prevalence of nonmalignant skin lesions in transplant recipients may range between 49% and 87% [2][3][4][5]. The lesions are mainly related to the prolonged use of immunosuppressive drugs, but an important contributing role may also be played by exposure to sunlight and viral infections. Although the pathogenesis of these lesions is often multifactorial, we will separate them into lesions caused by drugs and by infections.Drug-related skin lesions (Table 1) Calcium channel blockers can cause some cutaneous abnormalities, including photo-damage of the head and neck, teleangiectasia, and solar elastosis [6] as well as gingival hyperplasia [7]. However, most skin lesions in renal transplant recipients are caused by immunosuppressive drugs, in particular glucocorticoids and cyclosporine. An important consequence of the esthetic changes caused by these agents is a poor adherence to treatment which represents a major cause of graft failure [8]. GlucocorticoidsRenal transplant recipients given glucocorticoids may show a number of dermatological lesions which are related to the doses and the time of exposure of these agents. While the doses of glucocorticoids used in transplantation were very high in the recent past, the current immunosuppression is based on low doses of glucocorticoids and some units even treat transplant recipients with steroid-free regimens. As a consequence, the skin changes Keywords fungal infections, mucocutaneous lesions, transplant complications, transplantation and skin lesions. CorrespondenceClaudio Ponticelli MD, Istituto Scientifico Humanitas,

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Unusual presentation of chromoblastomycosis due toCladophialophora carrioniiin a renal and pancreas transplant recipient patient successfully treated with posaconazole and surgical excision

Cited by 17 publications

References 14 publications

ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi

ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi

Chromoblastomycosis

Nonneoplastic mucocutaneous lesions in organ transplant recipients

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