In:
Journal of Clinical Microbiology, American Society for Microbiology, Vol. 53, No. 7 ( 2015-07), p. 2084-2094
Abstract:
Despite increasing reports of human infection, data about the optimal care of Phaeoacremonium infections are missing. We report a case of an infection due to Phaeoacremonium parasiticum and Paraconiothyrium cyclothyrioides , initially localized to skin and soft tissue, in a kidney transplant patient. Despite surgical drainage and excision of the lesion and combination antifungal therapy with voriconazole and liposomal amphotericin B, a disseminated infection involving the lungs and brain developed and led to death. We performed a systematic literature review to assess the general features and outcome of human infections due to Phaeoacremonium species. Thirty-six articles were selected, and 42 patients, including ours, were reviewed. Thirty-one patients (74%) were immunocompromised because of organ or bone marrow transplantation ( n = 17), diabetes or glucose intolerance ( n = 10), rheumatoid arthritis or Still's disease ( n = 4), chronic hematological diseases ( n = 3), or chronic granulomatous disease ( n = 3). Ten patients (24%) reported initial cutaneous trauma. Skin and soft tissue infections represented 57% of infections ( n = 24), and disseminated infections, all occurring in immunocompromised patients, represented 14% of infections ( n = 6). The main antifungal drugs used were azoles ( n = 41) and amphotericin B ( n = 16). Surgical excision or drainage was performed in 64% of cases ( n = 27). The cure rate was 67% ( n = 28). There were 10% cases of treatment failure or partial response ( n = 4), 19% relapses ( n = 8), and 7% losses to follow-up ( n = 3). The death rate was 19% ( n = 8). Management of Phaeoacremonium infections is complex because of slow laboratory identification and limited clinical data, and treatment relies on a combination of surgery and systemic antifungal therapy.
Type of Medium:
Online Resource
ISSN:
0095-1137
,
1098-660X
DOI:
10.1128/JCM.00295-15
Language:
English
Publisher:
American Society for Microbiology
Publication Date:
2015
detail.hit.zdb_id:
1498353-9
SSG:
12
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