Alternaria Sinusitis

Abstract

Alternaria is a fungus of the class Deuteromycetes and the family Dematiaceae. Fungi of this genus have generally been regarded as nonpathogenic and as contaminants when isolated from clinical specimens. Hypersensitivity to Alternaria spores, however, has long been recognized as a cause of allergic pulmonary disease. More recently, the organism has also been demonstrated to have potential for opportunistic invasion of immunosuppressed and debilitated patients. Presented is a case in which this organism was repeatedly isolated from naso-oral tissue specimens from an otherwise healthy patient. The organism was seen in biopsies from a granulomatous hyperplastic destructive disease of the maxilla and soft tissues of the face which extended to the ethmoid sinus and fistulized through the hard palate. The clinical course, pathophysiology and therapeutic approach are discussed. The management of this disease requires a multidisciplinary approach involving the otolaryngologist, infectious disease specialist and pathologist.

Cutaneous alternariosis in transplant recipients: Clinicopathologic review of 9 cases

“…6 The most common species implicated in human disease are A alternata, A dianthicola, A chartarum, and A tenuissima. 6 Alternaria has been implicated in several cases of keratomycosis, 7 osteomyelitis, 8 sinusitis, 9 peritonitis, 10 or granulomatous pulmonary nodules. 11 Cutaneous infections caused by Alternaria species are rare, but constitute the majority of pathologic processes reported in human beings, mostly observed in immunocompromised hosts.…”

Posaconazole Therapy of Disseminated Phaeohyphomycosis in a Murine Model

“…Many infections involve respiratory sites (sinusitis, pneumonia) or skin and subcutaneous lesions following local inoculation (8,10,12,14,15,20,22). While many localized infections occur in otherwise healthy individuals, there is a predilection for phaeohyphomycosis in patients with solid-organ transplants or corticosteroid therapy, and a few cases have been reported in patients with AIDS (20,22,25). Infection of immune-suppressed patients suggests that cell-mediated immune defenses may be important for the control of phaeohyphomycosis.…”

Alternaria Osteomyelitis in an Immunocompetent Host Treated With Voriconazole

“…5 In all instances, the patients were young (range, 23Y50 years), had chronic sinus infections, and developed hard palate lesions. 8 What is apparent after reviewing the literature is that there is no consensus on which antifungal agent to use or length of therapy. 7 The second patient received 7 weeks of D-AMB, followed by surgical excision, but the infection recurred.…”