Exophiala dermatitidis pneumonia with bronchiectasis required prolonged voriconazole treatment

Abstract

Exophiala dermatitidis is a black fungus that rarely causes respiratory infection. We report a case of E . dermatitidis pneumonia with bronchiectasis that relapsed after 11 months of voriconazole (VRCZ) treatment in a rheumatoid arthritis (RA) patient with bronchiectasis. A 65‐year‐old woman with RA and abnormal findings on chest radiography was referred for assessment of chronic cough and increased sputum production. She underwent bronchoscopy, and E . dermatitidis was identified from bronchoalveolar lavage fluid (BALF). Exophiala dermatitidis chronic lower respiratory tract infection and pneumonia were diagnosed. Although her condition improved after 11 months of VRCZ treatment, chest computed tomography (CT) images showed worsening at five months after the cessation of VRCZ treatment and E . dermatitidis was again detected in BALF. Re‐administration of VRCZ for two years improved symptoms and chest CT images, and her condition is currently stable. In patients with bronchiectasis, E . dermatitidis pneumonia might require prolonged antifungal treatment.

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

“…However, the duration of antifungal therapy may be critical, because some cases were reported to be recurrent although the patient received VRCZ for 11 months. 1 , 2 , 4 More than 2 years of treatment may be necessary depending on the patients’ status. 2 Further studies of prolonged therapy are needed.…”

“… 1 , 2 , 4 More than 2 years of treatment may be necessary depending on the patients’ status. 2 Further studies of prolonged therapy are needed.…”

“… 1 It is also regularly isolated from respiratory samples from cystic fibrosis (CF) patients as colonization, with rates varying between 1% and 19%, but it is sometimes diagnosed as the pathogen in similar respiratory Diseases with bronchiectasis. 2 , 3 …”

Distribution of Yeast Species and Risk Factors of Oral Colonization after Oral-Care Education among the Residents of Nursing Homes

“…There were seven residents colonized by C. pararugosa , which was first reported in 2017 to cause bloodstream infections [ 27 ]. Hence, it is worth noting that in addition to those common species that cause diseases in humans, some rare species that were recovered in the present study such as Candida norvegensis [ 28 ], C. utilis [ 29 ], Cystobasidium minutum ( Rhodotorula minute ) [ 30 ], Exophiala dermatitidis [ 31 , 32 , 33 ], Lodderomyces elongisporus [ 34 , 35 ], Magnusiomyces capitatus [ 36 ], and Trichosporon mucoides [ 37 ] have been reported to cause invasive infections in humans.…”

Cutaneous phaeohyphomycosis caused by <i>Exophiala dermatitidis</i> in an immunosuppressed patient: A case report and brief review

“…In this case, the identified fungal species, Exophiala dermatitidis is widely distributed in the natural environment, principally in warm and humid areas in tropical climates. Although uncommon, E. dermatitidis can cause cutaneous, corneal, and respiratory infections, affecting particularly patients with bronchiectasis or immunosuppression 16,17 .…”