Subcutaneous black fungus (phaeohyphomycosis) infection in renal transplant recipients:three cases

Yehia, Maha; Thomas, Mark G.; Pilmore, Helen; Merwe, Walter van der; Dittmer, Ian

doi:10.1097/01.tp.0000107287.70512.e7

Cited by 43 publications

(45 citation statements)

References 11 publications

(12 reference statements)

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“…6,48 At our institution all patients received surgical treatment for phaeohyphomycosis and 11 (64.7%) of 17 patients also received systemic antifungal therapy with itraconazole. Although amphotericin B, 16,35,49 fluconazole, 50 ketoconazole, 49,51 and 5-fluorocytosine 21,49 have been proposed for the treatment of phaeohyphomycosis, these drugs were considered as alternative therapy for those patients with severe disease, poor response, or hepatic toxicity to itraconazole.…”

Section: Discussionmentioning

confidence: 99%

Treatment of subcutaneous phaeohyphomycosis and prospective follow-up of 17 kidney transplant recipients

Ogawa

Galante

Godoy

et al. 2009

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 99%

Treatment of subcutaneous phaeohyphomycosis and prospective follow-up of 17 kidney transplant recipients

Ogawa

Galante

Godoy

et al. 2009

Journal of the American Academy of Dermatology

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“…Many patients are immunocompetent, and they often are from a rural background, i.e., farmers with frequent, minor trauma from plant material or gardeners (133,192,206,233,277,359,576,751,815). Organ transplantation is also a common risk factor (28,38,112,142,235,236,262,271,286,296,465,484,514,556,587,645,679,704,725).…”

Section: Phaeohyphomycosismentioning

confidence: 99%

“…Clinically significant species in the mostly wood-inhabiting genus Pleurostomophora include P. richardsiae (obsolete Phialophora richardsiae) and P. repens (obsolete Phialophora repens), and individuals acquiring these mycoses are commonly immunocompromised (369,601,815). Species are anamorphs of the genus Pleurostoma.…”

Section: Sordarialesmentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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SUMMARY Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease, melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years. The spectrum of diseases with which they are associated has also broadened and includes allergic disease, superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi. Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants. Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.

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“…Maha Yahin et al, reported three cases of subcutaneous skin infection with pheohyphomycosis of lower extremities in RT recipients [10].…”

Section: Discussionmentioning

confidence: 99%

Pheohyphomycosis in Renal Transplant Recipient Presenting as a Rare Case of Submandibular Salivary Gland Swelling

Patel¹,

Vanikar²,

Trivedi

2016

JCDR

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A 37-year-old renal transplant recipient underwent Live Donor Renal Transplant (LDRT) with mother's kidney in 2006. He lost this graft to chronic rejection after 2 years inspite of triple immunosuppression of Tacrolimus 0.04 mg/kg/day, Azathioprine 50 mg/day, and Prednisone 10 mg/day. He underwent second transplantation in 2009 with wife's kidney (haplo-identical). He had been maintaining stable graft function with serum creatinine around 1.4 mg/dL with the same triple immunosuppression. At 3 years post-transplant he developed Post-Transplantation Diabetes Mellitus (PTDM) with complains of dysuria and urinary retention. Ultrasonography of abdomen and MRI were suggestive of prostatic abscess. About 120ml of pus was drained out by trans-urethroscopy and was subjected to microbiological studies. E.coli sensitive to Meropenom and Levoflox were isolated. He was treated with these drugs.Three months later he complained of swelling in the left submandibular region. On examination a well-defined, non-tender and freely mobile lump of size 3x3cm was observed in the left submandibular region. Fine needle aspiration cytology (FNAC) showed polymorphonuclear cells, lymphoctes, macrophages and foreign body giant cells along with aseptate fungal hyphae and buds [Table/ Fig-1]. Excision biopsy of tissue showed salivary glands with large number of foreign body giant cells forming granulomas, scattered areas of necrosis with nuclear debris and aseptate fungal hyphae and buds [Table/ Fig-2] with haematoxylineosin stain and Periodic acid-Schiff stain [Table /Fig-3,4]. He was treated with antifungal agent Voriconazole.Over a follow-up of 2 years he was asymptomatic, and had stable graft function with S.Cr of 1.35 mg/dL on Sirolimus 1 mg/day and Prednisone 5mg/day. Keywords: ABSTRACTRenal transplant patients are at high risk of developing various infections causing morbidity and mortality. Invasive fungal infection has been recognized as a significant complication of organ transplantation. The major fungal infections in these patients are due to candida, aspergillus and mucormycosis. However, infection because of infrequently encountered fungi like hyaline molds, dematiaceous filamentous fungi and zygomycetes are increasing in immunocompromised hosts. Dematiaceous fungi are recognized pathogens in organ transplant recipients with skin and soft tissue infection. We report the case of a 37-year-old man, a renal transplant recipient who developed an asymptomatic dematiaceous fungal infection in submandibular salivary gland. He recovered after excision and antifungal therapy.

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Subcutaneous black fungus (phaeohyphomycosis) infection in renal transplant recipients:three cases

Cited by 43 publications

References 11 publications

Treatment of subcutaneous phaeohyphomycosis and prospective follow-up of 17 kidney transplant recipients

Treatment of subcutaneous phaeohyphomycosis and prospective follow-up of 17 kidney transplant recipients

Melanized Fungi in Human Disease

Pheohyphomycosis in Renal Transplant Recipient Presenting as a Rare Case of Submandibular Salivary Gland Swelling

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