Successful treatment of subcutaneous phaeohyphomycosis owing to <i>Exophiala jeanselmei</i> with oral terbinafine

Rallis, Εfstathios; Frangoulis, E.

doi:10.1111/j.1365-4632.2006.03077.x

Cited by 23 publications

(12 citation statements)

References 10 publications

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“…and Phialophora spp. are the next most common fungi, followed by Cladosporium spp., Exserohilum spp., Veronaea botryosa, and many others with scattered case reports (7,12,19,23,32,36,56,61,65,81,140,143,194,209,230,241,251,258,306,313,342,362,365,369,387,413,418,421,457,469,482,486,487,495,539,559,556,568,571,576,590,609,613,614,646,659,694,699,720,728,…”

Section: Phaeohyphomycosismentioning

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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Section: Phaeohyphomycosismentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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“…An additional benefit is the minimal tissue loss with surgical removal of the lesions. 12 Complete surgical resection of localized lesions results in cure with no recurrence in the major- 3,8,11,13,14 Although the study conducted by Silveira and Nucci (2001) showed high minimum inhibitory concentration (MIC) values for dematiaceous fungi in general with fluconazole 15 , in the present case report the use of fluconazole preceding surgery led to a reduction in the size of the lesion and principally in the inflammatory process, improving local conditions during surgery and facilitating surgical removal of the entire lesion.…”

Section: Discussionmentioning

confidence: 85%

“…1,3,13 Terbinafine alone has also been shown to be useful in the treatment of refractory subcutaneous infection, which may suggest future standardization of its use in combination with other antifungal agents. 8,13 The lesions may also be treated surgically. 1 Some authors propose Mohs micrographic surgery as an effective therapeutic option, this constituting an alternative to the prolonged, expensive pharmacological treatments that require laboratory follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Feo-hifomicose subcutânea por Exophiala jeanselmei localizada na bolsa escrotal: relato de caso

Rossetto

Dellatorre

Pérsio

et al. 2010

An. Bras. Dermatol.

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Subcutaneous phaeohyphomycosis is a disease caused by dematiaceous fungi that develops mainly in immunocompromised patients. Lesions are generally located on the lower limbs. The present report describes a case of phaeohyphomycosis in an immunocompetent patient in whom a subcutaneous abscess was located in an unusual site, on the left hemiscrotum. The abscess was treated successfully with oral fluconazole associated with surgical excision. Keywords: Dermatomicoses; Exophiala; Fluconazole; Mycoses; Scrotum Resumo: A feo-hifomicose subcutânea é uma doença causada por fungos demáceos que acomete principalmente indivíduos imunocomprometidos e geralmente cursa com lesões localizadas nos membros inferiores. Os autores relatam um caso de feo-hifomicose subcutânea em um paciente imunocompetente, com localização atípica -na hemibolsa escrotal esquerda -, tratado com sucesso com fluconazol sistêmico associado à excisão cirúrgica.

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“…Recently, several reports showed that administration of terbinafine p.o. was also effective for E. jeanselmei infection 12,13 . We also successfully treated the patient with terbinafine in case 2.…”

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confidence: 93%