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Exophiala dermatitidis pneumonia with bronchiectasis required prolonged voriconazole treatment
Author(s) -
Sekiguchi Ryo,
Urabe Naohisa,
Sakamoto Susumu,
Sasaki Masakazu,
Homma Sakae,
Kishi Kazuma
Publication year - 2021
Publication title -
respirology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.304
H-Index - 9
ISSN - 2051-3380
DOI - 10.1002/rcr2.783
Subject(s) - medicine , voriconazole , bronchiectasis , bronchoalveolar lavage , sputum , pneumonia , surgery , lung , gastroenterology , pathology , dermatology , antifungal , tuberculosis
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.

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