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A case of subcutaneous Mycoleptodiscus indicus infection in a liver transplant recipient successfully treated with antifungal therapy
Author(s) -
Garrison A.P.,
Procop G.W.,
Vincek V.,
Moon J.,
Morris M.I.,
DobleckiLewis S.,
Cleary T.J.,
Brust D.,
RosaCunha I.
Publication year - 2008
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2007.00278.x
Subject(s) - voriconazole , medicine , micafungin , histopathology , amphotericin b , scedosporium apiospermum , population , hyaline , antifungal , immunology , dermatology , pathology , environmental health
Mycoleptodiscus indicus , a dematiaceous mold, occurs on the leaves of a number of different host plants and has been only recently described as a cause of human infection. Immunosuppressed individuals are at risk for developing infections with opportunistic fungal pathogens, which are a major cause of morbidity and mortality in this population. In addition, the treatment of infections caused by these fungi is frequently challenging. We report a case of M . indicus subcutaneous infection in a 51‐year‐old man with human immunodeficiency virus and hepatitis C co‐infection, who had a liver transplant. He developed skin nodules with a sporotrichoid lymphangitic distribution. Histopathology demonstrated unusual fungal elements with angioinvasion. Mycology cultures isolated a dematiaceous mold with the characteristic curved hyaline conidia of M . indicus . Initial treatment involved a combination of amphotericin B lipid complex and voriconazole, followed by monotherapy with voriconazole. The subcutaneous lesions resolved completely after 4 months of antifungal therapy.