Premium
Subcutaneous phaeohyphomycosis in kidney transplant recipients: A series of seven cases
Author(s) -
Haridasan Satish,
Parameswaran Sreejith,
Bheemanathi Srinivas Hanuman,
Chandrasekhar Laxmisha,
Suseela Bibilash Babu,
Singh Rakesh,
Rabindranath Jayasurya,
Padhi Rajesh Kumar,
Sampath Ezhilnilavan,
Dubey Avinash Kumar,
Puthenpurackal Priyamvada Sivan Pillai
Publication year - 2017
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/tid.12788
Subject(s) - medicine , histopathology , immunosuppression , phaeohyphomycosis , itraconazole , lesion , transplantation , incidence (geometry) , kidney transplantation , pathology , surgery , dermatology , antifungal , physics , optics
Background Superficial and deep fungal infections are more frequent in transplant recipients primarily because of the failure of cell‐mediated immunity and lesser amount of antigen‐presenting Langerhans cells in their epidermis. Here, we report seven cases of post‐renal transplant subcutaneous phaeohyphomycosis, all of which manifested within 1 year after transplantation and were unresponsive to prolonged courses of itraconazole. This is the first case series, to our knowledge, of phaeohyphomycosis in transplant recipients in India. Method We performed a retrospective review of cases of phaeohyphomycosis among kidney transplant recipients for type of transplant, immunosuppression, histopathology, and treatment, with prospective follow‐up of healed lesion. Results An overall incidence of 8.3% was noted, with a median duration of approximately 6 months post transplant to the onset of skin lesion. None of the lesions responded to itraconazole alone and 6/7 lesions were surgically excised. Histopathology showed various lesions and culture could isolate N eocytalidium and E xophiala jeanselmi in two cases. Conclusion Dematiaceous fungi are increasingly implicated in cutaneous lesions in transplant recipients. Histopathology and surgical excision are the appropriate tools for diagnosis and treatment, respectively.