Invasive Fungal Infection Caused by Exophiala Dermatitidis in a Patient After Lung Transplantation: Case Report and Literature Review

Overview

Journal Mycopathologia

Specialties Microbiology
Pharmacology

Date 2018 Jun 28

PMID 29948438

Citations 12

Authors

Romana Klasinc

Martin Riesenhuber

Andreas Bacher

Birgit Willinger

Affiliations

Soon will be listed here.

Abstract

This report describes a case of invasive Exophiala dermatitidis infection after double lung transplantation in a 76-year-old man. After thoracotomy, the patient's wound showed dehiscence with purulent secretion. The black yeast was isolated from cultures taken from the wound, and species identification was confirmed by sequence analysis of the internal transcribed spacer (ITS-S2) region. The results of the susceptibility testing showed voriconazole as the most active drug. Despite adaptation of the antifungal therapy the clinical condition worsened, and the patient died. In addition, we evaluated the fungicidal activity of antiseptics towards E. dermatitidis and aimed to provide a brief literature review of previously reported infections caused by this rare fungus. To the best of our knowledge, this is the first report of a rapidly progressing invasive fungal infection with E. dermatitidis originating from a colonized wound after lung transplantation.

Citing Articles

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References

Szekely A, Johnson E, Warnock D . Comparison of E-test and broth microdilution methods for antifungal drug susceptibility testing of molds. J Clin Microbiol. 1999; 37(5):1480-3. PMC: 84808. DOI: 10.1128/JCM.37.5.1480-1483.1999. View

Espinel-Ingroff A . In vitro fungicidal activities of voriconazole, itraconazole, and amphotericin B against opportunistic moniliaceous and dematiaceous fungi. J Clin Microbiol. 2001; 39(3):954-8. PMC: 87856. DOI: 10.1128/JCM.39.3.954-958.2001. View

Xu X, Low D, Palevsky H, Elenitsas R . Subcutaneous phaeohyphomycotic cysts caused by Exophiala jeanselmei in a lung transplant patient. Dermatol Surg. 2001; 27(4):343-6. DOI: 10.1046/j.1524-4725.2001.00308.x. View

Diemert D, Kunimoto D, Sand C, Rennie R . Sputum isolation of Wangiella dermatitidis in patients with cystic fibrosis. Scand J Infect Dis. 2001; 33(10):777-9. DOI: 10.1080/003655401317074644. View

Revankar S, Patterson J, Sutton D, Pullen R, Rinaldi M . Disseminated phaeohyphomycosis: review of an emerging mycosis. Clin Infect Dis. 2002; 34(4):467-76. DOI: 10.1086/338636. View

Chua J, Gordon S, Banbury J, Hall G, Procop G . Relapsing Exophiala jeanselmei phaeohyphomycosis in a lung-transplant patient. Transpl Infect Dis. 2002; 3(4):235-8. DOI: 10.1034/j.1399-3062.2001.30408.x. View

Nucci M, Akiti T, Barreiros G, Silveira F, Revankar S, Wickes B . Nosocomial outbreak of Exophiala jeanselmei fungemia associated with contamination of hospital water. Clin Infect Dis. 2002; 34(11):1475-80. DOI: 10.1086/340344. View

. Exophiala infection from contaminated injectable steroids prepared by a compounding pharmacy--United States, July-November 2002. MMWR Morb Mortal Wkly Rep. 2003; 51(49):1109-12. View

Matos T, Haase G, Gerrits van den Ende A, de Hoog G . Molecular diversity of oligotrophic and neurotropic members of the black yeast genus Exophiala, with accent on E. dermatitidis. Antonie Van Leeuwenhoek. 2003; 83(4):293-303. DOI: 10.1023/a:1023373329502. View

10.

Greig J, Harkness M, Taylor P, Hashmi C, Liang S, Kwan J . Peritonitis due to the dermatiaceous mold Exophiala dermatitidis complicating continuous ambulatory peritoneal dialysis. Clin Microbiol Infect. 2003; 9(7):713-5. DOI: 10.1046/j.1469-0691.2003.00569.x. View

11.

Kusenbach G, Skopnik H, Haase G, Friedrichs F, DOHMEN H . Exophiala dermatitidis pneumonia in cystic fibrosis. Eur J Pediatr. 1992; 151(5):344-6. DOI: 10.1007/BF02113255. View

12.

Kantarcioglu A, de Hoog G . Infections of the central nervous system by melanized fungi: a review of cases presented between 1999 and 2004. Mycoses. 2004; 47(1-2):4-13. DOI: 10.1046/j.1439-0507.2003.00956.x. View

13.

Graybill J, Najvar L, Johnson E, Bocanegra R, Loebenberg D . Posaconazole therapy of disseminated phaeohyphomycosis in a murine model. Antimicrob Agents Chemother. 2004; 48(6):2288-91. PMC: 415573. DOI: 10.1128/AAC.48.6.2288-2291.2004. View

14.

Horre R, Schaal K, Siekmeier R, Sterzik B, de Hoog G, Schnitzler N . Isolation of fungi, especially Exophiala dermatitidis, in patients suffering from cystic fibrosis. A prospective study. Respiration. 2004; 71(4):360-6. DOI: 10.1159/000079640. View

15.

Zeng J, Sutton D, Fothergill A, Rinaldi M, Harrak M, de Hoog G . Spectrum of clinically relevant Exophiala species in the United States. J Clin Microbiol. 2007; 45(11):3713-20. PMC: 2168524. DOI: 10.1128/JCM.02012-06. View

16.

Haase G, Skopnik H, Groten T, Kusenbach G, Posselt H . Long-term fungal cultures from sputum of patients with cystic fibrosis. Mycoses. 1991; 34(9-10):373-6. DOI: 10.1111/j.1439-0507.1991.tb00797.x. View

17.

Fothergill A, Rinaldi M, Sutton D . Antifungal susceptibility testing of Exophiala spp.: a head-to-head comparison of amphotericin B, itraconazole, posaconazole and voriconazole. Med Mycol. 2008; 47(1):41-3. DOI: 10.1080/13693780802512451. View

18.

Li D, de Hoog G . Cerebral phaeohyphomycosis--a cure at what lengths?. Lancet Infect Dis. 2009; 9(6):376-83. DOI: 10.1016/S1473-3099(09)70131-8. View

19.

Calvo E, Rodriguez M, Marine M, Mayayo E, Pastor F, Guarro J . Comparative virulence of three species of Exophiala in mice. Med Mycol. 2010; 48(6):853-7. DOI: 10.3109/13693780903582481. View

20.

Griffard E, Guajardo J, Cooperstock M, Scoville C . Isolation of Exophiala dermatitidis from pigmented sputum in a cystic fibrosis patient. Pediatr Pulmonol. 2010; 45(5):508-10. DOI: 10.1002/ppul.21187. View