Cutaneous Infection with Alternaria Alternata Complicating Immunosuppression: Successful Treatment with Itraconazole

We report an immunosuppressed patient who presented with unusual leg ulceration caused by Alternaria alternata infection. Alternaria is a common saprophyte that is not usually pathogenic in humans. However, infections have previously been documented. Most cases occur in immunocompromised patients and the skin manifestations may vary considerably. The diagnosis is often missed initially as it is not frequently suspected. The treatment is controversial both in choice of agent used and in duration of therapy.