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Internal medicine (Tokyo, Japan)
Mar 15, 2019;58 (6): 877-882.

Community-acquired Disseminated Exophiala dermatitidis Mycosis with Necrotizing Fasciitis in Chronic Graft-versus-host Disease.

Eiichi Sato, Atsushi Togawa, Michio Masaki, Akihiko Shirahashi, Midori Kumagawa, Yasumasa Kawano, Hiroyasu Ishikura, Yuri Yamashiro, Satoshi Takagi, Hiromi To, Katsumi Kobata, Morishige Takeshita, Koji Kusaba, Eisaburo Sueoka, Kazuo Tamura, Yasushi Takamatsu, Tohru Takata
Author Information
  1. Eiichi Sato: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan.
  2. Atsushi Togawa: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan.
  3. Michio Masaki: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan.
  4. Akihiko Shirahashi: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan.
  5. Midori Kumagawa: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan.
  6. Yasumasa Kawano: Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, Japan.
  7. Hiroyasu Ishikura: Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, Japan.
  8. Yuri Yamashiro: Department of Plastic and Reconstructive Surgery, Fukuoka University Hospital, Japan.
  9. Satoshi Takagi: Department of Plastic and Reconstructive Surgery, Fukuoka University Hospital, Japan.
  10. Hiromi To: Department of Clinical Laboratory Medicine, Fukuoka University Hospital, Japan.
  11. Katsumi Kobata: Department of Pathology, Fukuoka University Hospital, Japan.
  12. Morishige Takeshita: Department of Pathology, Fukuoka University Hospital, Japan.
  13. Koji Kusaba: Department of Laboratory Medicine, Saga University Hospital, Japan.
  14. Eisaburo Sueoka: Department of Laboratory Medicine, Saga University Hospital, Japan.
  15. Kazuo Tamura: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan.
  16. Yasushi Takamatsu: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan.
  17. Tohru Takata: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan.
PMID: 30449799 DOI: 10.2169/internalmedicine.1706-18

Abstract

We herein report a case of systemic phaeohyphomycosis by Exophiala dermatitidis (E. dermatitidis) with chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (HSCT). The patient had been taking oral corticosteroids for years to control the GVHD. Yeast-like fungi were identified in a blood culture, so treatment with micafungin (150 mg/day) was begun, with no improvement. The patient passed away on hospital Day 12. A sequence analysis of rRNA revealed the isolate to be E. dermatitidis. This report brings attention to an emerging Mycosis of community-acquired Exophiala species infection in the very-late phase after allogenic HSCT in patients with chronic GVHD.

Keywords

Exophiala dermatitidis acute myeloid leukemia chronic graft versus host disease (GVHD) immunosuppressive drug necrotizing fasciitis phaeohyphomycosis

References

  1. Clin Microbiol Infect. 2014 Apr;20 Suppl 3:47-75 [PMID: 24483780]
  2. Mycoses. 2005 Mar;48(2):142-5 [PMID: 15743434]
  3. Med Mycol J. 2016;57(4):E117-E163 [PMID: 27904053]
  4. J Antimicrob Chemother. 2010 Jul;65(7):1455-9 [PMID: 20488983]
  5. J Clin Microbiol. 2013 Nov;51(11):3478-83 [PMID: 23850953]
  6. Clin Infect Dis. 2009 Apr 15;48(8):1033-41 [PMID: 19267655]
  7. J Clin Microbiol. 2017 Apr;55(4):1162-1176 [PMID: 28122875]
  8. Respir Med. 2006 Nov;100(11):2069-71 [PMID: 16626952]
  9. Antimicrob Agents Chemother. 2004 May;48(5):1912-5 [PMID: 15105159]
  10. J Dermatol. 2015 Jan;42(1):100-1 [PMID: 25470108]
  11. Transpl Infect Dis. 2014 Aug;16(4):616-20 [PMID: 24890324]
  12. J Infect. 2014 Jan;68(1):85-9 [PMID: 23994063]
  13. PLoS Pathog. 2015 Jul 30;11(7):e1004982 [PMID: 26226483]
  14. Eur J Epidemiol. 1987 Jun;3(2):87-95 [PMID: 3301395]
  15. J Dermatol. 2017 Sep;44(9):1067-1068 [PMID: 27666328]
  16. MMWR Morb Mortal Wkly Rep. 2002 Feb 8;51(5):97-101 [PMID: 11892956]
  17. Med Mycol. 2015 Jun;53(5):440-6 [PMID: 25908651]
  18. Med Mycol Case Rep. 2012 Oct 17;1(1):95-8 [PMID: 24371750]
  19. Clin Microbiol Rev. 2010 Oct;23(4):884-928 [PMID: 20930077]
  20. Infect Chemother. 2017 Jun;49(2):142-145 [PMID: 28271644]
  21. Med Mycol. 2011 Nov;49(8):819-24 [PMID: 21612562]
  22. Int J Dermatol. 2017 Jun;56(6):623-629 [PMID: 28295235]

MeSH Term

Chronic Disease
Exophiala
Fasciitis, Necrotizing
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Phaeohyphomycosis
Young Adult
Case Reports Journal Article

Word Cloud

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