Phaeohyphomycosis

OPPORTUNISTIC INFECTIONS caused by the dematiaceous (darkly pigmented) MITOSPORIC FUNGI of ALTERNARIA, Bipolaris, CLADOSPORIUM, Curvularia, and EXOPHIALA. These fungi have pigmented HYPHAE due to MELANIN in the cell wall. The initial subcutaneous cyst from the infection can become systemic and spread rapidly to renal, pulmonary and cerebral systems (see CEREBRAL PHAEOHYPHOMYCOSIS) in an IMMUNOCOMPROMISED HOST.

Also Known As:

Networked: 151 relevant articles (12 outcomes, 5 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Infections
2.	Sporotrichosis
3.	Chromoblastomycosis (Chromomycosis)
4.	Mycetoma
5.	Aspergillosis

Experts

1.	Anzawa, Kazushi: 4 articles (01/2021 - 03/2015)
2.	Mochizuki, Takashi: 4 articles (01/2021 - 03/2015)
3.	Petraitis, Vidmantas: 3 articles (02/2021 - 12/2015)
4.	Walsh, Thomas J: 3 articles (02/2021 - 12/2015)
5.	Chongtrakool, Piriyaporn: 3 articles (12/2019 - 05/2013)
6.	Kontoyiannis, Dimitrios P: 3 articles (11/2019 - 02/2010)
7.	Hiruma, Masataro: 2 articles (05/2022 - 01/2013)
8.	Naing, Ethan: 2 articles (02/2021 - 03/2020)
9.	Petraitiene, Ruta: 2 articles (02/2021 - 03/2020)
10.	Machado, Amanda Sanchez: 2 articles (12/2020 - 01/2017)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Phaeohyphomycosis:

1.	Itraconazole (Sporanox)FDA LinkGeneric 01/01/2023 - "This case report provides the first evidence of multifocal cutaneous phaeohyphomycosis caused by E spinifera with clinical resolution after combined surgical and itraconazole treatment in an immunocompromised cat." 11/01/2016 - "There is currently no standard treatment for E. spinifera phaeohyphomycosis; however, itraconazole, alone or in combination, allowed partial or complete response in 16 out of 20 cases." 10/01/2015 - "Although aggressive surgical excision of local lesions is recommended prior to drug treatment when dealing with subcutaneous phaeohyphomycosis, surgery followed by itraconazole treatment did not resolve the E. " 01/01/2012 - "Although optimal treatment options remain controversial, this case of phaeohyphomycosis was successfully treated with itraconazole monotherapy." 01/01/2011 - "Cutaneous Phaeohyphomycosis Caused by Alternaria alternata Unresponsive to Itraconazole Treatment."
2.	Antifungal AgentsIBA 04/01/2000 - "Subcutaneous phaeohyphomycosis in transplant recipients: review of the literature and demonstration of in vitro synergy between antifungal agents." 07/01/2002 - "Surgical excision or debridement with or without antifungal agents may offer the possibility of cure for phaeohyphomycosis due to Exophiala species." 12/01/2007 - "Disseminated phaeohyphomycosis is an uncommon infection affecting immunocompetent and immunocompromised individuals in which response to older antifungal agents has been variable. " 02/01/2004 - "Phaeohyphomycosis is a rare mycotic infection that is caused by dematiaceous fungi requiring surgical excision or long-term use of oral antifungal agents for treatment. " 09/01/1990 - "Itraconazole appears to be highly effective in some patients with phaeohyphomycosis, including patients refractory to other antifungal agents."
3.	Terbinafine (Lamisil)FDA LinkGeneric 08/01/2020 - "Successful Terbinafine Treatment for Cutaneous Phaeohyphomycosis Caused by Trematosphaeria grisea in a Heart Transplanted Man: Case Report and Literature Review." 11/01/2006 - "Successful treatment of subcutaneous phaeohyphomycosis owing to Exophiala jeanselmei with oral terbinafine." 07/01/2020 - "Case of phaeohyphomycosis caused by Cladophialophora boppii successfully treated with local hyperthermia and systemic terbinafine." 01/01/2020 - "Mycetoma-like phaeohyphomycosis treated with terbinafine." 12/01/1999 - "Patients with chromoblastomycosis, and other mycoses (phaeohyphomycosis, maduromycosis, and mucormycosis) have also been successfully treated with terbinafine. "
4.	posaconazoleFDA Link 11/01/2019 - "This case highlights the role of neurosurgery during cerebral phaeohyphomycoses, even those caused by posaconazole-susceptible black fungi." 01/01/2014 - "Pulmonary phaeohyphomycosis caused by phaeoacremonium in a kidney transplant recipient: successful treatment with posaconazole." 02/01/2013 - "Subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei treated with wide surgical excision and posaconazole: case report." 11/01/2006 - "Chronic refractory phaeohyphomycosis: successful treatment with posaconazole." 02/01/2004 - "Case study: posaconazole treatment of disseminated phaeohyphomycosis due to Exophiala spinifera."
5.	Voriconazole (Vfend)FDA LinkGeneric 10/01/2018 - "Successful treatment of cutaneous phaeohyphomycosis caused by Exophiala lecanii-corni with voriconazole." 07/01/2014 - "Subcutaneous phaeohyphomycosis due to Phialemoniopsis ocularis successfully treated by voriconazole." 11/01/2009 - "Subcutaneous phaeohyphomycosis in a renal transplant recipient successfully treated with voriconazole." 12/01/2015 - "When voriconazole was used as single agent for treatment of hyalohyphomycosis and phaeohyphomycosis, an overall response rate was achieved in 94.1% of cases. " 12/01/2013 - "However, isolated organisms were markedly different, with a shift from aspergillosis to phaeohyphomycosis after the implementation of voriconazole prophylaxis. "
6.	Amphotericin B (Amphotericin)FDA LinkGeneric 05/01/1989 - "To our knowledge, this is the first documented case of isolated pulmonary phaeohyphomycosis due to E dermatitidis, and it was successfully treated with amphotericin B and 5-fluocytosine." 02/01/2002 - "Amphotericin B has a relatively broad spectrum of action and is useful in treating cases of candidosis, cryptococcosis, histoplasmosis, blastomycosis, paracoccidioidomycosis, coccidioidomycosis, aspergillosis, extracutaneous sporotrichosis and mucormycosis, and some cases of hyalohyphomycosis and phaeohyphomycosis. " 08/20/1982 - "Cutaneous phaeohyphomycosis of the sole caused by Exophiala jeanselmei and its susceptibility to amphotericin B, 5-FC and ketoconazole." 04/01/2000 - "We report a case of subcutaneous phaeohyphomycosis occurring in a bone marrow transplant recipient receiving high doses of immunosuppressive agents, in whom widespread subcutaneous infection due to Exophiala jeanselmei was not eradicated by repeated resections and therapy with amphotericin B and flucytosine. "
7.	liposomal amphotericin BFDA Link 03/01/2015 - "He was successfully treated with a total of 3 weeks of liposomal amphotericin B, but died of pneumonia approximately 3 months after cure of phaeohyphomycosis." 05/01/2013 - "We believe this is the first reported case of co-infection of the brain with scedosporiosis and phaeohyphomycosis in a renal transplant recipient, who had received intravenous liposomal amphotericin B. " 02/04/2021 - "Antifungal efficacy of isavuconazole and liposomal amphotericin B in a rabbit model of Exserohilum rostratum meningoencephalitis: A preclinical paradigm for management of CNS phaeohyphomycosis." 11/01/2015 - "The subcutaneous phaeohyphomycosis was treated with surgical drainage and liposomal amphotericin B for 4 weeks followed by a combination of itraconazole and terbinafine. "
8.	Flucytosine (Ancobon)FDA Link 03/01/1984 - "Feline phaeohyphomycosis: treatment with ketaconazole and 5-fluorocytosine." 03/01/1984 - "Two cats with phaeohyphomycosis, one infected with Phialophora verrucosa and the other with Exophiala jeanselmei, were treated with ketaconazole alone and in combination with 5-fluorocytosine after recurrence of the infections following surgical excision. " 01/01/2000 - "He was diagnosed as pulmonary tuberculosis complicated with subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei and was successfully treated with anti-tuberculosis drugs and anti-fungal agent, 5-fluorocytosine." 04/01/2000 - "We report a case of subcutaneous phaeohyphomycosis occurring in a bone marrow transplant recipient receiving high doses of immunosuppressive agents, in whom widespread subcutaneous infection due to Exophiala jeanselmei was not eradicated by repeated resections and therapy with amphotericin B and flucytosine. "
9.	isavuconazoleIBA 12/01/2019 - "Successful treatment with isavuconazole of subcutaneous phaeohyphomycosis in a kidney transplant recipient." 02/04/2021 - "We hypothesized that isavuconazole alone or in combination with LAMB or micafungin may be alternative options for treatment of CNS phaeohyphomycosis. " 02/04/2021 - "Antifungal efficacy of isavuconazole and liposomal amphotericin B in a rabbit model of Exserohilum rostratum meningoencephalitis: A preclinical paradigm for management of CNS phaeohyphomycosis." 11/01/2019 - "We compared the in vitro pharmacodynamics of isavuconazole, voriconazole, and posaconazole against 92 clinical isolates from documented cases of invasive aspergillosis, mucormycosis, fusariosis, and phaeohyphomycosis. " 11/01/2019 - "Comparative in vitro pharmacodynamic analysis of isavuconazole, voriconazole, and posaconazole against clinical isolates of aspergillosis, mucormycosis, fusariosis, and phaeohyphomycosis."
10.	Immunosuppressive Agents (Immunosuppressants)IBA 01/01/2022 - "Due to more attentions paid to melanized fungi over the past few decades and under the background of the global coronavirus disease 2019 pandemic (COVID-19) the fact that the virus itself and the immunosuppressive agents such as glucocorticoids can further increase the risk of infections of deep mycoses, the number of patients with phaeohyphomycosis (PHM) has a substantial increase. " 04/01/2000 - "We report a case of subcutaneous phaeohyphomycosis occurring in a bone marrow transplant recipient receiving high doses of immunosuppressive agents, in whom widespread subcutaneous infection due to Exophiala jeanselmei was not eradicated by repeated resections and therapy with amphotericin B and flucytosine. "

Therapies and Procedures

1.	Therapeutics 11/01/2002 - "Immunohistochemical study of inflammatory infiltrate was carried out in five cases of subcutaneous phaeohyphomycosis before and after therapy. " 02/21/2023 - "While the wide diversity of dematiaceous fungi and their host range make it difficult to offer a uniform approach for phaeohyphomycosis, an early diagnosis and therapy are critical in preventing the dissemination of disease in the immunocompromised host." 02/21/2023 - "Here, we describe three cases of phaeohyphomycosis in SOT recipients who were successfully treated with surgical excision and/or antifungal therapy. " 05/01/2022 - "Empiric antifungal therapy in patients with cutaneous and subcutaneous phaeohyphomycosis." 03/01/2022 - "The treatment of subcutaneous phaeohyphomycosis was managed by surgical excision without antifungal therapy in 34 cases (34/68; 50%), and the association of both methods occurred in 18 cases (18/68; 26.5%). "
2.	Debridement 01/01/2023 - "Phaeohyphomycosis in Kidney Transplant Recipients: Highlighting the Importance of Early Recognition and Surgical Debridement." 12/01/2004 - "theobromae is able to act as an agent of subcutaneous phaeohyphomycosis and that, when this occurs, debridement alone may be sufficient to eradicate it." 07/01/2002 - "Surgical excision or debridement with or without antifungal agents may offer the possibility of cure for phaeohyphomycosis due to Exophiala species." 01/01/2014 - "Phaeoacremonium parasiticum phaeohyphomycosis in a patient with systemic lupus erythematosus treated successfully with surgical debridement and voriconazole: A case report and review of the literature." 09/01/2009 - "Prior to presentation, he had received a steroid injection for left middle finger stenosing tenosynovitis and subsequently developed culture-proven phaeohyphomycosis fungal infection and secondary enterococcal bacterial infection, requiring pharmacotherapy and incision, drainage, and debridement for abscess formation. "
3.	Mohs Surgery (Mohs' Micrographic Surgery) 02/01/2004 - "To report a case of phaeohyphomycosis of the dorsal hand successfully cleared with Mohs micrographic surgery. " 08/01/2013 - "Phaeohyphomycosis of the hand treated using Mohs micrographic surgery." 02/01/2004 - "We performed Mohs micrographic surgery on phaeohyphomycosis of the dorsal hand. " 02/01/2004 - "Mohs micrographic surgery for the eradication of phaeohyphomycosis of the hand." 02/01/2004 - "Mohs micrographic surgery is an effective, tissue-sparing technique for the eradication of phaeohyphomycosis, potentially eliminating the need for costly long-term antifungal therapy."
4.	Glycemic Control 12/01/2019 - "The present case involved subcutaneous phaeohyphomycosis caused by Medicopsis romeroi in an 80-year-old Thai male with poorly controlled diabetes, for whom the lesion underwent spontaneous remission after his glycemic control was improved. "
5.	Liver Transplantation 08/01/2023 - "Invasive Phaeohyphomycosis Caused by Cladophialophora bantiana in the Patient After Liver Transplantation." 07/01/1994 - "Phaeohyphomycosis due to Scopulariopsis brumptii in a liver transplant recipient." 06/01/2019 - "Disseminated phaeohyphomycosis with hepatic artery and portal vein thrombosis caused by Pleurostomophora richardsiae in a liver transplant recipient: A case report." 09/01/1999 - "Cutaneous phaeohyphomycosis caused by Veronaea bothryosa in a liver transplant recipient successfully treated with itraconazole." 09/01/1995 - "To our knowledge, this is the second case of phaeohyphomycosis caused by Dactylaria constricta var. gallopava in a liver transplant patient and it developed even though he had been receiving fungal prophylaxis with fluconazole. "