Successful Posaconazole Therapy of Disseminated Alternariosis due to Alternaria infectoria in a Heart Transplant Recipient.

Abstract

We report a case of phaeohyphomycosis caused by Alternaria infectoria in a 61-year-old heart transplant recipient with multiple skin lesions and pulmonary infiltrates. The infection spread via the haematogenous route from the primary cutaneous lesions into the lungs. The diagnosis was based on the histopathological examination, direct microscopy, skin lesion cultures and detection of Alternaria DNA in the bronchoalveolar lavage fluid using molecular methods. The treatment consisted of a combination of surgical excision and systemic antifungal therapy. Voriconazole was the first agent used but had a weak effect. Posaconazole was subsequently used to achieve a successful response. The isolate was identified as A. infectoria by sequencing of the rDNA ITS region and the partial β-tubulin gene.

• Authors: Pavlina Lyskova, Milos Kubanek, Vit Hubka, Eva Sticova, Ludek Voska, Dana Kautznerova, Miroslav Kolarik, Petr Hamal, Martina Vasakova
• Journal: Mycopathologia (Mycopathologia) Vol. 182 Issue 3-4 Pg. 297-303 (Apr 2017) ISSN: 1573-0832 [Electronic] Netherlands
• PMID: 27866319 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antifungal Agents
• DNA, Fungal
• DNA, Ribosomal Spacer
• Triazoles
• Tubulin
• posaconazole

Topics

• Alternaria (classification, drug effects, genetics, isolation & purification)
• Antifungal Agents (therapeutic use)
• DNA, Fungal (chemistry, genetics)
• DNA, Ribosomal Spacer (chemistry, genetics)
• Debridement
• Dermatomycoses (diagnosis, drug therapy, microbiology)
• Heart Transplantation
• Histocytochemistry
• Humans
• Lung Diseases, Fungal (diagnosis, drug therapy, microbiology)
• Male
• Microscopy
• Middle Aged
• Phaeohyphomycosis (diagnosis, drug therapy, microbiology)
• Sequence Analysis, DNA
• Transplant Recipients
• Treatment Outcome
• Triazoles (therapeutic use)
• Tubulin (genetics)