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Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature.
- Source :
-
Annals of clinical microbiology and antimicrobials [Ann Clin Microbiol Antimicrob] 2017 Apr 14; Vol. 16 (1), pp. 31. Date of Electronic Publication: 2017 Apr 14. - Publication Year :
- 2017
-
Abstract
- Background: Scedosporium apiospermum is an emerging opportunistic filamentous fungus, which is notorious for its high levels of antifungal-resistance. It is able to cause localized cutaneous or subcutaneous infections in both immunocompromised and immunocompetent persons, pulmonary infections in patients with predisposing pulmonary diseases and invasive mycoses in immunocompromised patients. Subcutaneous infections caused by this fungus frequently show chronic mycetomatous manifestation.<br />Case Report: We report the case of a 70-year-old immunocompromised man, who developed a fungal mycetomatous infection on his right leg. There was no history of trauma; the aetiological agent was identified by microscopic examination and ITS sequencing. This is the second reported case of S. apiospermum subcutaneous infections in Hungary, which was successfully treated by surgical excision and terbinafine treatment. After 7 months, the patient remained asymptomatic. Considering the antifungal susceptibility and increasing incidence of the fungus, Scedosporium related subcutaneous infections reported in the past quarter of century in European countries were also reviewed.<br />Conclusions: Corticosteroid treatment represents a serious risk factor of S. apiospermum infections, especially if the patient get in touch with manure-enriched or polluted soil or water. Such infections have emerged several times in European countries in the past decades. The presented data suggest that besides the commonly applied voriconazole, terbinafine may be an alternative for the therapy of mycetomatous Scedosporium infections.
- Subjects :
- Aged
Cluster Analysis
DNA, Fungal chemistry
DNA, Fungal genetics
DNA, Ribosomal Spacer chemistry
DNA, Ribosomal Spacer genetics
Dermatomycoses diagnosis
Dermatomycoses microbiology
Dermatomycoses pathology
Dermatomycoses therapy
Humans
Hungary
Immunocompromised Host
Male
Microscopy
Mycetoma microbiology
Mycetoma pathology
Phylogeny
Recurrence
Scedosporium classification
Scedosporium cytology
Scedosporium genetics
Sequence Analysis, DNA
Terbinafine
Treatment Outcome
Antifungal Agents administration & dosage
Debridement
Leg pathology
Mycetoma diagnosis
Mycetoma therapy
Naphthalenes administration & dosage
Scedosporium isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1476-0711
- Volume :
- 16
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of clinical microbiology and antimicrobials
- Publication Type :
- Academic Journal
- Accession number :
- 28410611
- Full Text :
- https://doi.org/10.1186/s12941-017-0195-z