The treatment of pulmonary Wangiella dermatitidis infection with oral voriconazole

P>What is known and Objective: Wangiella dermatitidis is a darkly pigmented fungus that has been isolated from the soil, dead plant material and areas of high humidity. Infection from the pathogen has not been extensively documented and few published cases report survival. Of the antifungal agents used in previous reports, none has been proven to improve outcomes. Voriconazole is known to have in vitro activity against the organism, but clinical experience for the treatment of W. dermatitidis infection is limited. The objective of this case report is to describe the use of voriconazole for the treatment of W. dermatitidis infection. Case summary: An 86-year-old American woman with a past medical history significant only for mild dementia is successfully treated for pulmonary W. dermatitidis infection using oral voriconazole monotherapy with minimal adverse effects. What is new and Conclusion: Voriconazole appears to be effective as monotherapy for the treatment of pulmonary W. dermatitidis infections. A minimum of 3-4 months of antifungal treatment should be given. Adverse effects with prolonged voriconazole use do not appear to be a barrier to treatment.