期刊
MEDICAL MYCOLOGY
卷 50, 期 2, 页码 207-213出版社
OXFORD UNIV PRESS
DOI: 10.3109/13693786.2011.603367
关键词
Phaeohyphomycotic cyst; Exophiala spinifera; in vitro antifungal susceptibility; ITS rDNA
资金
- Ministry of Health and Medical Education of Islamic Republic of Iran [13081]
- School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Astellas
- Merck
- Basilea
- Schering-Plough
- Pfizer
- Janssen Pharmaceutica
Here we report a case of a 55-year-old Indian male presenting with multiple subcutaneous cysts, which developed from painful nodules at the dorsal right wrist joint. Subsequently a painful nodule appeared on the left knee joint. Cytological examination of the knee swelling revealed a suppurative inflammatory lesion consisting of neutrophils, lymphocytes, multinucleated giant cells and few fungal elements, without involvement of the overlying skin. Exophiala spinifera was cultured (CBS 125607) and its identity was confirmed by sequencing of the internal transcribed spacer (ITS rDNA). The cysts were excised surgically, without need of additional antifungal therapy. There was no relapse during one-year follow-up and the patient was cured successfully. In vitro antifungal susceptibility testing showed that posaconazole (0.063 mu g/ml) and itraconazole (0.125 mu g/ml) had the highest and caspofungin (4 mu g/ml) and anidulafungin (2 mu g/ml) the lowest activity against this isolate. However, their clinical effectiveness in the treatment of E. spinifera infections remains to be evaluated. In this case report, we have also compiled cases of human E. spinifera mycoses which have been reported so far.
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