Multidisciplinary management of disseminated Exophiala dermatitidis mycosis in an infant with mixed phenotype acute leukemia: a case report.
Background: Exophiala dermatitidis is a dematiaceous fungus isolated from various environmental sources. Systemic E. dermatitidis infections can lead to fatal outcomes, and treatment has not yet been standardized. Although E. dermatitidis is also known to cause cutaneous infection, it has not been p...
| Publicado en: | BMC Infectious Diseases Vol. 22; no. 1; pp. 1 - 8 |
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| Autores principales: | , , , , , , , |
| Formato: | case study Journal Article |
| Publicado: |
BioMed Central
10/23/2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=159838309&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 159838309 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 10/23/2022 vid: 22 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 159838309 159838309 NLM36274136 159838309 10.1186/s12879-022-07773-w NLM36274136 159838309 ppf: 1 ppct: 7 formats: tig: atl: Multidisciplinary management of disseminated Exophiala dermatitidis mycosis in an infant with mixed phenotype acute leukemia: a case report. aug: au: Nakatani, Ryo Ashiarai, Miho Yoshihara, Hiroki Yada, Keigo Nozaki, Taiki Ushigusa, Takeshi Mori, Nobuyoshi Hasegawa, Daisuke affil: Department of Pediatrics, St. Luke's International Hospital, 9-1, Akashi-Cho, Chuo-Ku, Tokyo, Japan sug: subj: Mycoses Drug Therapy Pyoderma Drug Therapy Leukemia Drug Therapy Acute Disease Phenotype Ethanol Male Antifungal Agents Therapeutic Use Antibiotics Questionnaires Male ab: Background: Exophiala dermatitidis is a dematiaceous fungus isolated from various environmental sources. Systemic E. dermatitidis infections can lead to fatal outcomes, and treatment has not yet been standardized. Although E. dermatitidis is also known to cause cutaneous infection, it has not been previously reported to appear as ecthyma gangrenosum (EG), an uncommon cutaneous lesion in neutropenic patients that is mainly caused by Pseudomonas aeruginosa.Case Presentation: A 2-month-old male infant with mixed-phenotype acute leukemia presented with prolonged fever unresponsive to antibacterial and antifungal agents during myelosuppression due to remission induction therapy. He also presented with skin lesions on the left wrist and left lower quadrant of the abdomen. The abdominal lesion gradually turned black and necrotic, which was consistent with the findings of the EG. E. dermatitidis was isolated from the blood, stool, wrist skin, and endotracheal aspirate. During hematopoietic recovery, consolidation in both lungs was evident. Multiagent antifungal treatment failed to eliminate E. dermatitidis from blood. In order to salvage the central venous catheter, ethanol lock therapy (ELT) was adopted, following which the blood culture became negative. The abdominal lesion that evolved as a necrotic mass connecting the small intestine and subcutaneous tissue adjacent to the skin was surgically resected. After these interventions, the general condition improved.Conclusion: Disseminated E. dermatitidis mycosis in the neutropenic infant was successfully managed with a multidisciplinary treatment consisting of multiagent antifungal treatment, ELT, and surgery. pubtype: Academic Journal doctype: case study Journal Article ougenre: Unknown language: English refInfo: holdings: @attributes: islocal: N |
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