RRC ID 46948
Author Sato Y, Suzino K, Suzuki A, Fukasawa N, Ouchi Y, Yaguchi T, Sato T.
Title [Case of primary cutaneous Aspergillus caldioustus infection caused by nerve block therapy].
Journal Med Mycol J
Abstract We report a case of primary cutaneous Aspergillus caldioustus infection caused by nerve block therapy. A 67-year-old Japanese woman had been treated with oral predonisolon and tacrolimus for adult-onset Still disease and interstitial pneumonia. She presented with a 2-month-history of the lesions on the left back. A biopsy specimen from the skin lesion revealed granulomatous inflammation with hyphae. Culture of the pus and the skin specimen confirmed the diagnosis of cutaneous Aspergillus infection. The sequence of β- tubulin gene was analyzed to confirm the mycological diagnosis and the causative agent was identified as A. caldioustus. The patient was treated with surgical removal of the lesions and oral 200 mg/day itraconazole but she died of infectious interstitial pneumonia due to Pneumocystis jiroveci and Cytomegalovirus infection Percutaneous infection may have been responsible for the incidence of localized infection. There was no evidence of systemic aspergillosis. A. caldioustus is an emerging opportunistic fungal pathogen in immunocompromised patients. Immunocompromised patients who have persistent traumatic atypical skin lesion need to be ruled out of such rare fungus infection. An opportunistic infection in Immunocompromised patients can be life-threatening and prompt treatment based on accurate diagnosis is important.
Volume 52(3)
Pages 239-44
Published 2011
PII JST.JSTAGE/mmj/52.239
PMID 21891986
MeSH Aged Antifungal Agents / administration & dosage Aspergillosis / complications* Aspergillosis / microbiology* Aspergillosis / therapy Aspergillus / genetics Aspergillus / isolation & purification* Dermatomycoses / complications* Dermatomycoses / microbiology* Dermatomycoses / therapy Fatal Outcome Female Humans Immunocompromised Host* Itraconazole / administration & dosage Nerve Block / adverse effects* Opportunistic Infections / complications* Opportunistic Infections / microbiology* Opportunistic Infections / therapy Tubulin / genetics
Pathogenic microorganisms IFM59481 IFM59482 IFM 59483