Geotrichosis of oral mucosa.
A livid, sharply defined enanthema of the oral mucosa with ulcerations on the soft palate in a patient presenting with de novo acute myeloid leukaemia with prolonged, therapy-induced granulocytopenia (< 0.5 nl-1 for 113 days!) was diagnosed as geotrichosis. Geotrichum capitatum was identified both in vivo and in vitro. Pneumonic infiltrates in the upper lobes of both lungs were treated with amphotericin B infusions. Healing of the aforementioned enanthema was only achieved after addition of 5-fluorocytosine to therapy. Susceptibility determinations with several Geotrichum capitatum isolates led to the conclusion that amphotericin B was unsuitable as a therapeutic agent in this case. 5-Fluorocytosine and itraconazole exhibited superior antifungal and antimycotic activity.
Listemann
H
H
Department of Dermatology, General Hospital St. Georg, Hamburg, Germany.
Schönrock-Nabulsi
P
P
Kuse
R
R
Meigel
W
W
D000380:Agranulocytosis; D000935:Antifungal Agents / Q000627:therapeutic use; D005437:Flucytosine / Q000627:therapeutic use; D005847:Geotrichosis / Q000175:diagnosis* / Q000188:drug therapy*; D005848:Geotrichum / Q000302:isolation & purification; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D007951:Leukemia, Myeloid / Q000188:drug therapy; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009061:Mouth Mucosa / Q000382:microbiology / Q000473:pathology*
D000935:Antifungal Agents; D017964:Itraconazole; D005437:Flucytosine