Phaeohyphomycosis from Exphiala jeanselmei with concomitant Nocardia asteroides infection in a renal transplant recipient: case report and review of the literature.
A 59-year-old black man who received a cadaveric renal transplant 15 months earlier developed subcutaneous nodules on his right upper extremity that were identified as phaeohyphomycosis caused by Exophiala jeanselmei. The man was admitted 4 weeks later with a swollen left arm and had Nocardia asteroides in this area and in the apex of his left lung. He was treated with surgical excision, and itraconazole, imipenem-cilastatin, and trimethoprim-sulfamethoxazole. With the potential presence of more than one microorganism in an immunocompromised patient, it is important to identify and differentiate them correctly to direct appropriate therapy.
Sartoris
K E
KE
Department of Clinical Pharmacy, Medical University of South Carolina, Charleston, USA.
Baillie
G M
GM
Tiernan
R
R
Rajagopalan
P R
PR
D001132:Arm / Q000382:microbiology; D005093:Exophiala / Q000502:physiology*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008168:Lung / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000209:etiology*; D009617:Nocardia Infections / Q000188:drug therapy / Q000209:etiology*