Lethal systemic dissemination from a cutaneous infection due to Curvularia lunata in a heart transplant recipient.
A 69-year-old male heart transplant recipient, being treated with Cell Cept, FK 506 and methylprednisolone had multiple deep brown skin nodules and nodes, on the upper right arm. Skin biopsy and culture detected a strain of Curvularia lunata. The infection disseminated to the whole skin surface, oral mucosa, upper third of the oesophagus and to the lungs. Therapy with antibiotics and antifungal drugs was ineffective. The patient died of sepsis. We did not find any other case of systemic dissemination from a skin infection due to C. lunata among heart transplant recipients. We feel that heart transplant recipients need adequate education to prevent situations that would put them at risk for infection and to seek medical advice immediately for an early diagnosis and an effective therapy.
Tessari
G
G
Department of Biomedical and Surgical Sciences, Section of Dermatology and Venereal Disease, Institute of Cardiac Surgery, University of Verona, Verona Italy. gtessari@libero.it
Forni
A
A
Ferretto
R
R
Solbiati
M
M
Faggian
G
G
Mazzucco
A
A
Barba
A
A
D000368:Aged; D000900:Anti-Bacterial Agents; D000935:Antifungal Agents / Q000627:therapeutic use; D003881:Dermatomycoses / Q000175:diagnosis* / Q000188:drug therapy; D018450:Disease Progression; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D017809:Fatal Outcome; D016469:Fungemia / Q000175:diagnosis* / Q000188:drug therapy; D016027:Heart Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D003904:Mitosporic Fungi; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents