title: Subcutaneous black fungus (phaeohyphomycosis) infection in renal transplant recipients:three cases.
abstract: We describe three cases of subcutaneous phaeohyphomycosis developing in the lower limbs of renal transplant recipients shortly after transplantation. Each case presented with dark-colored nodules that subsequently ulcerated. Histopathologic examination revealed dematiaceous fungal hyphae with a surrounding granulomatous reaction. The fungi were subsequently identified as Alternaria alternatum in two cases and Phialophora richardsiae in one case. In one case, the lesions resolved during a prolonged (6-month) course of itraconazole without the requirement for surgical excision. In the other two cases, combined medical and surgical treatment resulted in cure. A review of the literature on phaeohyphomycosis is presented.
authors.affiliation: Auckland Renal Transplant Group, Auckland Hospital, Auckland, New Zealand. mahay@adhb.govt.nz
authors.forename: Maha
authors.initials: M
authors.lastname: Yehia
authors.forename: Mark
authors.initials: M
authors.lastname: Thomas
authors.forename: Helen
authors.initials: H
authors.lastname: Pilmore
authors.forename: Walter
authors.initials: W
authors.lastname: Van Der Merwe
authors.forename: Ian
authors.initials: I
authors.lastname: Dittmer
mesh_terms: D000368:Aged; D000528:Alternaria; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003881:Dermatomycoses / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010676:Phialophora
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B