title: Subcutaneoous phaeohyphomycosis by Exophiala jeanselmei in a cardiac transplant recipient.
abstract: We report a case of phaeohyphomycosis caused by Exophiala jeanselmei in a cardiac transplant recipient maintained on immunosuppressive therapy with mycophenolate mofetil tacrolimus and prednisone. The lesion began after trauma on the right leg that evolved to multiple lesions with nodules and ulcers. Diagnosis was performed by histological examination and culture of pus from skin lesions. Treatment consisted of itraconazole (200 mg/day) for three months with no improvement and subsequently with amphotericin B (0.5 mg/Kg per day to a total of 3.8 g intravenously). After four months of treatment, the lesions showed marked improvement with reduction in the swelling and healing of sinuses and residual scarring.
authors.affiliation: Departamento de Microbiologia, Imunologia, Parasitologia e Patologia, IPTSP-UFG, Goiânia, Goiás, Brazil. rosario@iptsp.ufg.br
authors.forename: Maria do Rosário R
authors.initials: Mdo R
authors.lastname: Silva
authors.forename: Orionalda de F L
authors.initials: Ode F
authors.lastname: Fernandes
authors.forename: Carolina R
authors.initials: CR
authors.lastname: Costa
authors.forename: Aiçar
authors.initials: A
authors.lastname: Chaul
authors.forename: Luciano F
authors.initials: LF
authors.lastname: Morgado
authors.forename: Luis Fernando
authors.initials: LF
authors.lastname: Fleury-Júnior
authors.forename: Maurício B
authors.initials: MB
authors.lastname: Costa
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003881:Dermatomycoses / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D005093:Exophiala; D016027:Heart Transplantation; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D040521:Subcutaneous Tissue / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D017964:Itraconazole; D000666:Amphotericin B