title: Invasive cutaneous infection with Geotrichum candidum: sequential treatment with amphotericin B and voriconazole.
abstract: A rare case of an invasive cutaneous infection by Geotrichum candidum in an 80-year-old male patient with diabetes mellitus is reported. The primary site of infection manifested after trauma as an ulcerative lesion on the distal phalanx of the midfinger and extended throughout the right hand. Histological examination showed fungal invasion in the deep dermis without vascular involvement and G. candidum was grown in cultures from the biopsy material. Angiography revealed severe obstructive disease of the right brachial artery and its branches. Treatment, after susceptibility testing of the isolated strain, consisted of sequential administration of intravenous liposomal amphotericin B with oral voriconazole followed by liposomal amphotericin B, resulting in substantial improvement of the infection.
authors.affiliation: Department of Dermatology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Sfakianakis
authors.forename: Konstantin
authors.initials: K
authors.lastname: Krasagakis
authors.forename: Maria
authors.initials: M
authors.lastname: Stefanidou
authors.forename: Sofia
authors.initials: S
authors.lastname: Maraki
authors.forename: Anastassios
authors.initials: A
authors.lastname: Koutsopoulos
authors.forename: Diamantis
authors.initials: D
authors.lastname: Kofteridis
authors.forename: George
authors.initials: G
authors.lastname: Samonis
authors.forename: Androniki
authors.initials: A
authors.lastname: Tosca
mesh_terms: D000369:Aged, 80 and over; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D003920:Diabetes Mellitus / Q000382:microbiology; D005847:Geotrichosis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D005848:Geotrichum / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D011743:Pyrimidines / Q000627:therapeutic use*; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D065819:Voriconazole