A case of subcutaneous Mycoleptodiscus indicus infection in a liver transplant recipient successfully treated with antifungal therapy.
Mycoleptodiscus indicus, a dematiaceous mold, occurs on the leaves of a number of different host plants and has been only recently described as a cause of human infection. Immunosuppressed individuals are at risk for developing infections with opportunistic fungal pathogens, which are a major cause of morbidity and mortality in this population. In addition, the treatment of infections caused by these fungi is frequently challenging. We report a case of M. indicus subcutaneous infection in a 51-year-old man with human immunodeficiency virus and hepatitis C co-infection, who had a liver transplant. He developed skin nodules with a sporotrichoid lymphangitic distribution. Histopathology demonstrated unusual fungal elements with angioinvasion. Mycology cultures isolated a dematiaceous mold with the characteristic curved hyaline conidia of M. indicus. Initial treatment involved a combination of amphotericin B lipid complex and voriconazole, followed by monotherapy with voriconazole. The subcutaneous lesions resolved completely after 4 months of antifungal therapy.
Garrison
A P
AP
Division of Infectious Diseases, Jackson Memorial Hospital, University of Miami School of Medicine, Miami, Florida 33136, USA. AGarrison2@med.miami.edu
Procop
G W
GW
Vincek
V
V
Moon
J
J
Morris
M I
MI
Doblecki-Lewis
S
S
Cleary
T J
TJ
Brust
D
D
Rosa-Cunha
I
I
D000935:Antifungal Agents / Q000627:therapeutic use*; D003881:Dermatomycoses / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D003904:Mitosporic Fungi
D000935:Antifungal Agents