title: Disseminated infection by Bipolaris spicifera in an immunocompetent subject.
abstract: We report a case of disseminated infection due to Bipolaris spicifera in an immunocompetent male. Histopathological studies of lymph node, lung, and liver biopsy specimens showed a dark pigmented, granular fungal structure inside the granuloma. The disease was accompanied by the unusual feature of positive lupus anticoagulant in serum and low-density areas expanding along the portal vein in the liver. The disease responded to combination therapy with intravenous amphotericin B and voriconazole, but recurred during oral itraconazole. The fungal isolate from the lymph node was identified as Bipolaris spicifera on the basis of morphology and molecular biological data.
authors.affiliation: Division of Pulmonary Diseases, Department of Internal Medicine, Saga University Medical School, Saga, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Ayako
authors.initials: A
authors.lastname: Sano
authors.forename: Naoko
authors.initials: N
authors.lastname: Aragane
authors.forename: Mami
authors.initials: M
authors.lastname: Fukuoka
authors.forename: Masahide
authors.initials: M
authors.lastname: Tanaka
authors.forename: Futoshi
authors.initials: F
authors.lastname: Kawaura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fukuno
authors.forename: Eijo
authors.initials: E
authors.lastname: Matsuishi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D001203:Ascomycota / Q000166:cytology / Q000302:isolation & purification*; D004271:DNA, Fungal / Q000032:analysis; D004275:DNA, Ribosomal / Q000032:analysis; D006801:Humans; D007121:Immunocompetence; D017964:Itraconazole / Q000627:therapeutic use; D008198:Lymph Nodes / Q000382:microbiology; D008297:Male; D009181:Mycoses / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D011743:Pyrimidines / Q000627:therapeutic use; D017422:Sequence Analysis, DNA; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D004271:DNA, Fungal; D004275:DNA, Ribosomal; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D000666:Amphotericin B; D065819:Voriconazole