title: Systemic phaeohyphomycosis due to Exophiala (Wangiella) in an immunocompetent child.
abstract: We report a rare case of systemic lymphadenitis and hepatic involvement due to Exophiala (Wangiella) dermatitidis in a pediatric patient. An 8-year-old immunocompetent boy with chronic fever was examined through the use of sonography and CT scan which demonstrated cervical and mesenteric lymph node enlargement and numerous small hepatic lesions. The etiologic agent was isolated by means of lymph node aspiration. The fungus was identified by its morphological characteristics and through DNA sequencing of the internal transcribed spacer region of rDNA. Despite initial amphotericin B and voriconazole therapy, the child's jaundice subsided and he died 7 months later. In addition to pathogenic aspects of Exophiala dermatitidis, the diagnostic approaches and relevant therapeutic strategies are discussed.
authors.affiliation: Pediatric Infectious Diseases Department, Cukurova University, Adana, Turkey. deryaalabaz@yahoo.com
authors.forename: Derya
authors.initials: D
authors.lastname: Alabaz
authors.forename: Filiz
authors.initials: F
authors.lastname: Kibar
authors.forename: Sevtap
authors.initials: S
authors.lastname: Arikan
authors.forename: Banu
authors.initials: B
authors.lastname: Sancak
authors.forename: Umit
authors.initials: U
authors.lastname: Celik
authors.forename: Necmi
authors.initials: N
authors.lastname: Aksaray
authors.forename: Mehmet
authors.initials: M
authors.lastname: Turgut
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D005093:Exophiala / Q000187:drug effects / Q000302:isolation & purification*; D017809:Fatal Outcome; D006099:Granuloma / Q000382:microbiology / Q000473:pathology; D006801:Humans; D025301:Hyphae / Q000302:isolation & purification; D007121:Immunocompetence; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008198:Lymph Nodes / Q000382:microbiology / Q000473:pathology; D008297:Male; D008826:Microbial Sensitivity Tests; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D011859:Radiography
chemical_list: D000935:Antifungal Agents