title: Case of cutaneous Scedosporium apiospermum infection successfully treated with voriconazole.
abstract: We report a case of cutaneous infection due to Scedosporium apiospermum in a 75-year-old immunocompromised male patient who had received long-term corticosteroid and immunosuppressant therapy for the treatment of nephrotic syndrome. The patient came to our department complaining of erythema with a number of pustules on the dorsal surface of the right hand. S. apiospermum was identified from a culture taken from the pus. After unsuccessful treatment with topical ketoconazole, oral itraconazole and oral terbinafine, the lesion quickly resolved with the daily administration of 400 mg voriconazole. No recurrence was observed despite discontinuation of voriconazole due to drug-induced hepatitis. Voriconazole holds out the promise of an effective treatment for invasive Scedosporium infection.
authors.affiliation: Department of Dermatology, Tokyo Medical University, Tokyo, Japan. yuka-m@tokyo-med.ac.jp
authors.forename: Yuka
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Tsunao
authors.initials: T
authors.lastname: Oh-I
authors.forename: Ayako
authors.initials: A
authors.lastname: Nagai
authors.forename: Fuminori
authors.initials: F
authors.lastname: Ohyama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ooishi
authors.forename: Ryoji
authors.initials: R
authors.lastname: Tsuboi
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D008271:Mycetoma / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology*; D009404:Nephrotic Syndrome / Q000188:drug therapy; D011743:Pyrimidines / Q000627:therapeutic use*; D021681:Scedosporium / Q000302:isolation & purification*; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole