title: Deep skin infection of Scedosporium apiospermum in a patient with refractory idiopathic thrombocytopenic purpura.
abstract: Infection of Scedosporium apiospermum is very rare but is now emerging as an important cause of both localized and disseminated infections in immunocompromised patients. A 62-year-old woman, who had undergone steroid therapy for refractory idiopathic thrombocytopenic purpura and had a history of diffuse large B cell lymphoma, developed a deep skin ulcer complicated with lymphangitis. After culture study demonstrated the presence of S. apiospermum, voriconazole (VRCZ) was administered and prompt improvement was observed. Because it is difficult to distinguish S. apiospermum from Aspergillus by histopathology and S. apiospermum is resistant to amphotericin B, VRCZ should be selected as the first choice of antifungal agent when mold is considered to be the causative organism.
authors.affiliation: Division of Hematology, National Hospital Organization Minami-Okayama Medical Center, Japan. takeuchim@s-okayama.hosp.go.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Chikamasa
authors.initials: C
authors.lastname: Yoshida
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ota
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Fujiwara
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008205:Lymphangitis / Q000150:complications; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications; D008875:Middle Aged; D008271:Mycetoma / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications*; D011743:Pyrimidines / Q000627:therapeutic use; D021681:Scedosporium / Q000302:isolation & purification / Q000472:pathogenicity; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole