title: Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum.
abstract: Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.
authors.affiliation: Dermatology Residency Program, University Hospital of Brasilia, Universidade de Brasília, Brasília, Brazil.
authors.forename: Orlando Oliveira de
authors.initials: OO
authors.lastname: Morais
authors.forename: Cláudia
authors.initials: C
authors.lastname: Porto
authors.forename: Anglya Samara Silva Leite
authors.initials: AS
authors.lastname: Coutinho
authors.forename: Carmélia Matos Santiago
authors.initials: CM
authors.lastname: Reis
authors.forename: Marcus de Melo
authors.initials: Mde M
authors.lastname: Teixeira
authors.forename: Ciro Martins
authors.initials: CM
authors.lastname: Gomes
mesh_terms: D001203:Ascomycota / Q000235:genetics / Q000302:isolation & purification*; D004893:Erythema Nodosum / Q000150:complications*; D006801:Humans; D015440:Leprosy, Lepromatous / Q000150:complications*; D008206:Lymphatic Diseases / Q000150:complications / Q000382:microbiology*; D008297:Male; D009181:Mycoses / Q000150:complications / Q000382:microbiology*; D055815:Young Adult