title: Ochroconis gallopava infection in a patient with chronic granulomatous disease: case report and review of the literature.
abstract: Ochroconis spp. are dematiaceous fungi and have recently become recognized as the cause of human disease. Infections due to members of this genus have primarily occurred in patients with impaired immunity following organ transplantation or chemotherapy for hematologic malignancies. There is no universally agreed upon therapy or duration of treatment, but amphotericin B and/or triazoles are typically employed. We present a case of Ochroconis gallopava infection in a patient with chronic granulomatous disease (CGD). The organism exhibited elevated minimal inhibitory concentrations against itraconazole (0.5 μg/ml) and voriconazole (2 μg/ml) in comparison with results from other studies reported in the literature. This case illustrates the complexities associated with antibiotic susceptibility testing, selection of appropriate drugs, and management in patients with Ochroconis infections. We also review the literature of human infections with Ochroconis to date, and discuss its microbiology to apprise both clinicians and laboratory personnel of this infrequently encountered but potentially aggressive pathogen.
authors.affiliation: Department of Pathology, Division of Infectious Disease, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Zina
authors.initials: Z
authors.lastname: Meriden
authors.forename: Kieren A
authors.initials: KA
authors.lastname: Marr
authors.forename: Howard M
authors.initials: HM
authors.lastname: Lederman
authors.forename: Peter B
authors.initials: PB
authors.lastname: Illei
authors.forename: Kathryn
authors.initials: K
authors.lastname: Villa
authors.forename: Stefan
authors.initials: S
authors.lastname: Riedel
authors.forename: Karen C
authors.initials: KC
authors.lastname: Carroll
authors.forename: Sean X
authors.initials: SX
authors.lastname: Zhang
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology; D001203:Ascomycota / Q000187:drug effects / Q000302:isolation & purification*; D006105:Granulomatous Disease, Chronic / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D008826:Microbial Sensitivity Tests; D009181:Mycoses / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D011743:Pyrimidines / Q000494:pharmacology; D014230:Triazoles / Q000494:pharmacology; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole