title: [Cutaneous and subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei after renal transplantation: a case report].
abstract: We report a case of cutaneous and subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei after renal transplantation in Guangdong. A 66-year-old man who had a renal transplantation 6 years ago was admitted in October 2011 for the presence of 16 nodules (0.5-1.5 cm) found on his right middle finger, wrist and forearm for 5 months. Microscopic examination of the purulent exudate showed segmented and branched brown mycelium, and tissue biopsy and PAS staining showed fungal hyphae. The isolate was processed for morphological identification and molecular sequence analysis. A black colony was found after culture of the isolate on SDA at 26 degrees Celsius;, and small culture identified the isolate as Exophiala jeanselmei. ITS sequence analysis of the isolate showed a 100% homology with Exophiala jeanselmei. E-test strip was used in drug sensitivity test, and the isolate was sensitive to amphotericin B, voriconazole, itraconazole and fluconazole, but resistant to 5-flucytosine and caspofungin. Good response was obtained with surgical intervention, local injection and systemic antifungal treatment.
authors.affiliation: Department of Dermatology and Venereology, Third Affiliated Hospital of Southern Medical University, Guangzhou, China. zxy1962@163.com
authors.forename: Xianyi
authors.initials: X
authors.lastname: Zhou
authors.forename: Yongxuan
authors.initials: Y
authors.lastname: Hu
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Hu
authors.forename: Kangxing
authors.initials: K
authors.lastname: Liu
authors.forename: Luxia
authors.initials: L
authors.lastname: Wang
authors.forename: Qingzhu
authors.initials: Q
authors.lastname: Wei
authors.forename: Xue
authors.initials: X
authors.lastname: Han
authors.forename: Dejiang
authors.initials: D
authors.lastname: Zhu
authors.forename: Yan
authors.initials: Y
authors.lastname: Lu
authors.forename: Zuhao
authors.initials: Z
authors.lastname: Mao
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wu
mesh_terms: D000368:Aged; D005093:Exophiala / Q000472:pathogenicity*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D060446:Phaeohyphomycosis / Q000209:etiology*; D011183:Postoperative Complications