title: Invasive cutaneous Neoscytalidium infections in renal transplant recipients: a series of five cases.
abstract: BACKGROUND
  Neoscytalidium species (formerly Scytalidium species) are black fungi that usually cause cutaneous infections mimicking dermatophytes lesions. Very few publications have reported invasive or disseminated infections.
  
  
  METHODS
  In this paper, we report the clinical presentations, treatments and outcomes of five cases of invasive Neoscytalidium infections with cutaneous involvement, including two cases with disseminated infection, in five renal transplant recipients. To our knowledge, this is the first report of a series-albeit small-of renal transplant patients in whom this infection was identified. All cases occurred in a single hospital in Paris, France, between 2001 and 2011. Patients all originate from tropical area.
  
  
  CONCLUSIONS
  Treatments of Neoscytalidium infection varied greatly, underlining the lack of a recommendation for a standardized treatment. All patients were cured after long-term antifungal therapy and/or surgical excision. Interestingly, one patient with disseminated infection involving the left elbow, the right leg, the lungs and the nasal septum was cured by medical therapy only without surgery. This may suggest that in contrast to others mycoses (such as mucormycosis), an adequate medical treatment could be sufficient for treating Neoscytalidium. We also point out the difficulties we had in diagnosing two patients with Kaposi's sarcoma because of the similarity of the lesions. Furthermore, our report underlines the need to check for this rare infection in immunocompromised kidney transplant recipients originating from tropical areas.
authors.affiliation: AP-HP, Groupe hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013, Paris, France. simon.garinet@orange.fr.
authors.forename: Simon
authors.initials: S
authors.lastname: Garinet
authors.affiliation: Département d'urologie, néphrologie et transplantation, AP-HP, Groupe hospitalier Pitié-Salpêtrière, F-75013, Paris, France. jerome.tourret@aphp.fr.|Sorbonne Universités, UPMC Univ Paris 06, F-75005, Paris, France. jerome.tourret@aphp.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Tourret
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, F-75005, Paris, France. stephane.barete@aphp.fr.|AP-HP, Groupe hospitalier Pitié-Salpêtrière, Unité fonctionnelle de Dermatologie F-75013, Université Paris Sorbonne-UPMC, Paris, France. stephane.barete@aphp.fr.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Barete
authors.affiliation: Département d'urologie, néphrologie et transplantation, AP-HP, Groupe hospitalier Pitié-Salpêtrière, F-75013, Paris, France. nadia.arzouk@aphp.fr.
authors.forename: Nadia
authors.initials: N
authors.lastname: Arzouk
authors.affiliation: AP-HP, Groupe hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013, Paris, France. ismayameyer@gmail.com.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Meyer
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, F-75005, Paris, France. camille.frances@aphp.fr.|AP-HP, Groupe hospitalier Pitié-Salpêtrière, Unité fonctionnelle de Dermatologie F-75013, Université Paris Sorbonne-UPMC, Paris, France. camille.frances@aphp.fr.
authors.forename: Camille
authors.initials: C
authors.lastname: Frances
authors.affiliation: AP-HP, Groupe hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013, Paris, France. annick.datry@aphp.fr.|Sorbonne Universités, UPMC Univ Paris 06, F-75005, Paris, France. annick.datry@aphp.fr.
authors.forename: Annick
authors.initials: A
authors.lastname: Datry
authors.affiliation: AP-HP, Groupe hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013, Paris, France. dominique.mazier@upmc.fr.|Sorbonne Universités, UPMC Univ Paris 06, F-75005, Paris, France. dominique.mazier@upmc.fr.|Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris, F-75013, Paris, France. dominique.mazier@upmc.fr.
authors.forename: Dominique
authors.initials: D
authors.lastname: Mazier
authors.affiliation: Département d'urologie, néphrologie et transplantation, AP-HP, Groupe hospitalier Pitié-Salpêtrière, F-75013, Paris, France. benoit.barrou@aphp.fr.|Sorbonne Universités, UPMC Univ Paris 06, F-75005, Paris, France. benoit.barrou@aphp.fr.
authors.forename: Benoit
authors.initials: B
authors.lastname: Barrou
authors.affiliation: AP-HP, Groupe hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013, Paris, France. arnaud.fekkar@psl.aphp.fr.|Sorbonne Universités, UPMC Univ Paris 06, F-75005, Paris, France. arnaud.fekkar@psl.aphp.fr.|Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris, F-75013, Paris, France. arnaud.fekkar@psl.aphp.fr.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fekkar
mesh_terms: D000368:Aged; D001203:Ascomycota / Q000302:isolation & purification / Q000472:pathogenicity; D054242:Emigrants and Immigrants; D005260:Female; D005602:France; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D003904:Mitosporic Fungi / Q000302:isolation & purification / Q000472:pathogenicity; D060446:Phaeohyphomycosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D012514:Sarcoma, Kaposi / Q000175:diagnosis; D066027:Transplant Recipients; D014329:Tropical Climate