title: NOCARDIA BEIJINGENSIS PSOAS ABSCESS AND SUBCUTANEOUS PHAEOHYPHOMYCOSIS CAUSED BY PHAEOACREMONIUM PARASITICUM IN A RENAL TRANSPLANT RECIPIENT: THE FIRST CASE REPORT IN THAILAND.
abstract: We describe the first case of a psoas muscle abscess caused by Nocardia beijingensis and subcutaneous phaeohyphomycosis caused by Phaeoacremonium parasiticum in a renal transplant recipient. The patient was treated for nocardiosis with percutaneous drainage and intravenous trimethoprim/sulfamethoxazole (TMP/SMX) combined with imipenem for 2 weeks, followed by a 4-week course of intravenous TMP/SMX and then oral TMP/SMX. During hospitalization for the psoas muscle abscess the patient developed cellulitis with subcutaneous nodules of his right leg. Skin biopsy and cultures revealed a dematiaceous mold, subsequently identified as P. parasiticum by DNA sequencing. The subcutaneous phaeohyphomycosis was treated with surgical drainage and liposomal amphotericin B for 4 weeks followed by a combination of itraconazole and terbinafine. The patient gradually improved and was discharged home after 18 weeks of hospitalization.
authors: Nattawan
authors: N
authors: Palavutitotai
authors: Piriyaporn
authors: P
authors: Chongtrakoo
authors: Popchai
authors: P
authors: Ngamskulrungroj
authors: Methee
authors: M
authors: Chayakulkeeree
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D004322:Drainage; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D017964:Itraconazole / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009615:Nocardia; D009617:Nocardia Infections / Q000209:etiology* / Q000628:therapy; D009894:Opportunistic Infections / Q000209:etiology*; D060446:Phaeohyphomycosis / Q000209:etiology* / Q000628:therapy; D016659:Psoas Abscess / Q000209:etiology* / Q000628:therapy; D013785:Thailand; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D007166:Immunosuppressive Agents; C068538:liposomal amphotericin B; D017964:Itraconazole; D000666:Amphotericin B; D015662:Trimethoprim, Sulfamethoxazole Drug Combination