Subcutaneous black fungus (phaeohyphomycosis) infection in renal transplant recipients:three cases

We describe three cases of subcutaneous phaeohyphomycosis developing in the lower limbs of renal transplant recipients shortly after transplantation. Each case presented with dark-colored nodules that subsequently ulcerated. Histopathologic examination revealed dematiaceous fungal hyphae with a surr...

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Bibliographic Details
Published inTransplantation Vol. 77; no. 1; p. 140
Main Authors Yehia, Maha, Thomas, Mark, Pilmore, Helen, Van Der Merwe, Walter, Dittmer, Ian
Format Journal Article
LanguageEnglish
Published United States 15.01.2004
Subjects
Aged
Alternaria
Amphotericin B - therapeutic use
Antifungal Agents - therapeutic use
Dermatomycoses - drug therapy
Dermatomycoses - etiology
Dermatomycoses - pathology
Dermatomycoses - surgery
Drug Therapy, Combination
Female
Humans
Itraconazole - therapeutic use
Kidney Transplantation - adverse effects
Male
Middle Aged
Phialophora
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Summary:We describe three cases of subcutaneous phaeohyphomycosis developing in the lower limbs of renal transplant recipients shortly after transplantation. Each case presented with dark-colored nodules that subsequently ulcerated. Histopathologic examination revealed dematiaceous fungal hyphae with a surrounding granulomatous reaction. The fungi were subsequently identified as Alternaria alternatum in two cases and Phialophora richardsiae in one case. In one case, the lesions resolved during a prolonged (6-month) course of itraconazole without the requirement for surgical excision. In the other two cases, combined medical and surgical treatment resulted in cure. A review of the literature on phaeohyphomycosis is presented.
ISSN:0041-1337
DOI:10.1097/01.TP.0000107287.70512.E7