Successful Terbinafine Treatment for Cutaneous Phaeohyphomycosis Caused by Trematosphaeria grisea in a Heart Transplanted Man: Case Report and Literature Review

Phaeohyphomycosis is a chronic infectious disease caused by dematiaceous fungi. It is characterized by the presence of pigmented septate mycelia within tissues. In the case of superficial infection, the lesion(s) chronically evolve(s) toward painless pseudo-tumor(s) of the soft parts. We report here...

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Published inMycopathologia (1975) Vol. 185; no. 4; pp. 709 - 716
Main Authors Mercier, Victor, Bastides, Frédéric, Bailly, Eric, Garcia-Hermoso, Déa, Miquelestorena-Standley, Elodie, El Baz, Zaki, Marteau, Emilie, Vermes, Emmanuelle, de Muret, Anne, Bernard, Louis, Desoubeaux, Guillaume
Format Journal Article
LanguageEnglish
Published Springer Verlag 19.06.2020
Subjects
Life Sciences
Microbiology and Parasitology
Mycology
Phaeohyphomycosis
Trematosphaeria grisea
Isavuconazole
Dematiaceous fungus
Terbinafine
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Summary:Phaeohyphomycosis is a chronic infectious disease caused by dematiaceous fungi. It is characterized by the presence of pigmented septate mycelia within tissues. In the case of superficial infection, the lesion(s) chronically evolve(s) toward painless pseudo-tumor(s) of the soft parts. We report herein the original case of a heart transplanted man who exhibited phaeohyphomycosis of the left hand, with no mention of travels in endemic areas. Trematosphaeria grisea was identified as the causative agent, which is quite innovative since this species has been rather described in mycetoma. The antifungal treatment initially based on isavuconazole alone was not sufficient to cure the patient. In contrast, its association with local terbinafine ointment allowed total clinical improvement. This finding is unusual as diagnosis of phaeohyphomycosis caused by T. grisea is uncommon in nontropical countries, and as the outcome appeared successful by the means of add-on therapeutic strategy with terbinafine.
ISSN:0301-486X
1573-0832
DOI:10.1007/s11046-020-00467-4(