Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum

Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection...

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Bibliographic Details
Published in:The Brazilian journal of infectious diseases 2011-05, Vol.15 (3), p.288-292
Main Authors: Morais, Orlando Oliveira de, Porto, Cláudia, Coutinho, Anglya Samara Silva Leite, Santiago Reis, Carmélia Matos, Melo Teixeira, Marcus de, Martins Gomes, Ciro
Format: Article
Language:English
Subjects:
Ascomycota - genetics
Ascomycota - isolation & purification
Erythema Nodosum - complications
HIV
Humans
Leprosy, Lepromatous - complications
Lymphatic Diseases - complications
Lymphatic Diseases - microbiology
macrolides
Male
mortality
Mycoses - complications
Mycoses - microbiology
pneumonia
Young Adult
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Summary:Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.
ISSN:1413-8670
1678-4391
DOI:10.1016/S1413-8670(11)70191-X