Successful treatment of antifungal- and cryotherapy-resistant subcutaneous hyalohyphomycosis in an immunocompetent case with topical 5% imiquimod cream

Hyalohyphomycosis is an unusual opportunistic mycotic infection where the tissue morphology of the causative organism is mycelial. Etiological agents, which are not responsible for the otherwise-named infections like aspergillosis, are the species of non-dematiaceous hyaline hyphomycetes including P...

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Bibliographic Details
Published in:Mycopathologia (1975) 2005-06, Vol.159 (4), p.521-526
Main Authors: Erbagci, Zulal, Tuncel, A Almila, Erkilic, Suna, Zer, Yasemin
Format: Article
Language:English
Subjects:
Acremonium
Acremonium - growth & development
Administration, Topical
Adult
Aminoquinolines - administration & dosage
Aspergillus
Beauveria
Cephalosporium
Dermatomycoses - drug therapy
Dermatomycoses - microbiology
Emollients - administration & dosage
Female
Fusarium
Herpes simplex virus
Humans
Hyphomycetes
Immunologic Factors - administration & dosage
Mollusca
Paecilomyces
Penicillium
Scopulariopsis
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Summary:Hyalohyphomycosis is an unusual opportunistic mycotic infection where the tissue morphology of the causative organism is mycelial. Etiological agents, which are not responsible for the otherwise-named infections like aspergillosis, are the species of non-dematiaceous hyaline hyphomycetes including Penicillium, Paecilomyces, Acremonium (formerly known Cephalosporium), Beauveria, Fusarium, and Scopulariopsis. Several cases of Acremonium infection have been described in immunocompromised patients; however it can cause invasive disease in an immunocompetent person very rarely. Optimum therapy of Acremonium infection is unclear because of the limited number of reported cases and conflicting results of therapies. Imiquimod, an imidazoquinoline with potent antiviral, antitumor and immunoregulatory properties, is currently approved for the topical treatment of external anogenital warts and actinic keratosis. Imiquimod has also been found to be effective for other virus-associated dermatologic lesions, including common and flat warts, molluscum contagiosum, and herpes simplex virus type-2 as well as for some cases of cutaneous leishmaniasis. We report herein, for the first time, a case of unusually recalcitrant hyalohyphomycosis of the face due to Acremonium strictum successfully treated with topical 5% imiquimod in an immunocompetent patient, who had failed to respond to various antifungals, including itraconazole, and cryotherapy.
ISSN:0301-486X
1573-0832
DOI:10.1007/s11046-005-5260-z