Invasive cutaneous infection with Geotrichum candidum - sequential treatment with amphotericin B and voriconazole

A rare case of an invasive cutaneous infection by Geotrichum candidum in an 80-year-old male patient with diabetes mellitus is reported. The primary site of infection manifested after trauma as an ulcerative lesion on the distal phalanx of the midfinger and extended throughout the right hand. Histol...

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Bibliographic Details
Published in:Medical mycology (Oxford) 2007-02, Vol.45 (1), p.81-84
Main Authors: Sfakianakis, Andreas, Krasagakis, Konstantin, Stefanidou, Maria, Maraki, Sofia, Koutsopoulos, Anastassios, Kofteridis, Diamantis, Samonis, George, Tosca, Androniki
Format: Article
Language:English
Subjects:
Aged, 80 and over
Amphotericin B - therapeutic use
Antifungal Agents - therapeutic use
Diabetes Mellitus - microbiology
Geotrichosis - complications
Geotrichosis - drug therapy
Geotrichosis - microbiology
Geotrichum - isolation & purification
Geotrichum candidum
Humans
Male
Pyrimidines - therapeutic use
Triazoles - therapeutic use
Voriconazole
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Summary:A rare case of an invasive cutaneous infection by Geotrichum candidum in an 80-year-old male patient with diabetes mellitus is reported. The primary site of infection manifested after trauma as an ulcerative lesion on the distal phalanx of the midfinger and extended throughout the right hand. Histological examination showed fungal invasion in the deep dermis without vascular involvement and G. candidum was grown in cultures from the biopsy material. Angiography revealed severe obstructive disease of the right brachial artery and its branches. Treatment, after susceptibility testing of the isolated strain, consisted of sequential administration of intravenous liposomal amphotericin B with oral voriconazole followed by liposomal amphotericin B, resulting in substantial improvement of the infection.
ISSN:1369-3786
1460-2709
DOI:10.1080/13693780600939948