Phaeohyphomycosis caused by Alternaria infectoria presenting as multiple vegetating lesions in a renal transplant patient

• Published in: Revista iberoamericana de micología 2012-01, Vol.29 (1), p.44-46
• Main Authors: Cunha, Daniela, Amaro, Cristina, Vieira, María Raquel, Martins, María da Luz, Maduro, Ana Paula, Inácio, João, Afonso, Ana, Pinto, Gabriela Marques, Cardoso, Jorge
• Format: Article
• Language: English
• Subjects: Alternaria; Alternaria infectoria; Immunocompromised patient; Infectious Disease; Itraconazol; Itraconazole; Kidney transplantation; Micosis; Mycosis; Paciente inmunocomprometido; Trasplante renal
• ISSN: 1130-1406
• DOI: 10.1016/j.riam.2011.06.010

AbstractThe genus Alternaria is one of the most common black moulds and appears to be increasing as a causative agent of subcutaneous phaeohyphomycosis, particularly among immunosuppressed patients. A 53-year-old patient who had received a kidney transplant presented with multiple verrucous lesions on the distal extremities. Positive histopathology and cultures, in addition to rDNA ITS region sequencing, identified the fungal isolate as Alternaria infectoria. Oral itraconazole was administered for 10 months. A follow-up at 15 months demonstrated no signs of infection. Clinical manifestations of cutaneous alternariosis vary significantly and only a few cases have been described in the literature. Although optimal treatment options remain controversial, this case of phaeohyphomycosis was successfully treated with itraconazole monotherapy.