A Case of Cutaneous Mycosis Caused by Scedosporium dehoogii on an Immunocompromised Patient

• DOI: 10.1007/s11046-017-0198-5
• Publication Date: 2017-09-01T07:45:10Z
• Authors: Yuichi Sakata; Fumiaki Taga; Tsuyoshi Ushigami; Kiminobu Takeda; Kazushi Anzawa; Akiko Nishibu; Takashi Mochizuki
• Keywords: Male; Microbiological Techniques; 0301 basic medicine; Antifungal Agents; Sequence Analysis, DNA; 3. Good health; Arthritis, Rheumatoid; Immunocompromised Host; 03 medical and health sciences; Treatment Outcome; Tubulin; Dermatomycoses; Humans; Scedosporium; Immunosuppressive Agents; Aged

This report describes a 77-year-old man with cutaneous mycosis caused by Scedosporium dehoogii while taking oral betamethasone and tacrolimus for the treatment of rheumatoid arthritis. At examination in our clinic, the patient had multiple cystic lesions and nodules with slight tenderness, varying in size up to 4 cm, on his left knee and shin. He had not noticed any traumatic injury at the site of the lesions. Fungal cultures of samples taken from the abscesses, scales, and crusts of the lesions yielded white, later grayish brown, fluffy surfaced colonies. Partial sequencing of the β-tubulin gene confirmed the species of the isolate. The patient was initially treated with oral voriconazole and local hyperthermia, but experienced hepatic injury 2 weeks later. His treatment was changed to itraconazole (ITC) and local hyperthermia, followed by a combination of ITC and terbinafine. The patient recovered completely during the 12-month course of treatment.