Cutaneous phaeohyphomycosis caused by an Itraconazole and Amphoterecin B resistant strain of Veronaeae botryosa

International Journal of Dermatology
Yu-Ting ChenYuan-Hsin Lo

Abstract

Although the dematiaceous fungus Veronaea botryosa is rarely encountered clinically, it can be pathogenic. A patient with a history of diabetes mellitus, coronary artery disease, and Cushing's syndrome had recurrent multifocal, crusted, brownish-red noduloplaques on the right forearm, left upper limb, and right knee. A skin biopsy was obtained for histopathology and fungal cultures. The histopathology showed brownish hyphae and yeast-like cells scattered in granulomatous infiltrates. Slide cultures revealed erect and straight conidiophores with two-celled cylindrical conidia, which have round tops and truncated bases. The fungus was identified as Veronaea botryosa. The disease slowly progressed despite a 6-month itraconazole regimen (200 mg daily). Subsequent use of Amphoterecin B produced only mild clinical improvements. Susceptibility tests showed resistance to both agents. Cutaneous phaeohyphomycosis caused by V. botryosa is extremely rare. Antifungal susceptibility tests are important for choosing the appropriate drug and predicting the clinical outcome.

References

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Citations

Oct 12, 2010·Clinical Microbiology Reviews·Sanjay G Revankar, Deanna A Sutton
Oct 17, 2014·Diseases of Aquatic Organisms·Natalie K StecklerThomas B Waltzek
Apr 9, 2015·Medical Mycology·Tsuyoshi HosoyaYumi Une
Mar 31, 2016·Mycopathologia·Mariana Machado Fidelis do NascimentoVania Aparecida Vicente

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