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Phaeoacremonium parasiticum phaeohyphomycosis in a patient with systemic lupus erythematosus treated successfully with surgical debridement and voriconazole: A case report and review of the literature. IDCases 2014;1(4):84-8 PMID: 26839782 PMCID: PMC4735079

Pubmed ID

26839782

DOI

10.1016/j.idcr.2014.10.004

Abstract

A 26-year old woman presented for evaluation of extensive edema, erythema, sinus tract formation and purulent drainage from the left lower extremity after trauma from a wooden object approximately three months prior. Skin biopsies and blood cultures revealed Phaeoacremonium parasiticum consistent with a diagnosis of phaeohyphomycosis. Despite hospitalization and initial treatment with several antifungals, including voriconazole, her infection progressed. Surgical debridement with split thickness skin grafting was performed. Subsequent clinical improvement allowed a transition from intravenous to oral voriconazole and discharge home. Seven months post presentation she remained on oral voriconazole with significant improvement and no clinical evidence of recurrence. This case illustrates an approach to management where aggressive debridement with split-thickness skin grafting and a prolonged course of intravenous and oral antifungals resulted in a good long-term outcome for the patient.

Author List

El-Herte RI, Schouweiler KE, Farah RS, Arbulu R, Diekema D, Wanat KA, Ford BA

Author

Karolyn A. Wanat MD Associate Professor in the Dermatology department at Medical College of Wisconsin




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