Alternaria alternata soft tissue infection in a forearm transplant recipient

Area of Science:

• Mycology
• Transplantation Immunology
• Infectious Diseases

Background:

• Composite tissue allograft recipients require intensive immunosuppression, increasing susceptibility to infections.
• Filamentous fungal infections pose significant management challenges in organ transplant recipients.

Observation:

• A patient developed a thigh lesion two years post-bilateral forearm transplantation after a hiking injury.
• Microscopic examination revealed a filamentous fungal infection, identified as Alternaria alternata.

Findings:

• Successful treatment of invasive Alternaria alternata infection with complete local excision and systemic antifungal therapy.
• Liposomal amphotericin B induction followed by oral itraconazole maintenance achieved a favorable outcome without recurrence at 18 months.

Implications:

• This case highlights the potential for rare fungal infections in immunocompromised transplant patients.
• Successful management underscores the importance of prompt diagnosis and combined therapeutic approaches for invasive fungal infections in allograft recipients.