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Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum

Orlando Oliveira de Morais1, Cláudia Porto, Anglya Samara Silva Leite Coutinho

  • 1Dermatology Residency Program, University Hospital of Brasilia, Universidade de Brasília, Brasília, Brazil.

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
|June 15, 2011
PubMed

Insights

Aureobasidium pullulans caused a rare lymphatic system infection in a patient with erythema nodosum leprosum. Treatment with amphotericin B deoxycholate led to complete recovery.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Clinical Case Study

Background:

  • Aureobasidium pullulans is an opportunistic fungal pathogen known to cause phaeohyphomycosis.
  • This fungus can lead to systemic infections, including fungemia and visceral abscesses, in immunocompromised individuals.
  • Infections in the lymphatic system are uncommon presentations of A. pullulans.

Observation:

  • A 23-year-old patient with erythema nodosum leprosum presented with prolonged fever, hoarseness, odynophagia, and weight loss.
  • Clinical findings included pancytopenia with severe neutropenia, cervical adenomegaly, and an oropharyngeal lesion.
  • Initial broad-spectrum antibiotic treatment failed to improve the patient's condition.

Findings:

  • Lymph node aspiration identified Aureobasidium pullulans in its yeast form via ITS sequencing.
  • The patient received treatment with amphotericin B deoxycholate.
  • Successful treatment resulted in complete recovery of bone marrow function and resolution of adenomegaly and the oropharyngeal lesion.

Implications:

  • This case highlights A. pullulans as a potential cause of lymphatic system infections, particularly in immunocompromised hosts.
  • Early and accurate diagnosis through fungal identification is crucial for effective treatment.
  • Amphotericin B deoxycholate is an effective therapeutic option for A. pullulans infections.

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