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Disseminated cutaneous Curvularia infection in an immunocompromised host; diagnostic challenges and experience with

Agnes Balla1, Joseph Pierson2, Jeremy Hugh2

  • 1Department of Pathology and Laboratory Medicine, University of Vermont Medical Center, Burlington, VT, USA.

Journal of Cutaneous Pathology
|November 5, 2015
PubMed

Insights

Disseminated phaeohyphomycosis, a rare fungal infection in immunocompromised patients, is increasingly reported. Early diagnosis via skin exams and molecular methods is crucial due to high mortality and limited treatment options.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Opportunistic fungal infections are rising, particularly disseminated phaeohyphomycoses caused by dematiaceous molds.
  • These infections pose a significant mortality risk in immunocompromised individuals, especially neutropenic patients.

Observation:

  • Early diagnosis of disseminated phaeohyphomycosis is challenging due to low fungal blood culture sensitivity and clinical suspicion.
  • Cutaneous manifestations frequently serve as the initial indicator of disease.
  • Thorough skin examinations in febrile neutropenic patients can expedite diagnosis and treatment initiation.

Findings:

  • Polymerase chain reaction (PCR) amplification and sequencing of mold RNA from paraffin-embedded tissue aid in diagnosing rare fungal infections when cultures are negative.
  • Effective therapeutic strategies for disseminated phaeohyphomycosis remain limited.

Implications:

  • Emphasizes the importance of clinical vigilance and dermatological examination for early detection of disseminated phaeohyphomycosis.
  • Highlights the utility of molecular diagnostic techniques in challenging cases.
  • Underscores the urgent need for reporting treatment experiences with novel antifungal agents to improve patient outcomes.
Keywords:
acute myelogenous leukemiafungal infectioninfectious diseasesmolecular pathologypathology dermatopathology

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