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[Clinical problems in medical mycology: Problem number 50]
Laura Guadalupe Walker1, Alicia Arechavala1, Fernando Messina1
1Unidad Micología, Hospital de Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
Revista Iberoamericana De Micologia
|July 25, 2016
Summary
A human immunodeficiency virus (HIV)-positive man with disseminated histoplasmosis experienced a Microsporum gypseum infection. Oral terbinafine successfully treated his tinea cruris and onychomycosis despite complex medical management.
Area of Science:
- Mycology
- Dermatology
- Infectious Diseases
Background:
- A 34-year-old human immunodeficiency virus (HIV)-positive male patient with a history of disseminated histoplasmosis treated with amphotericin B was admitted for non-lithiasic cholecystitis.
- The patient was undergoing highly active antiretroviral therapy (HAART) and itraconazole treatment.
Observation:
- Clinical examination revealed perigenital skin lesions consistent with tinea cruris.
- Proximal subungual onychomycosis of the toenails was also observed.
- Microsporum gypseum was identified as the causative agent in both cutaneous and nail infections.
Findings:
- Oral terbinafine was prescribed for the Microsporum gypseum infection.
- The patient demonstrated a positive clinical response to terbinafine treatment.
- Treatment posed a challenge due to potential drug interactions with HAART and itraconazole.
Implications:
- This case highlights the successful management of Microsporum gypseum infections in an immunocompromised patient with complex medication regimens.
- It underscores the importance of considering dermatophyte infections in HIV-positive individuals presenting with skin and nail abnormalities.
- Further research is warranted on the treatment of M. gypseum nail infections, particularly in patients on antiretroviral therapy.
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