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Pseudoallescheria boydii soft tissue abscess.

T G Sheftel, J T Mader, G Cierny

    Clinical Orthopaedics and Related Research
    |February 1, 1987
    PubMed
    Summary
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    Pseudoallescheria boydii can cause mycetoma, a fungal infection. This case highlights successful treatment of a rare soft tissue infection with surgical resection and oral ketoconazole.

    Area of Science:

    • Mycology
    • Infectious Diseases
    • Dermatology

    Background:

    • Pseudoallescheria boydii is a fungus commonly found in soil.
    • It frequently causes mycetoma, a type of fungal infection.
    • Standard treatment includes surgical removal and antifungal drugs, with varying efficacy.

    Observation:

    • A 50-year-old woman presented with an unusual nontraumatic soft tissue infection caused by P. boydii.
    • The infection did not present with the typical draining sinus tracts.
    • Diagnosis was confirmed via cytologic preparation and fungal cultures of aspirate.

    Findings:

    • In vitro studies show P. boydii is sensitive to miconazole but often resistant to amphotericin B and 5-fluorocytosine.
    • Limited data exists on ketoconazole treatment for P. boydii infections.

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  • This patient achieved successful treatment through en bloc resection and four months of oral ketoconazole.

    • Implications:

    • This case expands treatment options for P. boydii soft tissue infections.
    • Ketoconazole may be a viable therapeutic option, particularly when combined with surgical intervention.
    • Further research into antifungal resistance patterns and novel treatment strategies is warranted.