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Successful treatment of systemic and local infections due to Exophiala species
Abstract:
We report the successful treatment of three cases of infection due to Exophiala species. These organisms belong to the heterogeneous group of dematiaceous (darkly pigmented) fungi. Two cases of infection occurred in organ transplant recipients who were receiving immunosuppressive medications. Both of these infections remained localized to the subcutaneous tissues and were successfully treated with surgical excision of the lesions. We also describe what is to our knowledge the first reported case of prosthetic valve endocarditis due to Exophiala castellanii that was managed with a combination of medical and surgical therapies. Exophiala species remain an uncommon cause of infection. However, as the population of immunocompromised patients continues to grow and further improvements in the microbiological techniques for identification of these fungi occur, these organisms will be recognized with increasing frequency as a cause of human disease.
Insights
Successful treatments for Exophiala fungal infections in immunocompromised patients are reported. These cases highlight effective surgical and medical interventions for dematiaceous fungi, even in complex scenarios like prosthetic valve endocarditis.
Area of Science:
- Mycology
- Infectious Diseases
Background:
- Exophiala species are dematiaceous fungi causing uncommon human infections.
- Immunosuppressed individuals, particularly organ transplant recipients, are at higher risk.
Observation:
- Three cases of Exophiala infections were successfully treated.
- Two cases involved localized subcutaneous infections in transplant recipients.
- One case presented as prosthetic valve endocarditis due to Exophiala castellanii.
Findings:
- Localized subcutaneous Exophiala infections responded well to surgical excision.
- Prosthetic valve endocarditis required a combined medical and surgical approach for successful management.
Implications:
- Increased recognition of Exophiala as a pathogen in immunocompromised populations is expected.
- Advancements in mycological identification techniques will aid in diagnosing these infections.
- Effective treatment strategies involve tailored medical and surgical interventions based on infection site and severity.