Therapeutic management of subcutaneous phaeohyphomycosis and chromoblastomycosis in kidney transplant recipients: a retrospective study of 82 cases in a single center.

Autor: Lima ACC; Medical School, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Santos DWCL; Hospital do Rim, São Paulo, Brazil., Hirata SH; Department of Dermatology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Nishikaku AS; Department of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Enokihara MMSES; Department of Pathology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Ogawa MM; Department of Dermatology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Jazyk: angličtina
Zdroj: International journal of dermatology [Int J Dermatol] 2022 Mar; Vol. 61 (3), pp. 346-351. Date of Electronic Publication: 2021 Oct 11.
DOI: 10.1111/ijd.15948
Abstrakt: Background: Melanized fungi are a distinct group of pathogens that cause infections like chromoblastomycosis and phaeohyphomycosis, especially in a state of immunosuppression including solid organ transplant recipients. Guidelines for the treatment of these infections are lacking, and there is no available standard recommendation.
Objective: To evaluate the therapeutic aspects of subcutaneous melanized fungal infections in kidney transplant recipients.
Methods: A retrospective medical record was performed for kidney transplant recipients with melanized fungal infection evaluated in a single institution from January 1996 to December 2018.
Results: Eighty-two episodes were noticed in our series. The treatment of subcutaneous phaeohyphomycosis was managed by surgical excision without antifungal therapy in 34 cases (34/68; 50%), and the association of both methods occurred in 18 cases (18/68; 26.5%). A complete surgical excision without antifungal therapy was observed in six (6/14; 42.9%) episodes of chromoblastomycosis, and combined treatment was possible in three (3/14; 21.4%) cases. Five episodes of chromoblastomycosis and 16 episodes of phaeohyphomycosis were managed only with antifungal therapy.
Conclusion: Management depends on the dermatologic lesion, immunosuppression condition, and anatomical cleavage plane. The sample size is still small in order to dictate a guideline, but it can be hard to execute a larger study given the rarity of this group of infections.
(© 2021 the International Society of Dermatology.)
Databáze: MEDLINE
Externí odkaz: