Successful Posaconazole Therapy of Disseminated Alternariosis due to Alternaria infectoria in a Heart Transplant Recipient
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We report a case of phaeohyphomycosis caused by Alternaria infectoria in a 61-year-old heart transplant recipient with multiple skin lesions and pulmonary infiltrates. The infection spread via the haematogenous route from the primary cutaneous lesions into the lungs. The diagnosis was based on the histopathological examination, direct microscopy, skin lesion cultures and detection of Alternaria DNA in the bronchoalveolar lavage fluid using molecular methods. The treatment consisted of a combination of surgical excision and systemic antifungal therapy. Voriconazole was the first agent used but had a weak effect. Posaconazole was subsequently used to achieve a successful response. The isolate was identified as A. infectoria by sequencing of the rDNA ITS region and the partial β-tubulin gene.
KeywordsHeart transplantation Phaeohyphomycosis Pulmonary infection Alternariosis
This research was supported by the Ministry of Education, Youth and Sports of the Czech Republic (SVV project), and by the project “BIOCEV—Biotechnology and Biomedicine Centre of the Academy of Sciences and Charles University” (CZ.1.05/1.1.00/02.0109) from the European Regional Development Fund. Additional support was obtained from a research grant from the Ministry of Health, Czech Republic [MZ 15-27682A] and from the project of the Ministry of Health, Czech Republic, for development of research organization 00023001 (IKEM, Prague, Czech Republic). This work was also supported by grant no. IGA_LF_2016_022 and RVO: 61989592 (Palacky University Olomouc, Czech Republic). All rights reserved.
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Conflict of interest
The authors declare that they have no conflict of interest.
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