Abstract
This report describes a case of invasive Exophiala dermatitidis infection after double lung transplantation in a 76-year-old man. After thoracotomy, the patient’s wound showed dehiscence with purulent secretion. The black yeast was isolated from cultures taken from the wound, and species identification was confirmed by sequence analysis of the internal transcribed spacer (ITS-S2) region. The results of the susceptibility testing showed voriconazole as the most active drug. Despite adaptation of the antifungal therapy the clinical condition worsened, and the patient died. In addition, we evaluated the fungicidal activity of antiseptics towards E. dermatitidis and aimed to provide a brief literature review of previously reported infections caused by this rare fungus. To the best of our knowledge, this is the first report of a rapidly progressing invasive fungal infection with E. dermatitidis originating from a colonized wound after lung transplantation.
Highlights
This report describes a case of invasive Exophiala dermatitidis infection after double lung transplantation in a 76-year-old man
To the best of our knowledge, this is the first report of a rapidly progressing invasive fungal infection with E. dermatitidis originating from a colonized wound after lung transplantation
Exophiala spp. frequently causes soft tissue infections known as phaeohyphomycosis [5], which was described in case reports after lung transplantation [6, 7]
Summary
This report describes a case of invasive Exophiala dermatitidis infection after double lung transplantation in a 76-year-old man. To the best of our knowledge, this is the first report of a rapidly progressing invasive fungal infection with E. dermatitidis originating from a colonized wound after lung transplantation. Exophiala dermatitidis is a saprophytic black yeastlike fungus that rarely infects humans. It is commonly isolated from plant debris and soil and has been detected from indoor-habitats, e.g., dish washers, and other places with high humidity [1]. We present—to the best of our knowledge— the first clinical case of an invasive infection with E. dermatitidis in a patient presenting with a colonized wound after lung transplantation. Since the diagnosis and therapy of E. dermatitidis are very challenging, we aim to draw the attention of clinicians to this fungus in lung-transplant patients
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