Alternariosis Research Articles

Cutaneous alternariosis presenting as vasculitic ulcers

Cutaneous alternariosis presenting as vasculitic ulcers

A Case of Bilateral Cutaneous Alternariosis of the Lower Legs

A Case of Bilateral Cutaneous Alternariosis of the Lower Legs

Emerging Cutaneous Phaeohyphomycosis Caused by Alternaria infectoria.

Alternaria species belong to a group of opportunistic fungi that causes skin infection mainly in immunosuppressed patients. The authors describe two clinically distinct cases of cutaneous alternariosis caused by Alternaria infectoria in patients under prolonged corticosteroid treatment. Additionally, a brief review of published cases in portuguese patients is conducted.

Effectiveness of bioproducts Alirin-B and Rizoplan against alternariosis of tomatoes

Effectiveness of bioproducts Alirin-B and Rizoplan against alternariosis of tomatoes

Enhancement in serum (1–3)-β-D-glucan level by cutaneous alternariosis: A case report and literature review

Contamination with the fungus Alternaria spp. is often considered to have originated from laboratory sources, which occasionally causes infection in immunocompromised patients, termed as phaeohyphomycosis. Here, we have reported a case of cutaneous alternariosis caused by Alternaria alternata. This diagnosis was based on microscopic examination and mycological culturing of patient's vesicular lesions, with the use of 5 molecular markers (namely, ITS, ATPase, Actin, rpb2, and tef1) for strain identification. We noted that Alternaria infection caused an increase in the serum level of (1–3)-β-D-glucan (BG) in the patients. To the best of our knowledge, no such finding has been reported in previously in the literature.

Onset of disseminated cutaneous nodules following toe amputation in heart transplant patient

Alternaria spp. infections are rare, but organ transplant recipients and immunosuppressed patients are particularly at risk of developing cutaneous alternariosis. Although cutaneous alternariosis is well-defined, instances of disseminated infection are exceedingly rare. We report a case of disseminated Alternaria infection in an immunocompromised patient from a primary focus of ungual phaeohyphomycosis.

Cutaneous alternariosis in a renal transplant patient successfully treated with posaconazole: Case report and literature review

Cutaneous alternariosis is an uncommon fungal infection that most commonly presents in organ transplant patients on immunosuppressive therapy. There are no clinical trials or guidelines to guide treatment of this condition, however itraconazole is the most commonly used antifungal in published cases. Here we report on a case of cutaneous alternariosis in a renal transplant recipient treated with a newer antifungal, posaconazole. A review of published reports of cutaneous alternariosis since 2008 is also discussed.

Cutaneous alternariosis in an immunocompetent patient

Alternaria species are a type of dematiaceous fungi that cause a wide spectrum of disease with cutaneous infections being the most common. These infections are most common in immunocompromised individuals. However, only a few cases of primary cutaneous alternariosis have been reported in immunocompetent patients. We present a case of an otherwise healthy 13-year-old male who presented with primary cutaneous alternariosis on his left ankle that responded to the use of topical econazole and oral itraconazole. We also provide a review of previously described cases of primary cutaneous alternariosis in the literature.

深在性皮膚アルテルナリア症の 1 例

65 歳，男性。64 歳時発症の尋常性天疱瘡に対して，プレドニゾロン 13 mg/day およびシクロスポリン130 mg/day を内服中であり，ステロイド糖尿病を合併していた。また，繰り返すサイトメガロウイルス抗原血症にて当科で入退院を繰り返していた。2014 年に同症治療目的で当科に入院中，左大腿伸側に 2×1.5 cm の紅褐色結節を認め，圧迫にて少量の排膿を伴った。病理組織学的には，真皮全層に組織球や好中球を主体とする細胞浸潤を認め，PAS 染色陽性の菌要素が多数みられた。生検組織および膿汁からの分離培養では，いずれもポテトデキストロース寒天培地で，表面が羊毛状，緑褐色で，裏面が褐色から黒色の集落を形成した。スライド培養では洋梨型で，特有な隔壁で縦横に仕切られた分生子を連鎖して認めた。遺伝子解析にて Alternaria alternata と同定し，深在性皮膚アルテルナリア症と診断した。プレドニゾロンおよびシクロスポリンの漸減を行いつつ，ボリコナゾール 300 mg/day の内服で治療を開始したが，肝機能障害が出現し，イトラコナゾール 200 mg/day の内服に変更した。その後，約 3 週間の経過で皮疹はほぼ平坦化した。深在性皮膚アルテルナリア症は，本邦での報告は自験例を含め 27 例と稀であり，本稿では，2000 年以降の報告例13例についてまとめた。その多くでイトラコナゾールが奏効していた。

Cutaneous Alternariosis Caused by Alternaria infectoria: Three Cases in Kidney Transplant Patients.

The genus Alternaria has more than 80 species. Alternaria alternata and Alternaria infectoria are the most frequent species associated with infections in humans. Their clinical importance lies in the growing number of cases reported in immunocompromised patients. Herein, we report three cases of kidney-transplanted patients with different clinical presentations of cutaneous alternariosis and we discuss the treatment options.

Cutaneous Alternariosis With Trichosporon Infection in a Heart Transplant Recipient: A Case Report

Cutaneous alternariosis infection occurs mainly in immunocompromised individuals. The incidence of alternariosis in a heart transplant recipient is infrequent. Coincidence of the aforementioned infection with additional fugal agents is rare. We describe a case of alternariosis with Trichosporon fungal infection in a patient who was successfully treated with combined antifungal therapy, modulation of immunosuppressive regimen, and blood glucose management. The patient had a good response to treatment, and has had an uneventful 1-year follow-up at the time of this writing.

Cutaneous alternariosis in an immunocompetent patient successfully treated with oral fluconazole

Alternaria species are fungi characterized by the presence of brown or black pigment in their cell wall. They are common in the environment (soil, water, plants) as saprophytic fungi. They may rarely act as facultative pathogens, especially in the presence of immunosuppression, causing cutaneous infections with rare systemic involvement [1]. We report a case of cutaneous alternariosis infection, in an immunocompetent host, successfully treated with oral fluconazole.A 58-year-old male patient presented [...]

Mohs micrographic surgery for the treatment of localized cutaneous alternariosis

To the Editor: A 55-year-old man who underwent matched donor stem-cell transplantation for acute lymphoblastic leukemia presented with a 6-week history of a nonhealing ulcer on his left lower extremity. One month before presentation to our clinic, a surface culture was performed and grew Alternaria, for which oral voriconazole (200 mg twice a day) was started. The patient's wound was not healing despite antifungal therapy and an infectious disease consultant questioned whether the Alternaria represented a wound contaminant or a true opportunistic infection.

Deep cutaneous mycosis due to Alternaria infectoria after liver transplantation: successful treatment with fluconazole

ejd.2012.1885 Auteur(s) : Nabail Alhmali1, Petra Lindenlaub1, Beniam Ghebremedhin2, Ingolf Franke1, Harald Gollnick1, Bernd Bonnekoh1 bernd.bonnekoh@medizin.uni-magdeburg.de 1 Clinic for Dermatology and Venereology, 2 Institute for Medical Microbiology, Otto-von-Guericke-University, Leipziger Str. 44, D-39120 Magdeburg, Germany Cutaneous alternariosis is a rare, deep mycosis [1] with only a few hundred cases reported so far. In the past two decades it has occurred with increasing frequency, mainly [...]

Cutaneous alternariosis in a renal transplant recipient: A case report and literature review

Organ transplant recipients under immunosuppressive therapy have a highly increased risk of acquiring unusual opportunistic infections. Diagnosis of the etiology of infection may be difficult in clinical manifestations, which need further histological and biological investigations. We recently treated a male renal transplant recipient with a cutaneous phaeohyphomycosis due to Alternaria species. The diagnosis was based on microscopy and culture of the skin lesions. Treatment with oral itraconazole for 5 weeks was ineffective, then clinical improvement was achieved by combination of amphotericin B wet-packing and systemic antifungal therapy with oral voriconazole. Alternaria species are ubiquitous plant-inhabiting saprobes, which are increasingly associated with opportunistic phaeohyphomycosis in immunocompromised individuals. To the best of our knowledge, this is the second case report noting sporotrichoid pattern as the manifestation of cutaneous alternariosis. In this context, we reviewed recent renal-transplant-related cutaneous alternariosis reported in the English-language literature during 1995 to 2011 to summarize its clinical features and outcomes, and to guide clinicians in the care of kidney transplant patients with cutaneous alternariosis.

Cutaneous alternariosis in a renal transplant recipient

Alternariosis is a fungal infection that is usually described in immunocompromised patients. We report a case of cutaneous alternariosis in a renal transplant recipient caused by Alternaria tenuissima. The diagnosis was supported by histopathologic (ie, yeastlike cells, filamentous structures) and mycologic findings from a cutaneous biopsy. Cutaneous lesions regressed 1 month following a decrease in the dosage of immunosuppressive therapy. The patient also was treated with intravenous amphotericin B followed by oral fluconazole without improvement. Cryotherapy remarkably accelerated healing of the lesions.

Successful treatment of cutaneous alternariosis with caspofungin in a renal transplant recipient

Successful treatment of cutaneous alternariosis with caspofungin in a renal transplant recipient

Cutaneous alternariosis microscopically mimicking blastomycosis

A 57-year-old man status post several myocardial infarcts and heart transplantation presented with a slowly growing violaceous plaque on his lateral left knee at the site of prior minor trauma. A biopsy revealed a suppurative dermatitis with associated pseudocarcinomatous epithelial hyperplasia. There were multiple non-pigmented eosinophilic organisms with clear cytoplasmic halos within the infiltrate. A methenamine silver stain showed round to ovoid organisms of slightly variable size. Rare uni-polar budding, some of which was broad based, was apparent. A few short hyphae with indeterminate septa were also noted. Fontana-Masson, mucicarmine, Alcian blue and Fite stains were all negative. These findings suggested a diagnosis of blastomycosis. However, a fungal culture grew colonies of Alternaria species. Alternariosis has been previously shown to possess morphologic characteristics that can simulate other fungal infections. To our knowledge, a striking similarity to blastomycosis, as seen in our case, has not been previously reported. Dermatopathologists should be aware that alternariosis may mimic blastomycosis, especially when hyphal forms are rare or absent in tissue specimens. Culture is necessary for definitive classification.

Phaeohyphomycosis caused by Alternaria infectoria presenting as multiple vegetating lesions in a renal transplant patient

The genus Alternaria is one of the most common black moulds and appears to be increasing as a causative agent of subcutaneous phaeohyphomycosis, particularly among immunosuppressed patients.A 53-year-old patient who had received a kidney transplant presented with multiple verrucous lesions on the distal extremities. Positive histopathology and cultures, in addition to rDNA ITS region sequencing, identified the fungal isolate as Alternaria infectoria. Oral itraconazole was administered for 10 months. A follow-up at 15 months demonstrated no signs of infection.Clinical manifestations of cutaneous alternariosis vary significantly and only a few cases have been described in the literature. Although optimal treatment options remain controversial, this case of phaeohyphomycosis was successfully treated with itraconazole monotherapy.

Paraneoplastic pemphigus associated with corneal perforation and cutaneous alternariosis: A case report and review of cases treated with rituximab

The Journal of DermatologyVolume 38, Issue 11 p. 1084-1089 LETTERS TO THE EDITOR Paraneoplastic pemphigus associated with corneal perforation and cutaneous alternariosis: A case report and review of cases treated with rituximab Takashi ANAN, Takashi ANAN Departments of DermatologySearch for more papers by this authorFumiaki SHIMIZU, Fumiaki SHIMIZU Plastic Surgery, Faculty of Medicine, Oita University, Oita, JapanSearch for more papers by this authorYutaka HATANO, Yutaka HATANO Departments of DermatologySearch for more papers by this authorOsamu OKAMOTO, Osamu OKAMOTO Departments of DermatologySearch for more papers by this authorKazumoto KATAGIRI, Kazumoto KATAGIRI Departments of DermatologySearch for more papers by this authorSakuhei FUJIWARA, Sakuhei FUJIWARA Departments of DermatologySearch for more papers by this author Takashi ANAN, Takashi ANAN Departments of DermatologySearch for more papers by this authorFumiaki SHIMIZU, Fumiaki SHIMIZU Plastic Surgery, Faculty of Medicine, Oita University, Oita, JapanSearch for more papers by this authorYutaka HATANO, Yutaka HATANO Departments of DermatologySearch for more papers by this authorOsamu OKAMOTO, Osamu OKAMOTO Departments of DermatologySearch for more papers by this authorKazumoto KATAGIRI, Kazumoto KATAGIRI Departments of DermatologySearch for more papers by this authorSakuhei FUJIWARA, Sakuhei FUJIWARA Departments of DermatologySearch for more papers by this author First published: 21 March 2011 https://doi.org/10.1111/j.1346-8138.2010.01192.xCitations: 18 Sakuhei Fujiwara, M.D., Ph.D., Department of Dermatology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Yufu-shi, Oita 879-5593, Japan. Email: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume38, Issue11November 2011Pages 1084-1089 RelatedInformation