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A Case of Cutaneous Mycosis Caused by Scedosporium dehoogii on an Immunocompromised Patient

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Abstract

This report describes a 77-year-old man with cutaneous mycosis caused by Scedosporium dehoogii while taking oral betamethasone and tacrolimus for the treatment of rheumatoid arthritis. At examination in our clinic, the patient had multiple cystic lesions and nodules with slight tenderness, varying in size up to 4 cm, on his left knee and shin. He had not noticed any traumatic injury at the site of the lesions. Fungal cultures of samples taken from the abscesses, scales, and crusts of the lesions yielded white, later grayish brown, fluffy surfaced colonies. Partial sequencing of the β-tubulin gene confirmed the species of the isolate. The patient was initially treated with oral voriconazole and local hyperthermia, but experienced hepatic injury 2 weeks later. His treatment was changed to itraconazole (ITC) and local hyperthermia, followed by a combination of ITC and terbinafine. The patient recovered completely during the 12-month course of treatment.

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Acknowledgements

The authors thank Dr. Tetsuhiro Toga at Nihon Nohyaku Co., Ltd., Japan, for the determination of minimal inhibitory concentrations of antimycotics on the fungal strains. This study was partially supported by the Research Program on Emerging and Re-emerging Infectious Diseases from Japan Agency for Medical Research and Development, AMED.

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Correspondence to Takashi Mochizuki.

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Sakata, Y., Taga, F., Ushigami, T. et al. A Case of Cutaneous Mycosis Caused by Scedosporium dehoogii on an Immunocompromised Patient. Mycopathologia 183, 465–470 (2018). https://doi.org/10.1007/s11046-017-0198-5

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  • DOI: https://doi.org/10.1007/s11046-017-0198-5

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