Disseminating infection withScytalidium dimidiatum in a granulocytopenic child

  • C. A. Benne
  • C. Neeleman
  • M. Bruin
  • G. S. de Hoog
  • A. Fleer


A 13-year-old Moroccan boy in The Netherlands developed fever and a lesion resembling ecthyma gangrenosum on the abdomen during cytostatic drug treatment for a lymphoblastic B-cell lymphoma.Scytalidium dimidiatum was cultured from blood and the abdominal skin lesion. The patient was successfully treated with amphotericin B. The fungusScytalidium dimidiatum is a fairly common plant pathogen in tropical and subtropical countries and is known to cause dermatomycoses in humans in these areas. This case demonstrates that it is necessary to be aware that immigrants from these areas can import their own fungal flora, some members of which may cause life-threatening disease in the case of patients with immune suppression.


Lymphoma Drug Treatment Amphotericin Skin Lesion Plant Pathogen 
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  1. 1.
    Hawkins C, Amstrong D: Fungal infections in the immunocompromised host. Clinics in Haematology 1984, 13: 599–630.PubMedGoogle Scholar
  2. 2.
    Gold JWM: Opportunistic fungal infections in patients with neoplastic disease. American Journal of Medicine 1984, 76: 458–463.CrossRefPubMedGoogle Scholar
  3. 3.
    Whimbey E, Gold JWM, Polsky B, Dryansky J, Hawkins C, Blevins A, Brannon P, Kiehn TE, Amstrong D: Bacteremia and fungemia in patients with the acquired immune deficiency syndrome. Annals of Internal Medicine 1986, 104: 511–514.PubMedGoogle Scholar
  4. 4.
    Bodey GP: The emergence of fungi as major hospital infections. Journal of Hospital Infection 1988, 11, Supplement A: 411–426.CrossRefPubMedGoogle Scholar
  5. 5.
    Horn R, Wong B, Kiehn TE, Amstrong D: Fungemia in a cancer hospital: changing frequencies, earlier onset, and results of therapy. Reviews of Infectious Diseases 1985, 7: 646–655.PubMedGoogle Scholar
  6. 6.
    Anaissie E: Emerging fungal pathogens. European Journal of Clinical Microbiology and Infectious Diseases 1989, 8: 323–330.Google Scholar
  7. 7.
    Anaissie E, Bodey GP, Kantarjian H, Ro J, Vartivarian SH, Hopfer R, Hoy J, Rolston K: New spectrum of fungal disease in patients with cancer. Reviews of Infectious Diseases 1989, 11: 369–378.PubMedGoogle Scholar
  8. 8.
    Campbell CK, Aziz K, Abdel-Aziz AHM, Hodgson C: Fungal infections of skin and nails byHendersonula toruloidea. British Journal of Dermatology 1973, 89: 45–52.PubMedGoogle Scholar
  9. 9.
    Müller-Weihreich S, Hensen G, Langermann HJ, Oberwald-Reihm HM: Kindliche B-Zell Lymfome und Leukemien. Verbesserung der Prognose durch eine für B-Neoplasien konzipierte Therapie der BFM Studiengruppe. Onkologie 1984, 7: 205–208.PubMedGoogle Scholar
  10. 10.
    Campbell CK: Studies onHendersonula toruloidea isolated from skin and nail. Sabouraudia 1971, 12: 150–156.Google Scholar
  11. 11.
    Nattrass RM: A new species ofHendersonula (H. toruloidea) on deciduous trees in Egypt. Transactions of the British Mycology Society 1933, 18: 189–198.Google Scholar
  12. 12.
    Sutton BC, Dyko BJ: Revision ofHendersonula. Mycology Research 1989, 93: 466–488.Google Scholar
  13. 13.
    Gentles JC, Evans EGV: Infection of the feet and nails withHendersonula toruloidea. Sabouraudia 1970, 8: 72–75.PubMedGoogle Scholar
  14. 14.
    Carruthers JA, Stein L, Black WA: Persistent skin and nail infection by an exotic fungus,Hendersonula toruloidea. Canadian Medical Association Journal 1982, 127: 608.PubMedGoogle Scholar
  15. 15.
    Ho Ping Kong B, Kapica L, Lee R: Keratin invasion byHendersonula toruloidea, a tropical pathogenic fungus resistant to therapy. International Journal of Dermatology 1984, 23: 65–66.PubMedGoogle Scholar
  16. 16.
    Hay RJ, Moore MK: Clinical features of superficial fungal infections caused byHendersonula toruloidea andScytalidium hyalinum. British Journal of Dermatology 1984, 110: 677–683.PubMedGoogle Scholar
  17. 17.
    Moore MK:Hendersonula toruloidea andScytalidium hyalinum infections in London, England. Journal of Medical Veterinary Mycology 1986, 24: 219–230.PubMedGoogle Scholar
  18. 18.
    Frankel DM, Rippon JW:Hendersonula toruloidea infection in man. Index cases in the non-endemic North American host and a review of the literature. Mycopathologia 1989, 105: 175–186.CrossRefPubMedGoogle Scholar
  19. 19.
    Mariat F, Liautaud B, Liautaud M, Marill FG:Hendersonula toruloidea, agent d'une dermatite verruqueuse mycosique observée en Algérie. Sabouraudia 1978, 16: 133–140.PubMedGoogle Scholar
  20. 20.
    Drouhet E, Drouhet B: Laboratory and clinical assessment of ketoconazole in deep-seated mycoses. American Journal of Medicine 1983, 74: 30–47.CrossRefGoogle Scholar
  21. 21.
    Meunier F: Fungal infections in the compromised host. In: Rubin RH, Young LS (ed): Clinical approach to infection in the immunocompromised host. Plenum, New York, 1988, p. 193–220.Google Scholar
  22. 22.
    Fine JD, Miller JA, Harrist TJ, Haynes HA: Cutaneous lesions in disseminated candidiasis mimicking ecthyma gangrenosum. American Journal of Medicine 1981, 70: 1133–1135.CrossRefPubMedGoogle Scholar
  23. 23.
    Greene SL, Su WP, Muller SA: Ecthyma gangrenosum: report of clinical, histopathologic and bacterial aspects of eight cases. Journal of American Academy of Dermatology 1984, 11: 781–787.Google Scholar
  24. 24.
    Huminer D, Siegman-Igra Y, Morduchowicz G, Pitlik SD: Ecthyma gangrenosum without bacteremia. Report of six cases and a review of the literature. Archives of Internal Medicine 1987, 147: 299–301.CrossRefPubMedGoogle Scholar

Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1993

Authors and Affiliations

  • C. A. Benne
    • 1
  • C. Neeleman
    • 2
  • M. Bruin
    • 3
  • G. S. de Hoog
    • 4
    • 5
  • A. Fleer
    • 1
  1. 1.Department of Medical MicrobiologyWilhelmina University Children's HospitalUtrechtThe Netherlands
  2. 2.Department of General PediatricsWilhelmina University Children's HospitalUtrechtThe Netherlands
  3. 3.Department of Oncology and HematologyWilhelmina University Children's HospitalUtrechtThe Netherlands
  4. 4.Centraalbureau voor SchimmelculturesBaarnThe Netherlands
  5. 5.Department of Molecular Cell BiologyUniversity of AmsterdamAmsterdamThe Netherlands

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