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Abstract
The genus Alternaria contains several species of melanized hypomycetes that cause opportunistic human infections. The most frequent clinical manifestations of alternariosis are cutaneous and subcutaneous infections, followed by oculomycosis, invasive and non-invasive rhinosinusitis, and onychomycosis. So far, only 17 cases of rhinosinusitis caused by Alternaria species have been reported since 1977. Although several domestic cases of cutaneous alternariosis have been reported, there is no report of Alternaria rhinosinusitis in Korea. The majority of Alternaria rhinosinusitis involves immunocompromised patients. We report the first case of alternariosis in a patient with neutropenia and myelodysplastic syndrome that was treated with endoscopic debridement and a conventional antifungal agent.
Figures and Tables
Figure 1
Anterior portion of uncinate process shows dark-colored crust formation in rhinoscopy during routine medical checkup before stem cell transplantation.
References
1. Pfaller MA, Pappas PG, Wingard JR. Invasive fungal pathogens: current epidemiologic trends. Clin Infect Dis. 2006. 43:Suppl 1. S3–S14.
2. Ajello L, Georg LK, Steigbigel RT, Wang CJ. A case of phaeohyphomycosis caused by a new species of Phialophora. Mycologia. 1974. 66:490–498.
3. Pastor FJ, Guarro J. Alternaria infections: laboratory diagnosis and relevant clinical features. Clin Microbiol Infect. 2008. 14:734–746.
4. Chang JY, Lee JH, Lee KH. A case of cutaneous alternariosis in liver transplant patient. Korean J Med Mycol. 2006. 11:159–162.
5. Rhee CH, Nam KH, Cho YS, Song KH, Yun SK, Kim HU. A case of cutaneous alternariosis treated with fluconazole. Korean J Med Mycol. 2010. 15:182–187.
6. Lee JC, Kim HY, Lee WJ, Lee SJ, Kim DW, Jun JB, Suh SB. A case of cutaneous alternariosis due to Alternaria alternata. Korean J Med Mycol. 2007. 12:27–30.
7. Bush RK, Prochnau JJ. Alternaria-induced asthma. J Allergy Clin Immunol. 2004. 113:227–234.
8. de Hoog GS, Horré R. Molecular taxonomy of the alternaria and Ulocladium species from humans and their identification in the routine laboratory. Mycoses. 2002. 45:259–276.
9. Ogawa H, Fujimura M, Amaike S, Matsumoto Y, Kitagawa M, Matsuda T. Eosinophilic pneumonia caused by Alternaria alternata. Allergy. 1997. 52:1005–1008.
10. Pant H, Kette FE, Smith WB, Wormald PJ, Macardle PJ. Fungal-specific humoral response in eosinophilic mucus chronic rhinosinusitis. Laryngoscope. 2005. 115:601–606.
11. Shugar MA, Montgomery WW, Hyslop NE Jr. Alternaria sinusitis. Ann Otol Rhinol Laryngol. 1981. 90:251–254.
12. Clancy CJ, Wingard JR, Hong Nguyen M. Subcutaneous phaeohyphomycosis in transplant recipients: review of the literature and demonstration of in vitro synergy between antifungal agents. Med Mycol. 2000. 38:169–175.
13. Garcia-Effron G, Gomez-Lopez A, Mellado E, Monzon A, Rodriguez-Tudela JL, Cuenca-Estrella M. In vitro activity of terbinafine against medically important non-dermatophyte species of filamentous fungi. J Antimicrob Chemother. 2004. 53:1086–1089.
14. Del Poeta M, Schell WA, Perfect JR. In vitro antifungal activity of pneumocandin L-743,872 against a variety of clinically important molds. Antimicrob Agents Chemother. 1997. 41:1835–1836.
15. Uchida K, Nishiyama Y, Yokota N, Yamaguchi H. In vitro antifungal activity of a novel lipopeptide antifungal agent, FK463, against various fungal pathogens. J Antibiot (Tokyo). 2000. 53:1175–1181.
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