NOCARDIA BEIJINGENSIS PSOAS ABSCESS AND SUBCUTANEOUS PHAEOHYPHOMYCOSIS CAUSED BY PHAEOACREMONIUM PARASITICUM IN A RENAL TRANSPLANT RECIPIENT: THE FIRST CASE REPORT IN THAILAND

Southeast Asian J Trop Med Public Health. 2015 Nov;46(6):1049-54.

Abstract

We describe the first case of a psoas muscle abscess caused by Nocardia beijingensis and subcutaneous phaeohyphomycosis caused by Phaeoacremonium parasiticum in a renal transplant recipient. The patient was treated for nocardiosis with percutaneous drainage and intravenous trimethoprim/sulfamethoxazole (TMP/SMX) combined with imipenem for 2 weeks, followed by a 4-week course of intravenous TMP/SMX and then oral TMP/SMX. During hospitalization for the psoas muscle abscess the patient developed cellulitis with subcutaneous nodules of his right leg. Skin biopsy and cultures revealed a dematiaceous mold, subsequently identified as P. parasiticum by DNA sequencing. The subcutaneous phaeohyphomycosis was treated with surgical drainage and liposomal amphotericin B for 4 weeks followed by a combination of itraconazole and terbinafine. The patient gradually improved and was discharged home after 18 weeks of hospitalization.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amphotericin B / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • Drainage
  • Graft Rejection / prevention & control*
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Itraconazole / therapeutic use
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Nocardia
  • Nocardia Infections / etiology*
  • Nocardia Infections / therapy
  • Opportunistic Infections / etiology*
  • Phaeohyphomycosis / etiology*
  • Phaeohyphomycosis / therapy
  • Psoas Abscess / etiology*
  • Psoas Abscess / therapy
  • Thailand
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents
  • Immunosuppressive Agents
  • liposomal amphotericin B
  • Itraconazole
  • Amphotericin B
  • Trimethoprim, Sulfamethoxazole Drug Combination