Exophiala dermatitidis Fungemia Diagnosed Using Time-of-flight Mass Spectrometry during Chemotherapy for Malignant Lymphoma and Successful Treatment with Voriconazole

Intern Med. 2019 Aug 1;58(15):2219-2224. doi: 10.2169/internalmedicine.2082-18. Epub 2019 Apr 17.

Abstract

Infectious diseases, including those caused by fungi, remain important issues in patients receiving malignant lymphoma chemotherapy. We herein report a rare case of Exophiala dermatitidis fungemia during chemotherapy in a 67-year-old woman admitted to our hospital. She had a fever that could not be resolved despite antifungal therapy. Yeast-like fungi were detected in blood culture samples, but biochemical identification was difficult. E. dermatitidis, a black mold, was identified using time-of-flight mass spectrometry. The patient finally improved after her treatment was switched to voriconazole. Fungal infection is difficult to diagnose and treat, but this novel approach can improve patients' outcomes.

Keywords: (2 to 6): malignant lymphoma; Exophiala dermatitidis; mass spectrometry; voriconazole.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antifungal Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Exophiala*
  • Female
  • Fungemia / complications
  • Fungemia / diagnosis
  • Fungemia / drug therapy*
  • Humans
  • Lymphoma / complications
  • Lymphoma / drug therapy*
  • Mass Spectrometry
  • Voriconazole / therapeutic use*

Substances

  • Antifungal Agents
  • Voriconazole