Intricate isavuconazole therapy of a subcutaneous nodule caused by Alternaria infectoria in a heart transplant recipient

J Mycol Med. 2022 May;32(2):101235. doi: 10.1016/j.mycmed.2021.101235. Epub 2021 Dec 16.

Abstract

Invasive fungal infections have appeared to be increasingly emergent in immunocompromised patients, especially in solid organ transplant (SOT) recipients. The Alternaria genus encompasses more than 80 dematiaceus species. Among them, Alternaria alternata and Alternaria infectoria are the most frequent isolated as responsible for infection in humans. To our knowledge, we report the first case of a heart transplant recipient suffering from subcutaneous nodule caused by Alternaria infectoria and who was treated with isavuconazole. Despite all the promises of this new azole drug, one should keep in mind the potential great variability of the inter-individual responses for such complex patients. We demonstrate herein how it can be challenging to manage Alternaria infection in SOT recipients. More comprehensive studies and recommendations are expected in the context of Alternaria infections.

Keywords: Alternaria; Alternariosis; Antifungal agents; Isavuconazole; Terbinafine.

Publication types

  • Case Reports

MeSH terms

  • Alternaria*
  • Antifungal Agents / therapeutic use
  • Heart Transplantation* / adverse effects
  • Humans
  • Nitriles
  • Pyridines
  • Triazoles

Substances

  • Antifungal Agents
  • Nitriles
  • Pyridines
  • Triazoles
  • isavuconazole

Supplementary concepts

  • Alternaria infectoria