Exophiala dermatitidis pneumonia successfully treated with long-term itraconazole therapy

J Infect Chemother. 2014 Jul;20(7):446-9. doi: 10.1016/j.jiac.2014.02.006. Epub 2014 Apr 22.

Abstract

Exophiala dermatitidis pneumonia is extremely rare. Here we report a case of E. dermatitidis pneumonia successfully treated with long-term itraconazole therapy. A 63-year-old woman without a remarkable medical history developed a dry and chest pain. Chest radiographs revealed consolidation in the middle lobe of the lung. Cytologic examination by bronchoscopy showed filamentous fungi and E. dermatitidis was detected in the bronchoalveolar lavage fluid. After 5 months of itraconazole therapy, her symptoms improved and the area of consolidation diminished. Two weeks after discontinuing the itraconazole therapy, the area of consolidation reappeared. Itraconazole therapy was restarted and continued for 7 months. The abnormal shadow observed on the chest X-ray gradually diminished. Over a 27-month follow-up with periodic examination, there was no relapse and the patient had a favorable clinical course.

Keywords: Bronchoalveolar lavage; Bronchoscope; Brushing cytology; Exophiala dermatitidis; Itraconazole; Pneumonia.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Exophiala / isolation & purification*
  • Female
  • Humans
  • Itraconazole / therapeutic use*
  • Middle Aged
  • Phaeohyphomycosis / drug therapy*
  • Phaeohyphomycosis / microbiology
  • Pneumonia / drug therapy*
  • Pneumonia / microbiology

Substances

  • Antifungal Agents
  • Itraconazole