Case report: Phialophora verrucosa infection in a BMT patient

T. S. Lundstrom; M. R. Fairfax; M. C. Dugan; J. A. Vazquez; P. H. Chandrasekar; E. Abella; C. Kasten-Sportes

doi:10.1038/sj.bmt.1700969

Case report: Phialophora verrucosa infection in a BMT patient

T. S. Lundstrom, M. R. Fairfax, M. C. Dugan, J. A. Vazquez, P. H. Chandrasekar, E. Abella, C. Kasten-Sportes

Research output: Contribution to journal › Article › peer-review

20 Scopus citations

Abstract

Phialophora is a dematiaceous fungus isolated from soil and wood. Human infections including chromoblastomycosis, mycotic keratitis, cutaneous infections, and prosthetic valve endocarditis have been reported. We report a case of fatal hemorrhage due to Phialophora verrucosa in a patient with prolonged neutropenia undergoing autologous bone marrow transplant (BMT) for acute myelogenous leukemia (AML). Bacterial infections complicated induction and consolidation chemotherapies. Liposomal amphotericin B (LAMB) was given from day + 33 to day + 72 for febrile neutropenia. Death occurred on day + 74 due to tracheal hemorrhage. Autopsy revealed granulation tissue on the posterior wall of the trachea with fungal hyphae on histopathology; the tissue grew Phialophora verrucosa. In vitro susceptibility studies revealed a minimum inhibitory concentration to AmB of 0.1 μg/ml. This represents the first reported case of invasive P. verrucosa in a BMT patient leading to fatal hemorrhage, despite large cumulative doses of LAMB to which the organism remained susceptible.

Original language	English (US)
Pages (from-to)	789-791
Number of pages	3
Journal	Bone marrow transplantation
Volume	20
Issue number	9
DOIs	https://doi.org/10.1038/sj.bmt.1700969
State	Published - Nov 1 1997
Externally published	Yes

Keywords

Chromoblastomycoses
Fungus
Phialophora

ASJC Scopus subject areas

Hematology
Transplantation

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10.1038/sj.bmt.1700969

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title = "Case report: Phialophora verrucosa infection in a BMT patient",

abstract = "Phialophora is a dematiaceous fungus isolated from soil and wood. Human infections including chromoblastomycosis, mycotic keratitis, cutaneous infections, and prosthetic valve endocarditis have been reported. We report a case of fatal hemorrhage due to Phialophora verrucosa in a patient with prolonged neutropenia undergoing autologous bone marrow transplant (BMT) for acute myelogenous leukemia (AML). Bacterial infections complicated induction and consolidation chemotherapies. Liposomal amphotericin B (LAMB) was given from day + 33 to day + 72 for febrile neutropenia. Death occurred on day + 74 due to tracheal hemorrhage. Autopsy revealed granulation tissue on the posterior wall of the trachea with fungal hyphae on histopathology; the tissue grew Phialophora verrucosa. In vitro susceptibility studies revealed a minimum inhibitory concentration to AmB of 0.1 μg/ml. This represents the first reported case of invasive P. verrucosa in a BMT patient leading to fatal hemorrhage, despite large cumulative doses of LAMB to which the organism remained susceptible.",

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author = "Lundstrom, {T. S.} and Fairfax, {M. R.} and Dugan, {M. C.} and Vazquez, {J. A.} and Chandrasekar, {P. H.} and E. Abella and C. Kasten-Sportes",

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AU - Lundstrom, T. S.

AU - Fairfax, M. R.

AU - Dugan, M. C.

AU - Vazquez, J. A.

AU - Chandrasekar, P. H.

AU - Abella, E.

AU - Kasten-Sportes, C.

PY - 1997/11/1

Y1 - 1997/11/1

N2 - Phialophora is a dematiaceous fungus isolated from soil and wood. Human infections including chromoblastomycosis, mycotic keratitis, cutaneous infections, and prosthetic valve endocarditis have been reported. We report a case of fatal hemorrhage due to Phialophora verrucosa in a patient with prolonged neutropenia undergoing autologous bone marrow transplant (BMT) for acute myelogenous leukemia (AML). Bacterial infections complicated induction and consolidation chemotherapies. Liposomal amphotericin B (LAMB) was given from day + 33 to day + 72 for febrile neutropenia. Death occurred on day + 74 due to tracheal hemorrhage. Autopsy revealed granulation tissue on the posterior wall of the trachea with fungal hyphae on histopathology; the tissue grew Phialophora verrucosa. In vitro susceptibility studies revealed a minimum inhibitory concentration to AmB of 0.1 μg/ml. This represents the first reported case of invasive P. verrucosa in a BMT patient leading to fatal hemorrhage, despite large cumulative doses of LAMB to which the organism remained susceptible.

AB - Phialophora is a dematiaceous fungus isolated from soil and wood. Human infections including chromoblastomycosis, mycotic keratitis, cutaneous infections, and prosthetic valve endocarditis have been reported. We report a case of fatal hemorrhage due to Phialophora verrucosa in a patient with prolonged neutropenia undergoing autologous bone marrow transplant (BMT) for acute myelogenous leukemia (AML). Bacterial infections complicated induction and consolidation chemotherapies. Liposomal amphotericin B (LAMB) was given from day + 33 to day + 72 for febrile neutropenia. Death occurred on day + 74 due to tracheal hemorrhage. Autopsy revealed granulation tissue on the posterior wall of the trachea with fungal hyphae on histopathology; the tissue grew Phialophora verrucosa. In vitro susceptibility studies revealed a minimum inhibitory concentration to AmB of 0.1 μg/ml. This represents the first reported case of invasive P. verrucosa in a BMT patient leading to fatal hemorrhage, despite large cumulative doses of LAMB to which the organism remained susceptible.

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Case report: Phialophora verrucosa infection in a BMT patient

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