Phaeohyphomycosis from Exophiala jeanselmei with Concomitant Nocardia asteroides Infection in a Renal Transplant Recipient: Case Report and Review of the Literature |
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Authors: | Dr. Kathleen E. Sartoris Pharm.D. Dr. G. Mark Baillie Pharm.D. MHA Dr. Rosemary Tiernan M.D. Dr. P. R. Rajagopalan M.D. |
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Affiliation: | 1. Department of Clinical Pharmacy, Medical University of South Carolina, Charleston, South Carolina;2. Department of Medicine, Medical University of South Carolina, Charleston, South Carolina;3. Department of Surgery, Medical University of South Carolina, Charleston, South Carolina |
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Abstract: | A 59-year-old black man who received a cadaveric renal transplant 15 months earlier developed subcutaneous nodules on his right upper extremity that were identified as phaeohyphomycosis caused by Exophiala jeanselmei. The man was admitted 4 weeks later with a swollen left arm and had Nocardia asteroides in this area and in the apex of his left lung. He was treated with surgical excision, and itraconazole, imipenem-cilastatin, and trimethoprimsulfamethoxazole. With the potential presence of more than one microorganism in an immunocompromised patient, it is important to identify and differentiate them correctly to direct appropriate therapy. |
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