A Case of Paecilomyces lilacinus Infection Occurring in Necrotizing Fasciitis-associated Skin Ulcers on the Face and Surrounding a Tracheotomy Stoma
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- Nagamoto Eiko
- Department of Dermatology and Plastic Surgery, Kumamoto University School of Medicine
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- Fujisawa Akihiko
- Department of Dermatology, Japanese Red Cross Kumamoto Hospital
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- Yoshino Yuichiro
- Department of Dermatology, Japanese Red Cross Kumamoto Hospital
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- Yoshitsugu Kanako
- Department of Internal Medicine, Japanese Red Cross Kumamoto Hospital
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- Odo Masashi
- Department of Internal Medicine, Japanese Red Cross Kumamoto Hospital
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- Watanabe Hidetaka
- Department of Plastic and Reconstructive Surgery, Japanese Red Cross Kumamoto Hospital
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- Igata Toshikatsu
- Department of Dermatology and Plastic Surgery, Kumamoto University School of Medicine
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- Noguchi Hiromitsu
- Noguchi Dermatological Clinic
書誌事項
- タイトル別名
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- A Case of <I>Paecilomyces lilacinus</I> Infection Occurring in Necrotizing Fasciitis-associated Skin Ulcers on the Face and Surrounding a Tracheotomy Stoma
この論文をさがす
抄録
A 28-year-old man undergoing treatment for hemophagocytic syndrome developed Paecilomyces lilacinus infection in skin ulcers on the face and in the tracheotomy stoma. While his bone marrow was suppressed by chemotherapy with dexamethasone, cyclosporin and etoposide for hemophagocytic syndrome, dental infection led to subacute necrotizing fasciitis caused by Pseudomonas aeruginosa on the right side of the face, resulting in a large area of soft tissue defects. Etoposide was discontinued, and prophylactic treatment with itraconazole was initiated. The ulcers resulting from necrotizing fasciitis were treated conservatively using trafermin and alprostadil alfadex ointment 0.003 %, and near-complete re-epithelialization occurred, except on the right lower eyelid, right buccal mucosa and perioral area. However, 6 weeks later, pustules/crusts started to form and break down repeatedly, leading to expansion of tissue defects on the face. Direct microscopic examination revealed fungal elements, and fungal culture identified Paecilomyces lilacinus suspicious twice some other day. Based on DNA extraction from the isolated fungus, this fungal strain was identified as Paecilomyces lilacinus. Cyclosporin and itraconazole were discontinued, and treatment with liposomal amphotericin B and a tapering dose of steroids was initiated. Cure was achieved in approximately 2.5 months after treatment initiation, and no relapse has been observed. The most important factor that ultimately contributed to the resolution of fungal infection might have been release of immunosuppression by discontinuing cyclosporin and tapering steroids.
収録刊行物
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- Medical Mycology Journal
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Medical Mycology Journal 55 (1), E21-E27, 2014
日本医真菌学会
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詳細情報 詳細情報について
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- CRID
- 1390001205397751168
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- NII論文ID
- 130003397213
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- NII書誌ID
- AA12518136
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- ISSN
- 2186165X
- 18820476
- 21856486
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- NDL書誌ID
- 025196990
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- PubMed
- 24682094
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可