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

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18 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 languageEnglish (US)
Pages (from-to)789-791
Number of pages3
JournalBone marrow transplantation
Volume20
Issue number9
DOIs
StatePublished - Nov 1 1997

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Keywords

  • Chromoblastomycoses
  • Fungus
  • Phialophora

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Lundstrom, T. S., Fairfax, M. R., Dugan, M. C., Vazquez, J. A., Chandrasekar, P. H., Abella, E., & Kasten-Sportes, C. (1997). Case report: Phialophora verrucosa infection in a BMT patient. Bone marrow transplantation, 20(9), 789-791. https://doi.org/10.1038/sj.bmt.1700969