Exophiala dermatitidis pneumonia with bronchiectasis required prolonged voriconazole treatment.
Ryo SekiguchiNaohisa UrabeSusumu SakamotoMasakazu SasakiSakae HommaKazuma KishiPublished in: Respirology case reports (2021)
Exophiala dermatitidis is a black fungus that rarely causes respiratory infection. We report a case of E. dermatitidis pneumonia with bronchiectasis that relapsed after 11 months of voriconazole (VRCZ) treatment in a rheumatoid arthritis (RA) patient with bronchiectasis. A 65-year-old woman with RA and abnormal findings on chest radiography was referred for assessment of chronic cough and increased sputum production. She underwent bronchoscopy, and E. dermatitidis was identified from bronchoalveolar lavage fluid (BALF). Exophiala dermatitidis chronic lower respiratory tract infection and pneumonia were diagnosed. Although her condition improved after 11 months of VRCZ treatment, chest computed tomography (CT) images showed worsening at five months after the cessation of VRCZ treatment and E. dermatitidis was again detected in BALF. Re-administration of VRCZ for two years improved symptoms and chest CT images, and her condition is currently stable. In patients with bronchiectasis, E. dermatitidis pneumonia might require prolonged antifungal treatment.
Keyphrases
- rheumatoid arthritis
- computed tomography
- cystic fibrosis
- depressive symptoms
- machine learning
- combination therapy
- deep learning
- positron emission tomography
- disease activity
- intensive care unit
- magnetic resonance
- replacement therapy
- ankylosing spondylitis
- systemic lupus erythematosus
- diffuse large b cell lymphoma
- systemic sclerosis
- idiopathic pulmonary fibrosis
- interstitial lung disease
- community acquired pneumonia
- hodgkin lymphoma