Exophiala dermatitidis pneumonia with bronchiectasis required prolonged voriconazole treatment

Abstract 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...

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Bibliographic Details
Main Authors: Ryo Sekiguchi, Naohisa Urabe, Susumu Sakamoto, Masakazu Sasaki, Sakae Homma, Kazuma Kishi
Format: Article
Language:English
Published: Wiley 2021-06-01
Series:Respirology Case Reports
Subjects:
Online Access:https://doi.org/10.1002/rcr2.783
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Summary:Abstract 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.
ISSN:2051-3380