A Case of Lumbar Vertebral Osteomyelitis Caused by Aspergillus fumigatus / 감염

Aspergillus fumigatus is the most common pathogen causing invasive aspergillosis. Although invasive aspergillosis mainly involves lung, brain, and sinus, Aspergillus fumigatus osteomyelitis of the spine has been reported very rarely. We experienced a case of vertebral Aspergillus osteomyelitis and report it with a review. A 70-year-old women was admitted due to progressive lower back pain, which had begun 1 month before admission. Although she had diabetes and hypertension, no other underlying disease or immune dysfunction was found. MRI of spine showed severely destroyeded lumbar spines. Debridement and bone graft was done for correction of unstable spine, and Aspergillus fumigatus was grown from surgical specimen. Amphotericin B was given up to total 2 g, and was switched to oral itraconazole maintenance therapy. She is well until now, 120 days after operation. On the other hand, anthracofibrosis due to Mycobacterium tuberculosis was found through bronchoscopic study, which was done because of atelectasis in left lower lobe of lung. Therefore she was treated with anti-tuberculous agents also.

Chromoblastomycosis Treated with Occlusive Dressing of Amphotericin B Cream / 대한의진균학회지

We report a case of chromoblastomycosis in a 65 year-old woman. She had a 3x4 cm sized, annular, erythematous, plaque with crusts and ulcers on the right lower arm. The lesion had grown slowly for 2 years. In fungal and histopathologic examinations, several muriform cells were found in dermis as well as in scales and crusts on the lesional skin surface. Isolated fungus was identified as Fonsecaea pedrosoi. We treated the patient occlusive dressing of amphotericin B (3%) ointment for 8 weeks and achieved a good response without any evidence of recurrence. We propose that the occlusive dressing therapy of amphotericin B cream is a good modality among the various treatments of small localized chromoblastomycosis.