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Feohifomicosis subcutánea en un paciente trasplantado renal / Subcutaneous pheohyphomycosis in a renal transplanted patient
Borroto Díaz, Gerardo; Henríquez Zschercher, Fernando; Guerrero Díaz, Carlos; Cairo Baez, José; Arteaga Hernández, Ernesto.
  • Borroto Díaz, Gerardo; Hospital Clinicoquirúrgico Hermanos Ameijeiras. La Habana. CU
  • Henríquez Zschercher, Fernando; Hospital Clinicoquirúrgico Hermanos Ameijeiras. La Habana. CU
  • Guerrero Díaz, Carlos; Hospital Clinicoquirúrgico Hermanos Ameijeiras. La Habana. CU
  • Cairo Baez, José; Hospital Clinicoquirúrgico Hermanos Ameijeiras. La Habana. CU
  • Arteaga Hernández, Ernesto; Hospital Clinicoquirúrgico Hermanos Ameijeiras. La Habana. CU
Rev. cuba. med ; 51(4): 336-343, oct.-dic. 2012.
Article in Spanish | LILACS | ID: lil-662296
Responsible library: CU1.1
RESUMEN
La feohifomicosis es una entidad poco frecuente causada por hongos formadores de hifas de la familia Dematiaceae, afecta principalmente a pacientes inmunosuprimidos, produce lesiones subcutáneas en forma de quistes y pseudoquistes que en su mayoría se tratan con la exéresis quirúrgica y tratamiento medicamentoso con anfotericin B e itraconazol. Se describió un caso de feohifomicosis, en un paciente masculino de 38 años de edad, con antecedentes de enfermedad renal crónica, hepatitis por virus C adquirida en hemodiálisis. Recibe trasplante renal en el 2010 y se le aplica triple terapia inmunosupresora, tacrolimus, micofenolato mofetil y prednisona. Desarrolla diabetes mellitus postrasplante. Un año después del injerto, comienza a presentar lesiones dermatológicas pseudoquísticas violáceas, solitarias, que forman conglomerados, en la pantorrilla, el tobillo y los dedos de ambos pies. Mediante examen clínico, micológico y por biopsia de la lesión se diagnostica feohifomicosis. Se realizó tratamiento quirúrgico con exéresis de las lesiones y medicamentoso con itraconazol 200 mg al día, se modificó el tratamiento inmunosupresor según interacción del itraconazol con los anticalcineurínicos, se sustituyó este por everolimus. Tres meses después se observó evolución satisfactoria
ABSTRACT
Pheohyphomycosis is a rare disease caused by Dematiaceae family hypha-forming fungi; it mainly affects immunosuppresed patients and causes subcutaneous lesions in the form of cysts and pseudocysts that are mostly treated with surgery and amphotericin B and Itraconazol-based treatment. A case of pheohyphomycosis was presented in a 38 years-old man with a history of chronic renal disease and of hepatitis C caught in hemodialysis. He was a renal transplant recipient in 2010 and was administered a triple immunosuppressive treatment with tacrolimus, mycophenolate mophetil and prednisone. He developed post-transplant diabetes mellitus and one year after the transplantation, he presented with purplish blue-colored pseudocystic dermatological lesions forming clusters in his calves, ankles and toes. The clinical, mycological and biopsy exams of the lesions yielded the diagnosis of pheohyphomycosis. The lesions were surgically removed and then 200mg of itraconazol was administered daily. This treatment was changed on account of the interaction between itraconazol and the anti-calcineuric drugs. The patient was then prescribed everolimus. Three months later, the patient recovered satisfactorily
Subject(s)

Full text: Available Index: LILACS (Americas) Main subject: Kidney Transplantation / Itraconazole / Phaeohyphomycosis Type of study: Case report Limits: Humans / Male Language: Spanish Journal: Rev. cuba. med Journal subject: Medicine Year: 2012 Type: Article Affiliation country: Cuba Institution/Affiliation country: Hospital Clinicoquirúrgico Hermanos Ameijeiras/CU
Full text: Available Index: LILACS (Americas) Main subject: Kidney Transplantation / Itraconazole / Phaeohyphomycosis Type of study: Case report Limits: Humans / Male Language: Spanish Journal: Rev. cuba. med Journal subject: Medicine Year: 2012 Type: Article Affiliation country: Cuba Institution/Affiliation country: Hospital Clinicoquirúrgico Hermanos Ameijeiras/CU