Eumycetoma of the hand caused by Leptosphaeria tompkinsii and refractory to medical therapy with voriconazole
Eumycetoma of the hand caused by Leptosphaeria tompkinsii and refractory to medical therapy with voriconazole
We report on the first case of eumycetoma caused by the organism Leptosphaeria tompkinsii to be diagnosed and possibly acquired within the United Kingdom. Conventional culture of fungal grains and surgical tissue specimens was negative and the diagnosis was achieved using panfungal polymerase chain reaction and sequencing technology. Despite limited surgical resection and prolonged antifungal therapy with voriconazole, the patient developed progressive disease with mycetoma bone involvement. This case highlights the usefulness of molecular diagnostic techniques in eumycetoma where organisms may fail to grow with conventional culture or be difficult to identify morphologically. It also reminds us that eumycetoma is a difficult infection to treat and despite optimism regarding the efficacy of the newer triazole antifungals in this condition, treatment failures may still occur.
leptosphaeria tompkinsii, eumycetoma, imported infection, panfungal PCR, voriconazole, treatment failure
311-315
Cartwright, Katharine E.
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Clark, Tristan W.
712ec18e-613c-45df-a013-c8a22834e14f
Hussain, Abid M.
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Wiselka, Martin
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Borman, Andrew
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Johnson, Elizabeth M.
72e301c1-5764-4e3f-ba52-fe1fa4a04309
October 2011
Cartwright, Katharine E.
dd6e6856-5e26-4387-b8f2-7742472da5fa
Clark, Tristan W.
712ec18e-613c-45df-a013-c8a22834e14f
Hussain, Abid M.
66591da2-997c-4328-9103-2973c6877fcf
Wiselka, Martin
8d98fe1b-b442-42ab-9c1a-87372d37ce43
Borman, Andrew
4a203203-514f-4f2a-8a3b-2308c2eeb529
Johnson, Elizabeth M.
72e301c1-5764-4e3f-ba52-fe1fa4a04309
Cartwright, Katharine E., Clark, Tristan W., Hussain, Abid M., Wiselka, Martin, Borman, Andrew and Johnson, Elizabeth M.
(2011)
Eumycetoma of the hand caused by Leptosphaeria tompkinsii and refractory to medical therapy with voriconazole.
Mycopathologia, 172 (4), .
(doi:10.1007/s11046-011-9432-8).
(PMID:21567225)
Abstract
We report on the first case of eumycetoma caused by the organism Leptosphaeria tompkinsii to be diagnosed and possibly acquired within the United Kingdom. Conventional culture of fungal grains and surgical tissue specimens was negative and the diagnosis was achieved using panfungal polymerase chain reaction and sequencing technology. Despite limited surgical resection and prolonged antifungal therapy with voriconazole, the patient developed progressive disease with mycetoma bone involvement. This case highlights the usefulness of molecular diagnostic techniques in eumycetoma where organisms may fail to grow with conventional culture or be difficult to identify morphologically. It also reminds us that eumycetoma is a difficult infection to treat and despite optimism regarding the efficacy of the newer triazole antifungals in this condition, treatment failures may still occur.
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Accepted/In Press date: 28 April 2011
e-pub ahead of print date: 13 May 2011
Published date: October 2011
Keywords:
leptosphaeria tompkinsii, eumycetoma, imported infection, panfungal PCR, voriconazole, treatment failure
Organisations:
Clinical & Experimental Sciences
Identifiers
Local EPrints ID: 386401
URI: http://eprints.soton.ac.uk/id/eprint/386401
ISSN: 0301-486X
PURE UUID: 0adb5b61-712b-412f-8acc-532c7219b7f9
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Date deposited: 01 Feb 2016 12:27
Last modified: 15 Mar 2024 03:49
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Contributors
Author:
Katharine E. Cartwright
Author:
Abid M. Hussain
Author:
Martin Wiselka
Author:
Andrew Borman
Author:
Elizabeth M. Johnson
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