Exophiala: Difference between revisions
From IDWiki
Exophiala
Content deleted Content added
Initial page creation |
No edit summary |
||
| (7 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
== Background == |
|||
| ⚫ | |||
* Genus of dematiaceous filamentous fungi |
|||
| ⚫ | |||
== Clinical |
== Clinical Manifestations == |
||
* Primarily in immunosuppressed or eldery patients |
|||
* Causes cutaneous and subcutaneous infection most commonly |
|||
** Most commonly, cutaneous and subcutaneous infection, including [[phaeohyphomycosis]], [[chromoblastomycosis]], [[Fungal keratitis|keratitis]], and nail infections |
|||
* Also pneumonia, brain abscess, disseminated disease |
** Also pneumonia, brain abscess, disseminated disease |
||
* |
* [[Exophiala dermatitidis]] is neurotropic, with high mortality, and this can occur in immunocompetent (often Asian) patients |
||
* Known to colonize [[cystic fibrosis]] patients (3-20%) |
|||
== Diagnosis == |
== Diagnosis == |
||
| Line 15: | Line 19: | ||
== Management == |
== Management == |
||
* No validated clinical breakpoints to guide therapy |
|||
* [[Is treated by::Itraconazole]] or oral [[Is treated by::terbinafine]], alone or in combination |
* [[Is treated by::Itraconazole]] or oral [[Is treated by::terbinafine]], alone or in combination |
||
* [[Is treated by::Amphotericin B]] is also commonly used, and [[Is treated by::voriconazole]] also likely works |
* [[Is treated by::Amphotericin B]] is also commonly used, and [[Is treated by::voriconazole]] also likely works |
||
* Echinocandins are likely ineffective |
|||
{{DISPLAYTITLE:''Exophiala'' |
{{DISPLAYTITLE:''Exophiala''}} |
||
[[Category:Diatemaceous molds]] |
[[Category:Diatemaceous molds]] |
||
Latest revision as of 15:00, 22 April 2026
Background
- Genus of dematiaceous filamentous fungi
- Exophiala dermatitidis is the most clinically relevant "black yeast"
Clinical Manifestations
- Primarily in immunosuppressed or eldery patients
- Most commonly, cutaneous and subcutaneous infection, including phaeohyphomycosis, chromoblastomycosis, keratitis, and nail infections
- Also pneumonia, brain abscess, disseminated disease
- Exophiala dermatitidis is neurotropic, with high mortality, and this can occur in immunocompetent (often Asian) patients
- Known to colonize cystic fibrosis patients (3-20%)
Diagnosis
- On histology of cutaneous infection, shows epidermal hyperkeratosis, hyperplasia, acanthosis, pseudoepitheliomatous and intraepidermal pustules
- Culture
- Colony: yeast-like, black, and mucoid
- Microscopy
- Can have pigmented fungal elements within or adjoining multinucleate giant cells
- Yeast form is budding and black, while filamentous form is septate and pigmented.
Management
- No validated clinical breakpoints to guide therapy
- Itraconazole or oral terbinafine, alone or in combination
- Amphotericin B is also commonly used, and voriconazole also likely works
- Echinocandins are likely ineffective
