Alternaria

Background

• A dematiaceous mold that mainly causes cutaneous infections in immunocompromised patients

Clinical Manifestations

• Predominantly causes cutaneous or subcutaneous lesions in immunocompromised patients
• Lesions are often on the dorsal part of the hands and feet, elbows, knees and pretibial area

Diagnosis

• Culture
  • Colony
    • Grows relatively rapidly (within 7 days) at 30ºC
    • Grey to brown colonies with black reverse
  • Microscopy
    • Yellow-brownish hyphae with or without budding cells
    • Muriform macroconidia
• Ultimately require culture/microcroscopy +/- DNA targets to make the identification

Management

• Wide excisional surgery, treatment with itraconazole, voriconazole, posaconazole and amphotericin B
• High MICs to echinocandins, but may possibly be used in combination