Alternaria Osteomyelitis in an Immunocompetent Host Treated With Voriconazole

Abstract An unusual site of Alternaria osteomyelitis is diagnosed in a 34-year-old immunocompetent woman in the right third metacarpal after being punctured by a Yucca plant while gardening. Her clinical symptoms of erythema and edema at the base of the right long finger did not improve despite first antibiotic and then steroid therapy. Debridement with bone biopsy confirmed the diagnosis of Alternaria osteomyelitis, and 7 weeks of voriconazole therapy was used. The patient showed radiographic improvement via magnetic resonance imaging and excellent clinical results.

[1]  N. Wengenack,et al.  Phaeohyphomycosis due to Alternaria species in transplant recipients , 2009, Transplant infectious disease : an official journal of the Transplantation Society.

[2]  D. Kontoyiannis,et al.  Phaeohyphomycosis in a tertiary care cancer center. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[3]  J. Guarro,et al.  Alternaria infections: laboratory diagnosis and relevant clinical features. , 2008, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[4]  R. Barton,et al.  Cutaneous infection with an Alternaria sp. in an immunocompetent host , 2008, Clinical and experimental dermatology.

[5]  D. Loebenberg,et al.  In Vitro Activities of Posaconazole, Fluconazole, Itraconazole, Voriconazole, and Amphotericin B against a Large Collection of Clinically Important Molds and Yeasts , 2006, Antimicrobial Agents and Chemotherapy.

[6]  J. Bañuls,et al.  Relapsing Cutaneous Alternariosis in a Kidney Transplant Recipient Cured with Liposomal Amphotericin B , 2003, European Journal of Clinical Microbiology and Infectious Diseases.

[7]  T. Walsh,et al.  Uncommon opportunistic fungi: new nosocomial threats. , 2001, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[8]  E. Anaissie,et al.  Emerging fungal pathogens in immunocompromised patients: classification, diagnosis, and management. , 1993, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[9]  H. Goodpasture,et al.  Alternaria osteomyelitis. Evidence of specific immunologic tolerance. , 1983, Archives of pathology & laboratory medicine.

[10]  W. Montgomery,et al.  Alternaria Sinusitis , 1981, The Annals of otology, rhinology, and laryngology.

[11]  J. Garau,et al.  Alternaria osteomyelitis. , 1977, Annals of internal medicine.