Table 1.
Clinical and Epidemiological Characteristics of 18 Human Cutaneous and/or Subcutaneous Infections Due to Coelomycetes Seen Between 2005 and 2014 in France
| Treatment |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patient | Sex, Age (Years) | Injury History | Geographical Area | Underlying Risk Factors | Lesion Type | Body Site (Lesion Characteristics) | Histology | Direct Microscopic Examination | Culture | Agent (Dosage, mg/day, Duration) | Surgery | Outcome | Follow-Up |
| 1 | F, 59 | Sri Lanka/ France | Diabetes mellitus/ Polymyalgia rheumatica Prednisone | Subcutaneous | Foot (1 nodule) | Pigmented hyphae, gran inf | Hyphae | Medicopsis romeroi | None | Total excision | Cured | 8 y | |
| 2 | F, 73 | India/France | Giant cell arteritis Prednisone | Subcutaneous | Foot (1 abscess), leg (2 cystic nodules) | Pigmented hyphae, gran inf | Negative | M romeroi | VCZ (400, 3 wk) | Total excision | Cured | 7 y | |
| 3 | M, 65 | West Africa /France | Renal graft IS therapy: Tac, MMF, prednisone |
Subcutaneous | Knee (1 abscess) | Aspecific chronic inf | Negative | M romeroi | POSA (800, 1 mo) | None | Cured | 6 y | |
| 4 | F, 47 | West Africa /France | Diabetes mellitus | Subcutaneous | Foot (1 abscess) | Pigmented hyphae, gran inf | Not done | M romeroi | None | Total excision | Cured | 1 y | |
| 5 | M, 53 | Pakistan /France | Liver graft IS therapy: Tac, MMF, prednisone |
Subcutaneous | Foot (1 abscess) | Not done | Hyphae | M romeroi | POSA (800, 2 wk) followed by LAMB (3 mg/kg, 2 mo) | 2 abscess drainages | Relapse under POSA. Cured by LAMB + total excision | 10 mo | |
| 6 | M, 54 | Farmer / injury | West Indies/ France | Chronic hepatitis C | Subcutaneous | Forearm (1 abscess) | Pigmented hyphae, gran inf | Hyphae | Gloniopsis sp | None | Total excision | Cured | 8 y |
| 7 | M, 63 | West Africa /France | Renal graft IS therapy: cyclosporine |
Subcutaneous | Hand (1 abscess) | Not done | Hyphae | Gloniopsis sp | POSA (800, 2 mo) | Relapse treated by total excision | Relapse 19 mo after POSA. Cured by excision | 5 y | |
| 8 | M, 53 | Sheperd /injury | West Africa /France | Acute B-cell leukemia, neutropenia |
Subcutaneous | Finger (1 infiltrated plaque), foot (2 abscesses) | Not done | Hyphae | Peyronellaea gardenia | LAMB (3 mg/kg, 6 wk) followed by VCZ (400, 6 wk) | None | Cured | 6 y |
| 9 | M, 58 | Farmer | West Africa /France | Renal graft IS therapy: Tac, MMF, prednisone Diabetes mellitus |
Subcutaneous | Foot (1 abscess) | Pigmented hyphae, gran inf | Hyphae | P gardeniae | VCZ (400, 13 mo) | Total excision | Cured | 5 y |
| 10 [9] | M, 71 | Gardener | West Indies (Guadeloupe) /France | Renal graft IS therapy: Tac, MMF, prednisone |
Subcutaneous | Elbow (1 nodule) | Not done | Hyphae | Paraconiothyrium cyclothyrioides | LAMB (3 mg/kg, 4 wk) and VCZ (400, 7 wk) | None | Died of underlying condition | 2 mo |
| 11 | M, 78 | West Indies (Guadeloupe) | Diabetes mellitus | Subcutaneous | Foot (1 nodule) | Not done | Hyphae | Diaporthe sp | ITRA (200, 18 mo) | None | Relapse 6 mo after ITRA | 2 y | |
| 12 | M, 51 | Foot trauma | West Africa /France | Renal graft IS therapy: Tac, MMF, prednisone Diabetes mellitus |
Subcutaneous | Finger (1 nodule), foot (2 nodules) | Pigmented hyphae, gran inf | Hyphae | Diaporthe raonikayaporum | None | Total excision | Cured | 2 y |
| 13 | M, 62 | West Africa /France | Renal graft IS therapy: Tac, prednisone |
Subcutaneous | Knee (multiple nodules with diffuse skin infiltration) | Pigmented hyphae, gran inf | Hyphae | Ascomycete order Pleosporales | POSA (800, 4 y) | 3 rounds of partial excision | 2 early relapses in the first 6 mo | 4 y | |
| 14 | M, 70 | West Africa /France | None | Subcutaneous | Elbow (1 aponeurotic cyst) | Pigmented hyphae, gran inf | Not done | Gloniopsis sp | None | Total excision | Cured | 3 mo | |
| 15 | M, 55 | La Réunion/ France | Renal graft IS therapy: Tac, MMF, prednisone Diabetes mellitus Chronic hepatitis B and C/cirrhosis |
Cutaneous | Foot sole (1 pigmented budding infiltrated plaque with central nodule) | Pigmented hyphae, gran inf | Hyphae | P cyclothyrioides | LAMB (3 mg/kg, 4 wk) and Caspofungin (50, 1 wk) |
None | Died of underlying condition | 1 mo | |
| 16 [10] | M, 68 | West Indies (Martinique) | B cell lymphoma, chemotherapy, methylprednisolone, neutropenia | Cutaneous | Foot sole (1 pigmented infiltrated plaque) |
Not done | Hyphae | P cyclothyrioides | VCZ (200, 10 wk) and corticosteroids discontinuation | None | Lesion regression. Died of underlying condition | 3 mo | |
| Cutaneous | Heel (1 pigmented infiltrated plaque) | Not done | Hyphae | Diaporthe sojae | |||||||||
| 17 [11] | M, 66 | Central Africa /France | Renal graft IS therapy: Tac, MMF, prednisolone |
Cutaneous | Foot sole (1 plantar wart) | Pigmented hyphae, gran inf | Hyphae | M romeroi | Reduction of IS therapy | total excision | Cured | 4 y | |
| 18 | F, 47 | West Indies (Martinique) | 2nd/3rd degree burn lesions over 60% of total BSA | Cutaneous | Forearm (3d degree necrotic burn lesion) | Not done | Negative | Lasiodiplodia theobromae species complex | None | Excision of necrotic tissues | Died of underlying condition | 2 wk | |
Abbreviations: BSA, body surface area; gran, granulomatous; inf, inflammation; IS, immunosuppressive; ITRA, itraconazole; LAMB, liposomal amphotericin B; MMF, mycophenolate mofetil; POSA, posaconazole; Tac, tacrolimus; VCZ, voriconazole.