amphotericin-b and Cholangitis--Sclerosing

Exophiala dermatitidis, one of the saprophytic dematiaceous fungi, is a cause of local and disseminated phaeohyphomycosis. We report a case of systemic phaeohyphomycosis resembling sclerosing cholangitis caused by E. dermatitidis in a 24-year-old woman.

Topics: Amphotericin B; Antifungal Agents; Cholangitis, Sclerosing; Diagnosis, Differential; Exophiala; Female; Humans; Lymph Nodes; Mycoses; Pyrimidines; Triazoles; Voriconazole; Young Adult

A 61-yr-old liver transplant recipient presented with abdominal cramping and nonbloody diarrhea resulting in orthostasis. Multiple ulcerations throughout the colon were seen during endoscopy, and biopsies from the ulcer edges revealed histoplasmosis. Treatment with a course of itraconazole improved the diarrhea. The patient later presented with pericarditis and symptomatic pleural effusions, the latter of which was confirmed to be a result of disseminated histoplasmosis. Treatment with amphotericin B led to resolution. Histoplasmosis should be considered in liver transplant patients with diarrhea and large ulcers in the colon. The presence of disseminated histoplasmosis should be ruled out once colonic histoplasmosis has been diagnosed.

Topics: Amphotericin B; Antifungal Agents; Cholangitis, Sclerosing; Histoplasmosis; Humans; Itraconazole; Liver Transplantation; Male; Middle Aged; Pericarditis; Pleural Effusion; Postoperative Complications; Reoperation; Treatment Outcome

Topics: Adult; Amphotericin B; Antifungal Agents; Cholangitis, Sclerosing; Female; Histoplasmosis; Humans; Immunocompromised Host; Liver Transplantation; Opportunistic Infections