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Vol. 15. Issue 3.
Pages 288-292 (May - June 2011)
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Vol. 15. Issue 3.
Pages 288-292 (May - June 2011)
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Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum
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Orlando Oliveira de Morais1, Cláudia Porto2,
Corresponding author
caca.porto@uol.com.br

Cláudia Porto Serviço de Dermatologia Hospital, Universitário de Brasília - UnB SGAN 605 Avenida, L2 Norte. Asa Norte, Brasília Distrito Federal, Brazil 70910-900, Phone/Fax: +55 61 3448-5415.
, Anglya Samara Silva Leite Coutinho1, Carmélia Matos Santiago Reis3, Marcus de Melo Teixeira4, Ciro Martins Gomes1
1 Dermatology Residency Program, University Hospital of Brasilia, Universidade de Brasília (UnB), Brasília, Brazil
2 Department of Dermatology, University Hospital of Brasilia, UnB, Brasília, Brazil
3 MD, PhD; Laboratory of Mycology, University Hospital of Brasilia, UnB, Brasília, Brazil
4 MSc., Laboratory of Molecular Biology, UnB, Brasília, Brazil
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Abstract

Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.

Keywords:
HIV
pneumonia
macrolides
mortality
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