Garinet Simon, Tourret Jérôme, Barete Stéphane, Arzouk Nadia, Meyer Isabelle, Frances Camille, Datry Annick, Mazier Dominique, Barrou Benoit, Fekkar Arnaud
AP-HP, Groupe hospitalier La Pitié-Salpêtrière, Service de Parasitologie Mycologie, F-75013, Paris, France.
Département d'urologie, néphrologie et transplantation, AP-HP, Groupe hospitalier Pitié-Salpêtrière, F-75013, Paris, France.
BMC Infect Dis. 2015 Nov 19;15:535. doi: 10.1186/s12879-015-1241-0.
Neoscytalidium species (formerly Scytalidium species) are black fungi that usually cause cutaneous infections mimicking dermatophytes lesions. Very few publications have reported invasive or disseminated infections.
In this paper, we report the clinical presentations, treatments and outcomes of five cases of invasive Neoscytalidium infections with cutaneous involvement, including two cases with disseminated infection, in five renal transplant recipients. To our knowledge, this is the first report of a series-albeit small-of renal transplant patients in whom this infection was identified. All cases occurred in a single hospital in Paris, France, between 2001 and 2011. Patients all originate from tropical area.
Treatments of Neoscytalidium infection varied greatly, underlining the lack of a recommendation for a standardized treatment. All patients were cured after long-term antifungal therapy and/or surgical excision. Interestingly, one patient with disseminated infection involving the left elbow, the right leg, the lungs and the nasal septum was cured by medical therapy only without surgery. This may suggest that in contrast to others mycoses (such as mucormycosis), an adequate medical treatment could be sufficient for treating Neoscytalidium. We also point out the difficulties we had in diagnosing two patients with Kaposi's sarcoma because of the similarity of the lesions. Furthermore, our report underlines the need to check for this rare infection in immunocompromised kidney transplant recipients originating from tropical areas.
新弯孢属真菌（以前为弯孢属真菌）是黑色真菌，通常引起类似皮肤癣菌病损的皮肤感染。极少有出版物报道侵袭性或播散性感染。
在本文中，我们报告了5例肾移植受者发生的伴有皮肤受累的侵袭性新弯孢属真菌感染的临床表现、治疗及转归，其中包括2例播散性感染。据我们所知，这是首例（尽管数量少）确诊该感染的肾移植患者系列报道。所有病例均于2001年至2011年期间发生在法国巴黎的一家医院。患者均来自热带地区。
新弯孢属真菌感染的治疗差异很大，这突出表明缺乏标准化治疗的推荐方案。所有患者经长期抗真菌治疗和/或手术切除后均治愈。有趣的是，1例累及左肘、右腿、肺部和鼻中隔的播散性感染患者仅通过药物治疗即治愈，未行手术。这可能表明，与其他真菌病（如毛霉病）不同，充分的药物治疗可能足以治疗新弯孢属真菌。我们还指出，由于病损相似，我们在诊断2例卡波西肉瘤患者时遇到困难。此外，我们的报告强调了对来自热带地区的免疫功能低下肾移植受者检查这种罕见感染的必要性。
