Infect Chemother.  2012 Apr;44(2):80-83. 10.3947/ic.2012.44.2.80.

A Case of Alternaria Rhinosinusitis in a Patient with Myelodysplastic Syndrome during Neutropenic Period

• Heo JY
• Yang YR
• Kim JW
• Choi JK
• Park M
• Lim YJ
• Hong KW
• Lee DG
• Eom KS
• Kim YJ

• KMID: 2054441
• DOI: http://doi.org/10.3947/ic.2012.44.2.80

Abstract

The genus Alternaria contains several species of melanized hypomycetes that cause opportunistic human infections. The most frequent clinical manifestations of alternariosis are cutaneous and subcutaneous infections, followed by oculomycosis, invasive and non-invasive rhinosinusitis, and onychomycosis. So far, only 17 cases of rhinosinusitis caused by Alternaria species have been reported since 1977. Although several domestic cases of cutaneous alternariosis have been reported, there is no report of Alternaria rhinosinusitis in Korea. The majority of Alternaria rhinosinusitis involves immunocompromised patients. We report the first case of alternariosis in a patient with neutropenia and myelodysplastic syndrome that was treated with endoscopic debridement and a conventional antifungal agent.

Keyword

Alternaria; Sinusitis; Myelodysplastic Syndrome

MeSH Terms

Alternaria
Alternariosis
Debridement
Eye Infections, Fungal
Humans
Immunocompromised Host
Korea
Myelodysplastic Syndromes
Neutropenia
Onychomycosis
Sinusitis

Figure

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  Figure 1 Anterior portion of uncinate process shows dark-colored crust formation in rhinoscopy during routine medical checkup before stem cell transplantation.

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  Figure 2 Fluid collections are noted in both maxillary (A) and ethmoid sinuses (B) in PNS CT.

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  Figure 3 Alternaria species showing typical darkly pigmented (dematiaceous) suede-like green colony in Sabouraud dextrose agar.

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  Figure 4 The spores are multi-celled and pigmented and they are produced in chains or branching chains in Lactophenol cotton blue stain (×400).

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