장기간 면역억제제를 복용한 천포창 환자에 발생한 심부 Adiaspiromycosis

Abstract

Adiaspiromycosis is known as an infection that is due to Chrysosporium species which are filamentous soil saprophytes that cause pulmonary infection in rare cases but are classified mainly as a contaminant rather than a pathogen in dermatological areas. Deep fungal infections, commonly by Aspergillosis and Candida, are associated with patients who have an impaired skin barrier or immunosuppression and it takes a long time to identify the pathogen because it is hard to diagnosis it without clinical suspicion. In our case, a 56-year-old female living in a rural area who took immunosuppressants including cyclophosphamide, mycophenolate mefetil, and prednisolone due to pemphigus vulgaris presented at our clinic with an erythematous patch with pustular discharges on the left forearm for 2 months. She had been treated with antibiotics under the impression of cellulitis but was not responsive to it. A Chrysosporium species was identified by tissue culture and treatment was successful with an antifungal agent. We here report a case of deep fungal infection caused by Chrysosporium species without pulmonary infiltration which is a rare manifestation.