%0 Journal Article
%T Feohifomicosis subcut芍nea en un paciente trasplantado renal Subcutaneous pheohyphomycosis in a renal transplanted patient
%A Gerardo Borroto D赤az
%A Fernando Henr赤quez Zschercher
%A Carlos Guerrero D赤az
%A Jos谷 Cairo Baez
%J Revista Cubana de Medicina
%D 2012
%I ECIMED
%X La feohifomicosis es una entidad poco frecuente causada por hongos formadores de hifas de la familia Dematiaceae, afecta principalmente a pacientes inmunosuprimidos, produce lesiones subcut芍neas en forma de quistes y pseudoquistes que en su mayor赤a se tratan con la ex谷resis quir迆rgica y tratamiento medicamentoso con anfotericin B e itraconazol. Se describi車 un caso de feohifomicosis, en un paciente masculino de 38 a os de edad, con antecedentes de enfermedad renal cr車nica, hepatitis por virus C adquirida en hemodi芍lisis. Recibe trasplante renal en el 2010 y se le aplica triple terapia inmunosupresora, tacrolimus, micofenolato mofetil y prednisona. Desarrolla diabetes mellitus postrasplante. Un a o despu谷s del injerto, comienza a presentar lesiones dermatol車gicas pseudoqu赤sticas viol芍ceas, solitarias, que forman conglomerados, en la pantorrilla, el tobillo y los dedos de ambos pies. Mediante examen cl赤nico, micol車gico y por biopsia de la lesi車n se diagnostica feohifomicosis. Se realiz車 tratamiento quir迆rgico con ex谷resis de las lesiones y medicamentoso con itraconazol 200 mg al d赤a, se modific車 el tratamiento inmunosupresor seg迆n interacci車n del itraconazol con los anticalcineur赤nicos, se sustituy車 este por everolimus. Tres meses despu谷s se observ車 evoluci車n satisfactoria. Pheohyphomycosis is a rare disease caused by Dematiaceae family hypha-forming fungi; it mainly affects immunosuppresed patients and causes subcutaneous lesions in the form of cysts and pseudocysts that are mostly treated with surgery and amphotericin B and Itraconazol-based treatment. A case of pheohyphomycosis was presented in a 38 years-old man with a history of chronic renal disease and of hepatitis C caught in hemodialysis. He was a renal transplant recipient in 2010 and was administered a triple immunosuppressive treatment with tacrolimus, mycophenolate mophetil and prednisone. He developed post-transplant diabetes mellitus and one year after the transplantation, he presented with purplish blue-colored pseudocystic dermatological lesions forming clusters in his calves, ankles and toes. The clinical, mycological and biopsy exams of the lesions yielded the diagnosis of pheohyphomycosis. The lesions were surgically removed and then 200mg of itraconazol was administered daily. This treatment was changed on account of the interaction between itraconazol and the anti-calcineuric drugs. The patient was then prescribed everolimus. Three months later, the patient recovered satisfactorily.
%K feohifomicosis
%K trasplante renal
%K inmunosupresi車n
%K complicaciones infecciosas
%K pheohyphomycosis
%K renal transplant
%K immunosuppression
%K infectious complications
%U http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232012000400007