INFECTIONS DUE TO DEMATIACEOUS FUNGI IN ORGAN TRANSPLANT RECIPIENTS -CASE-REPORT AND REVIEW

Dematiaceous fungi are being increasingly recognized as pathogens in o rgan transplant recipients. We describe a case of invasive esophagitis due to Cladophialophora bantiana in a small bowel transplant recipien t and review a total of 34 cases of infections due to dematiaceous fun gi in organ transplant recipients. The median time to the onset of fun gal infection after transplantation was 22 months. Clinically, two dis tinct patterns of infections were observed: 79% of the patients had sk in and/or soft-tissue infections or joint infections (predominantly du e to Exophiala species), and 21% had systemic invasive infections (pre dominantly brain abscesses due to Ochroconis gallopavum [Dactylaria ga llopava, Dactylaria constricta var. gallopava]). The overall mortality rate among the patients with skin and/or soft-tissue infections or jo int infections and the patients with systemic invasive disease was 7% and 57%, respectively; two of five patients with brain abscesses were cured with antifungal therapy. Recognition of infections due to demati aceous fungi is important since these infections, unlike invasive aspe rgillosis, may be more amenable to therapy.