ISOLATION OF EXOPHIALA-DERMATITIDIS (KANO) DEHOOG 1977 FROM A CHILD WITH SEPTICEMIA IN ACUTE LYMPHATIC-LEUKEMIA AND FROM PATIENTS WITH CYSTIC-FIBROSIS

In 1992 black yeasts of the species Exophiala dermatitidis were isolat ed for the first time from patients at the University Clinics in Dresd en. Since that time this relatively rarely detected fungus has been fr equently cultivated from clinical specimens. Our observations were: Pa tient with acute lymphatic leukaemia: In a 3 1/2 years old boy E. derm atitidis was isolated from 8 blood cultures during a septicaemic phase . Elimination of the fungus and decreasing of the fever were reached a fter removing a central venous catheter and treatment with amphoterici n B and 5-fluorocytosine for 3 weeks. In this patient E. dermatitidis was assessed to be the cause of the septicaemia setting in via cathete r. Patients with cystic fibrosis: In 8 of 51 mycologically surveyed pa tients E. dermatitidis was frequently - in 2 cases for a long time up to 7 months - isolated from sputum specimens. The occurence of this fu ngus was considered to be a colonization with subclinical development. In these patients no fungal invasion or systemic mycosis were seen. T he administration of itraconazole for 4 respectively 7 months did not succeed in eliminating E. dermatitidis out of the respiratory tract. I t is recommended to include mycological longtime cultures in the surve illance of cystic fibrosis patients for detection E. dermatitidis.