Two recent observations of mycoses due to Arthrographic langeronii in immunocompromised patients from South of France.

Purpose. We report here on two cases of cutaneous, subcutaneous and ungual infections in two immunocompromised patients from the South of France (Nime s) caused by rare fungus Arthrographis langeronii. The first case, describe d in 1939, was observed in the North of France. Observations. The first patient, a man 80 years old, treated for a severe p neumopathia with corticosteroids and antibiotics developed cutaneous lesion s of the left hand, wrist, and first phalanx of the third finger. Two biops ies of erythematous and nodular lesions showed granulomatous reaction with fragmented filaments with oval, cylindrical and round arrhrospores. A slow growing filamentous fragmented yellowish fungus was identified as A. langer onii n.g. n. sp. Cochet 1939. The subcutaneous lesions disappeared after on e month treatment with oral itraconazole 400 mg/day, 200 mg/day for two mon ths and 100 mg/day for the last month. Culture and histopathology control w ere negative 8 months later. The second patient, 33 years old, HIV positive , CD4: 544/mm(3), has onyxis of big toes, which was improved by oral terbin afine (250 mg/day for 3 months). The fungus, observed in yellowish nails an d cultures, was isolated more rapidly than from the first patient and ident ified as A. langeronii. Discussion. Conclusion. The taxonomy of this fungus described as A. langero nii Cochet 1939 is discussed and the literature of this rare fungus describ ed lately as Arthrographis (Oidiodendron) kalrai (Tewari et Macpherson) Sig ler et Carmichael 1976 is reviewed. The clinical observations, the mycologi cal studies of the epidemiological interest of this mycosis in immunocompro mised patients are developed.