Pseudallescheria boydii arthritis in a patient with acute lymphoblastic leukemia: A case report.

Introduction. - The outcome of neutropenic patients wit Pseudallescheria bo ydii infection is poor. Exegesis. - We report the first case of Pseudallescheria boydii hip arthrit is in a patient treated for acute lymphoblastic leukemia. In vitro suscepti bility testing showed that the strain was resistant to amphotericin B, fluo rocytosine and nystatin, but susceptible to itraconazole. The patient recei ved oral itraconazole (600 mg/day) and clinical symptoms initially resolved . Two months, later, after a course of chemotherapy and high-dose steroids while receiving oral irraconazole treatment, the patient developed fever, s kin lesions and disseminated lung infiltrates due to Pseudallescheria boydi i and finally died. Conclusion. - This case illustrates the severity of fungal infections due t o pseudallescheria boydii despite a presumable well-conducted antifungal th erapy. (C) 1999 Elsevier, Paris.