Wangiella dermatitidis (Exophiala dermatitidis) and Aspergillus fumigatus colonization in a teen ager patient with cystis fibrosis

Introduction. We report the case of a teenager with cystic fibrosis at whic h Wangiella dermatitidis and Aspergillus fumigatus had been regularly isola ted from its sputa for three years. Methodology. A simple culture of the expectorations, obtained after kinesit herapy, on medium of Sabouraud chloramphenicol at 37 degrees C made it poss ible to obtain the culture of W dermatitidis and A. fumigatus in a few days , Discussion. 9 to 16 % of the European patients are colonized by W: dermatit idis, 21 % and 30 % of them are by A, fumigatus. The dematiaceous contamina tion would be supported by concomitant bacterial infections, diabetes and a dministration of corticoids. A serology by indirect immunofluorescence (I.F .I) allows to differentiate colonization and infection with Uf dermatitidis , but is not current practice in France. The passage to serious forms is ra re for IC! dermatitidis. Pneumonia could occur in patients with cystic fibr osis. First line treatment should be amphothericin B (Fungizone(R)) and 5-f luorocytosine (Ancotil(R)), follow up of a treatment of maintenance by the itraconazole would then be necessary. Conclusion. The frequency of colonization in France of W: dermatitidis at t he patients with cystic fibrosis and its clinical significance remains to b e determined, as well as arguments to be retained for a treatment.