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Case Reports
. 2018 Mar 8;12(3):e0006173.
doi: 10.1371/journal.pntd.0006173. eCollection 2018 Mar.

Paradoxical worsening of Emergomyces africanus infection in an HIV-infected male on itraconazole and antiretroviral therapy

Kenneth Crombie  1 , Zandile Spengane  2 , Michael Locketz  3 , Sipho Dlamini  4 , Rannakoe Lehloenya  2 , Sean Wasserman  5 , Tsidiso G Maphanga  6 , Nelesh P Govender  6 , Chris Kenyon  4   7 , Ilan S Schwartz  8   9
Affiliations
Case Reports

Paradoxical worsening of Emergomyces africanus infection in an HIV-infected male on itraconazole and antiretroviral therapy

Kenneth Crombie et al. PLoS Negl Trop Dis. .
No abstract available

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Clinicopathological features of a patient with HIV-associated emergomycosis initially and following antiretroviral-mediated immune reconstitution.
(A) Clinical appearance of skin lesions at first biopsy. (B, C) High-power magnification histology of first skin punch biopsy showing (B) scanty macrophages and apoptotic nuclear debris around superficial dermal vessels (haematoxylin and eosin stain, x400) and (C) numerous small budding yeasts (Grocott methenamine silver stain, x400). (D) Clinical appearance at the time of second biopsy five months after the first. (E, F) High-power magnification histology of second skin punch biopsy showing (E) replacement of the entire dermis by dense sheets of foamy macrophages and admixed lymphocytes (haematoxylin and eosin stain, x400) and (F) isolated yeast-like structures (arrows; Periodic acid-Schiff stain, x400).
Fig 2
Fig 2. Clinical appearance of skin lesions after treatment with amphotericin B followed by itraconazole and concomitant prednisone tapered over three months.
See this image and copyright information in PMC

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References

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