Isolement d'Exophiala dermatitidis dans des prélèvements d'origine pulmonaire : à propos de six patients

From 2005 to 2007, the French National Reference Centre for Mycoses and Antifungals gathered six strains of dematiaceous fungi isolated from pulmonary samples. They were identified as the Exophiala dermatitidis on the basis of morphological characters. Identification was confirmed by the sequencing of the internally transcribed spacer ITS1-5,8S-ITS2 regions of ribosomal DNA. Patients had underlying pulmonary conditions such as cystic fibrosis, bronchiectasis, lung cancer or chronic pulmonary infections. One strain was isolated from a lung abscess and the other five were involved in bronchial colonization. The activity of six systemic antifungal agents was evaluated in vitro by the European Committee For Antimicrobial Susceptibility Testing (EUCAST) method. Amphotericin B, voriconazole and, to a lesser extent, itraconazole displayed the best activity. Two patients were successfully treated, one with voriconazole, the other by surgical resection.