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CC BY 4.0 · Arch Plast Surg 2024; 51(01): 135-138
DOI: 10.1055/a-2166-8413
Extremity/Lymphedema
Case Report

Microsurgical Debridement for Persistent Ulcers Due to Rare Fungus Infection: Case Report and Literature Review

Yu-Wen Tsui 
1   Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
,
Chia-Yu Tsai 
2   Department of Surgery, China Medical University Hospital, Taichung, Taiwan
,
Hung-Chi Chen 
2   Department of Surgery, China Medical University Hospital, Taichung, Taiwan
3   Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan
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Abstract

A patient suffered from chronic ulcer due to recalcitrant fungal infection for 3.5 years. Five antifungal agents and 40 times of debridement—all failed. Finally, radical microscopic debridement was performed for eradication of fungal conidiospores. Since then, there was no recurrence at 2 years of follow-up. Scopulariopsis brevicaulis is one of the rarest pathogens of cutaneous fungal infections, for which multidrug resistance increased the complexity and difficulty of treatment. Radical excision, especially microscopic debridement, was the key for eradication of fungal conidiospores in this case.

Keywords

fungal infections - wounds and injuries - Scopulariopsis brevicaulis - antifungal agents - microsurgical debridement

Authors' Contributions

Conceived and designed the analysis: Y.-W.T., C.-Y.T., and H.-C.C.

Collected the data: Y.-W.T.

Contributed data or analysis tools: Y.-W.T. and C.-Y.T.

Performed the analysis: Y.-W. and C.-Y.T.

Wrote the paper: Y.-W.T., C.-Y.T., H.-C.C.


Ethical Approval

The case report is deidentified and does not involves a patient who is deceased. The IRB approval is not required.


Patient Consent

We had taken informed consent from the patient.




Publication History

Received: 27 December 2022

Accepted: 01 September 2023

Accepted Manuscript online:
05 September 2023

Article published online:
07 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Kim SH, Cho SH, Youn SK. et al. Epidemiological characterization of skin fungal infections between the years 2006 and 2010 in Korea. Osong Public Health Res Perspect 2015; 6 (06) 341-345
    CrossrefPubMedSearch in Google Scholar
  • 2 Guégan S, Lanternier F, Rouzaud C, Dupin N, Lortholary O. Fungal skin and soft tissue infections. Curr Opin Infect Dis 2016; 29 (02) 124-130
    CrossrefPubMedSearch in Google Scholar
  • 3 Sandoval-Denis M, Sutton DA, Fothergill AW. et al. Scopulariopsis, a poorly known opportunistic fungus: spectrum of species in clinical samples and in vitro responses to antifungal drugs. J Clin Microbiol 2013; 51 (12) 3937-3943
    CrossrefPubMedSearch in Google Scholar
  • 4 Salmon A, Debourgogne A, Vasbien M. et al. Disseminated Scopulariopsis brevicaulis infection in an allogeneic stem cell recipient: case report and review of the literature. Clin Microbiol Infect 2010; 16 (05) 508-512
    CrossrefPubMedSearch in Google Scholar
  • 5 Yang Q, Wei J, Chen Z. Fatal bronchial invasion of Scopulariopsis brevicaulis in an acute monocytic leukemia patient. Diagn Microbiol Infect Dis 2012; 73 (04) 369-371
    CrossrefPubMedSearch in Google Scholar
  • 6 Pérez-Cantero A, Guarro J. Current knowledge on the etiology and epidemiology of Scopulariopsis infections. Med Mycol 2020; 58 (02) 145-155
    PubMedSearch in Google Scholar
  • 7 Cuenca-Estrella M, Gomez-Lopez A, Mellado E, Buitrago MJ, Monzón A, Rodriguez-Tudela JL. Scopulariopsis brevicaulis, a fungal pathogen resistant to broad-spectrum antifungal agents. Antimicrob Agents Chemother 2003; 47 (07) 2339-2341
    CrossrefPubMedSearch in Google Scholar