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Case Report
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| Exophiala pneumonia presenting as an eosinophilic pneumonia in an immunocompetent patient | ||||||
| Jonathan K. Callaway1, Adriane I. Budavari1, Kashif Yaqub2, Roberto L. Patron3, Karen L. Swanson2 | ||||||
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1MD, Department of Internal Medicine.
2Division of Pulmonary and Critical Care. 3MD, Assistant Professor of Medicine, Division of Infectious Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ USA 85259. | ||||||
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| How to cite this article |
| Callaway JK, Budavari AI, Yaqub K, Patron RL, Swanson KL. Exophiala pneumonia presenting as an eosinophilic pneumonia in an immunocompetent patient. Int J Case Rep Images 2016;7(12):836–840. |
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Abstract
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Introduction:
Exophiala is a common melanized environmental mold with a worldwide distribution. It is usually found in organic waste-enriched soil and decaying plants. Exophiala species are increasingly identified as the cause of human infection, typically causing cutaneous infections in immunocompromised hosts. It only rarely presents as isolated pneumonia and has never been reported as an eosinophilic pneumonia. We present a case of an immunocompetent patient with an eosinophilic pneumonia caused by an Exophiala species.
Case Report: A 72-year-old Caucasian male Arizona resident with moderate-severe chronic obstructive pulmonary disease, type 2 diabetes mellitus and a 20-pack-year history of smoking presented with a three-week history of cough and fatigue after placing ground sterilizer in his yard. A computed tomography scan of chest showed diffuse consolidation filling most of the right middle lobe, with associated lymphadenopathy. A bronchoalveolar lavage revealed a differential of 33% eosinophils, consistent with an eosinophilic pneumonia and bronchoalveolar fluid culture grew 1+ Exophiala species. He was treated with corticosteroids and fluconazole, with clinical improvement over several months. Conclusion: In conclusion, Exophiala pneumonia remains rare and is usually associated with underlying bronchiectasis or with an immunocompromised state. Eosinophilic pneumonia is also a rare disorder that has been associated with non-helminthic infections such as coccidioidomycosis in addition to certain medications and chemical exposure. Our patient likely developed the Exophiala pneumonia with an eosinophilic pneumonia syndrome due to the inhalation of dust and ground sterilizer. Our case emphasizes the importance of clinical history especially in an unusual pneumonia in an immunocompetent patient. | |
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Keywords:
Exophiala, Eosinophilic pneumonia, Phaeohyphomycoses
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Author Contributions
Jonathan K. Callaway – Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published Adriane I. Budavari – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Kashif Yaqub – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Roberto L. Patron – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Karen L. Swanson – Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Jonathan K. Callaway et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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