Subcutaneous phycomycosis: report of the first case observed in Colombia, South America.
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Biomedical subjects
Publications and source records attributed to D L Greer.
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Aspergillus spp. rarely cause mycetomata. We report a patient with diabetes and nephrotic syndrome with Aspergillus flavus mycetoma of the back, with the development of an epidural abscess, diskitis and vertebral osteomyelitis. The patient was successfully treated with decompressive laminectomy and a 14-month itraconazole regimen. Serial serum itraconazole levels and quantitative Aspergillus antigen levels were performed. This is the second reported and first extrapedal case of mycetoma caused by A. flavus.
Scopulariopsis, a soil saprophyte, rarely produces disease and has not been reported to cause invasive nasal destruction in a nonimmunocompromised host. We report the first case of Scopulariopsis in the otolaryngology literature. Prompt surgical debridement is required and usually adequate. Disagreement exists on the use of antifungals as an effective treatment. A case of invasive Scopulariopsis involving the nasal septum of a 72-year-old man is detailed, and successful treatment consisted of local debridement without antifungal drugs. His diagnosis, clinical course, and outcome illustrates the expanding differential diagnosis faced by the otolaryngologist in patients with nasal disease.