Abstract
We report a rare case of fungemia caused by the dematiaceous fungus Exophiala dermatitidis. The patient was a 47-year-old woman with lingual and esophageal cancer. Five years after tumor resection, tongue cancer recurred in September 2011. Malnutrition resulting from this recurrence also caused complications. Radiotherapy was planned to treat the recurrent lesions, and a tracheostomy was performed. A totally implantable central venous access device (CVAD) was also fitted via the chest to enable nutritional management. The tumor initially disappeared in response to radiotherapy, but then metastasized to the circumference of the thoracic aorta. Chemotherapy was subsequently decided on as a course of action. Myelosuppression occurred as a side effect of chemotherapy, and the patient had an ongoing fever. Administration of an antifungal agent and removal of the CVAD alleviated the fever. The detection of Exophiala dermatitidis in the CVAD led to a diagnosis of fungemia caused by Exophiala dermatitidis as opposed to Candida (the usual cause). Analysis of past reports suggests that fungemia caused by Exophiala dermatitidis is extremely uncommon.
