Abstract
Case report: A 62 year-old man was admitted to our hospital to undertake allo-PBSCT because of his refractory malignant lymphoma. He was initially diagnosed three years before, since when he had been treated with total 10 cycles of CHOP regimen and attained CR. Six months later, he relapsed and undertook auto-PBSCT in conjunction with high dose chemotherapy. However, his remission did not last only for two months. After admission, allo-PBSCT was performed from his HLA-matched sister as a donor, following pre-treatment with fludarabine and busufan. On post-transplant day 36, the administration of high dose mPSL was started for the advent of acute GVHD. On day 78, cyclosporin was switched to FK 506 due to GVHD aggravation. Thereafter, he came to complain of headache. Head MRI revealed a mass lesion in ethmoidal sinus without either bone destruction or exophthalmos. The biopsy was taken and subjected to microbiologic exam. As a result, a black mould was isolated which was finally identified as Exserohilum rostratum based on its morphological characteristics as well as rDNA sequences of both ITS region and LSU D1/D2 region. Discussion: Exserohilum belongs to Fungi Imperfecti and resides ubiquitously in the soil. Its infection has rarely been reported to date. We believe this is the first report of Exserohilum rostratum infection in Japan.
