A 56-year-old woman with a history of bronchiectasis presented with fever and a wet cough in August 2015. Chest radiography and CT scans carried out by her local doctor showed bronchiectasis and bronchial wall thickening with an infiltration shadow in the lingular lobe and left S6. No pathogenic bacteria were detected from a sputum culture, a bronchoscopy was performed and Exophiala dermatitidis was cultured from the bronchoalveolar lavage fluid.
She was diagnosed as having pulmonary phaeohyphomycosis caused by E. dermatitidis. Itoraconazole 150mg/day in capsule form was started in December 2015. Before confirming any amelioration, she was referred to our hospital in April 2016. We switched the treatment to itraconazole oral solution 200mg/day and it improved her symptoms and laboratory findings. We reported herein on this rare case of pulmonary phaeohyphomycosis caused by E. dermatitidis and effectively treated with itraconazole oral solution.
