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  • Title: Alternaria alternata soft tissue infection in a forearm transplant recipient.
    Author: Bonatti H, Lass-Flörl C, Zelger B, Lottersberger C, Singh N, Pruett TL, Margreiter R, Schneeberger S.
    Journal: Surg Infect (Larchmt); 2007 Oct; 8(5):539-44. PubMed ID: 17999589.
    Abstract:
    BACKGROUND: Composite tissue allograft recipients require intensive immunosuppression and are therefore at risk of infections. Filamentous fungal infections are among the complications most difficult to manage in organ transplant recipients. METHODS: Case report and literature review. CASE REPORT: Two years after bilateral forearm transplantation, a 35-year-old patient presented with a tumor-like lesion on his thigh after a penetrating injury caused by a sliver acquired during hiking. The lesion was excised completely, and microscopic examination revealed a filamentous fungal infection. Alternaria alternata was identified as the causative agent. Induction therapy with liposomal amphotericin B for one week followed by oral itraconazole maintenance therapy for eight weeks was successful, with no signs of recurrence or side effects at 18 months' follow-up. CONCLUSION: This is the first reported case of invasive A. alternata infection in a composite tissue allograft recipient. The infection was managed successfully with local excision and systemic antifungal treatment.
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