Abstract
Ochroconis spp. are dematiaceous fungi and have recently become recognized as the cause of human disease. Infections due to members of this genus have primarily occurred in patients with impaired immunity following organ transplantation or chemotherapy for hematologic malignancies. There is no universally agreed upon therapy or duration of treatment, but amphotericin B and/or triazoles are typically employed. We present a case of Ochroconis gallopava infection in a patient with chronic granulomatous disease (CGD). The organism exhibited elevated minimal inhibitory concentrations against itraconazole (0.5 μg/ml) and voriconazole (2 μg/ml) in comparison with results from other studies reported in the literature. This case illustrates the complexities associated with antibiotic susceptibility testing, selection of appropriate drugs, and management in patients with Ochroconis infections. We also review the literature of human infections with Ochroconis to date, and discuss its microbiology to apprise both clinicians and laboratory personnel of this infrequently encountered but potentially aggressive pathogen.
Acknowledgements
The authors would like to thank Rachel Green, Rick Lee, and other staff members in Mycology Laboratory, the Johns Hopkins Hospital for their technical assistance.
Declaration of interest: Dr Kieren A. Marr has served as a consultant for Astellas, Merck and Pfizer, and is a recipient of grants from Astellas, Merck, and Pfizer and Sigma Tau. The authors report no other conflicts of interest. The authors alone are responsible for the content and the writing of the paper.