Abstract
Two patients are described with subcutaneous infections due to Phialophora richardsiae. Both were diabetics and originally came from subtropical areas. One of the patients had a cystic lesion which was well encapsulated while the other had a large ulcerating lesion with draining sinus tracts. The organisms were found to be susceptible to cycloheximide but resistant to 5-fluorocytosine, miconazole and amphotericin B. There was some variability in the degree of resistance depending upon whether the primary or secondary phialoconidia were tested. While simple excision appears curative for the solitary cystic type of lesion, therapy of the ulcerating form of the disease remains problematic.
Resúmen
Se describen dos pacientes diabéticos con infección subcutánea por Phialophora richardsiae. Ambos pacientes eran naturales de regiones subtropicales. Uno de ellos era portador de una lesión quistica bien encapsulada y el otro, de una lesion grande, ulcerada, con tractos fistulosos supurativos.
Los organismos fueron susceptibles a ciclohexamida pero resistentes a 5-Fluorocitosina, miconazol y anfotericina B.
Se apreció cierta variabilidad en el grado de resistencia, la cual dependía del tipo de fialoconidia examinada; a saber: primaria o secundaria.
Aún cuando una excisión simple parece ser curativa en pacientes con lesión de tipo quistico, el tratamiento de la forma ulcerado constituye todavía un problema.