Deep cutaneous fungal infections in solid-organ transplant recipients

Abstract Background Deep cutaneous fungal infections (DCFIs) are varied in immunosuppressed patients with few data for such infections in solid-organ transplant recipients (s-OTRs). Objective To determine DCFIs diagnostic characteristics and outcome with treatments in s-OTRs. Methods A 20-year retrospective observational study in France was conducted in 8 primary dermatological dedicated centers for s-OTRs diagnosed with DCFIs. Relevant clinical data on transplantation, fungal species, treatments and outcome were analyzed. Results 46 s-OTRs developed DCFIs (median delay: 13 months after transplantation) with predominant phaeohyphomycoses (46%). Distribution of nodular lesions on limbs and granulomatous findings on histopathology were helpful diagnostic clues. Treatments received were systemic antifungal therapies (48%), combined with surgery (28%), surgery alone (15%) and modulation of immunosuppression (61%) leading to complete response in 63% of s-OTRs. Limitation Limits due to observational study Conclusion Phaeohyphomycoses are the most common DCFIs in s-OTRs. Multidisciplinary teams are helpful for optimal diagnosis and management.