An infective aetiology, including fungal infection, should be considered in the differential diagnosis of immunocompromised patients presenting with skin lesions. Dematiaceous fungi are recognised as pathogens in organ transplant recipients. Herein, we describe a rare case of a chronic necrotising granulomatous skin lesion caused by Pyrenochaeta romeroi in a renal transplant recipient, and review the existing literature on the topic. To the best of our knowledge, this is the first report of such a case in Singapore. Recognition of infections caused by dematiaceous fungi is important because some strains are difficult to identify and require special molecular diagnostic techniques. Treatment involves surgical excision and long-term antifungal therapy. Data on the optimal antifungal regimen in such a diagnosis is limited.
Abscess ; microbiology ; Antifungal Agents ; therapeutic use ; Ascomycota ; Fatal Outcome ; Humans ; Immunocompromised Host ; Kidney Failure, Chronic ; complications ; therapy ; Kidney Transplantation ; adverse effects ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Mitosporic Fungi ; Mycoses ; complications ; drug therapy ; Myocardial Infarction ; complications ; Postoperative Complications ; Singapore ; Transplant Recipients ; Treatment Outcome

Multidrug-resistant Salmonella is a well-recognised problem worldwide, especially in developing countries such as India, where non-typhoidal Salmonella infections and enteric fever are endemic. Antimicrobial resistance, particularly to fluoroquinolones, is common and leads to the frequent use of alternative agents, such as azithromycin. We herein describe the first reported case of azithromycin-resistant Salmonella gastroenteritis in a Singaporean patient.
Aged ; Anti-Bacterial Agents ; therapeutic use ; Azithromycin ; therapeutic use ; Drug Resistance, Bacterial ; Fluoroquinolones ; therapeutic use ; Gastroenteritis ; drug therapy ; microbiology ; Humans ; Male ; Microbial Sensitivity Tests ; Salmonella Infections ; drug therapy ; Salmonella enterica ; drug effects ; isolation & purification ; Singapore