Title : Role of Infectious disease Intervention and medical management in a rare case of aureobasidium pullulans

Abstract:

Introduction

A report on a rare case of fungemia due to Aureobasidium pullulans and the role of Infectious Disease in the evaluation and medical management of this skin condition.

Case presentation

A 42-year-old man with past medical history of Chronic Alcohol Abuse disorder, history of Esophageal esophagitis (treated with Omeprazole, asymptomatic for the past 3 years), and history of Depression (on Paroxetine), presented with skin lesions, initially positive for Methicillin-Susceptible Staphylococcus Aureus. The patient was given Doxycycline for 6 weeks along with Rifampin for 3 days for management of MSSA. The lesions decreased in size with antibiotic treatment, however later returned.

Lesions were re-cultured and found to be positive for Pantoea. The patient had completed multiple courses of antibiotic therapy and was referred by Dermatology to Infectious Disease. Infectious Disease workup was completed, patient tested negative for HIV. Infectious Disease referred the patient to Surgery for skin biopsy for fungal cultures with AFPB stain, Gram stain, and routine bacterial cultures. Skin biopsy revealed epidermal thickening, no squamous dysplasia, and no signs of malignancy.

Fungal cultures were positive for Aureobasidium pullulans. At which time, Infectious Disease was able to initiate medical management with IV Micafungin for 4 weeks and IV Liposomal Amphotericin B for 4 weeks, with significant improvement of skin lesions.

Conclusion

Identification of Pantoea species with skin biopsy and fungal culture as requested by Infectious disease, lead to effective medical management of fungemia due to Aureobasidium pullulans with IV antibiotic therapy resulting in resolution and improvement of skin lesions.

Biography:

My name is Dana Gangoo. I am presently a 4th Year medical student with Saint James School of Medicine, Saint Vincent and the Grenadines. I am also presently a Clinical Assistant for Essen Healthcare. I was born on the Caribbean island of Trinidad and Tobago. My hometown is Plantation, Florida. I attended Vanderbilt University College of Arts and Science for my Undergraduate degree, and earned my Masters in Science from the University of South Florida College of Medicine. I have a passion for patient care, education, and research.

My future career goal is to work as a Hospitalist in an underserved community, with a focus on providing informative transition of care. I hope to be heavily involved in Quality Improvement throughout my career as a physician. I try to leave any environment I have been a part of better than when I entered, be it by uplifting the staff, facilitating effective care, and assisting in any area of need. Hobbies include spending time with my cockatoo, miniature schnauzer, and 3-year old beta; cooking; teaching kids around the world virtually; sightseeing as much as I can; traveling internationally; learning about other cultures, cuisines, and religions; and massage therapy.