Pseudallescheriasis: a summary of patients from 1980-2003 in a tertiary care center

CONTEXT

Pseudallescheria boydii is being increasingly isolated in immunocompromised patients.

OBJECTIVE

To present 24 years of data on patients from whom P. boydii was isolated.

DESIGN

Retrospective review of archival laboratory data and patient charts at a tertiary care hospital with a full service mycology laboratory. All patients evaluated from whom P. boydii was isolated between 1980 and 2003 were included in this study.

RESULTS

Twenty-four patients from whom P. boydii had been isolated were identified. The majority of cases represented pulmonary involvement, particularly in cystic fibrosis patients. Three additional patients had infections in surgical or traumatic lesions of the head and 4 had disseminated disease. Invasive disease was associated with underlying malignancy or transplantation and resulted in death secondary to the fungal infection in the majority of cases.

CONCLUSIONS

Pseudallescheria boydii may cause significant disease in humans. Invasive infections with P. boydii are often misdiagnosed and inadequately treated. Aggressive treatment of locally invasive disease may be of value in preventing rapid and fatal dissemination with this organism.

Periurethral carcinosarcoma: a report of 2 cases with a review of the literature

Carcinosarcomas are rare, aggressive tumors that can arise in various sites of the body, especially the genitourinary system. In this system, the most common location for the tumor is the uterus in the female and the urinary bladder in the male. To our knowledge, only 2 cases with a periurethral location for this tumor have been previously described in the English literature. We describe 2 additional cases in this location, one in either sex, with a review of the relevant literature.