Tuméfaction de la jambe à Neocosmospora vasinfecta chez un transplanté rénal. Premier cas d'infection humaine

A 46-year old man, originated from Senegal, but living in France for more than 15 years, is dialized since January 1989, because of renal insuficiency. He had undergone a kidney graft in October 1990 with good initial evolution, without any graft rejection. The immunosuppressive tretment quite moderate, was prenisone 10mg/d, azathioprine 50 mg/d and ciclosporine 400mg/d. On the 8th month, a tumefaction affecting the anterior side of the left leg was discovered, which was thick, renitent and non inflammatory. It relapsed after two punctures. In both cases direct examination showed numerous hyphae and a fungus identified as Neocosmospora vasinfecta, was isolated by culture:it is the sexual form of an Ascomycete whose species name is not identified. The treatment associated a complete surgery and ketoconazole during a week (200mg/d) The tumor did not relapsed after a 30 months follow up.