{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T17:55:20Z","timestamp":1769018120440,"version":"3.49.0"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,1,19]]},"abstract":"<jats:p><jats:italic>Alternaria<\/jats:italic>and<jats:italic>Verruconis<\/jats:italic>are two dematiaceous moulds that occasionally cause disease in immunocompromised hosts. We present the case of a 58-year-old man with history of deceased donor renal transplantation 14 months prior, who presented with fevers and cough. He was found to have right upper lobe pneumonia and a non-healing eschar of his right knee. Dematiaceous fungi grew from bronchoalveolar lavage (BAL) and was sent to reference lab for identification. Meanwhile, the eschar on his right knee was biopsied and grew<jats:italic>Alternaria<\/jats:italic>spp. Pathology was consistent with invasive mould infection and he was treated as having disseminated<jats:italic>Alternaria<\/jats:italic>infection with voriconazole and amphotericin B lipid complex. Later on, the dematiaceous mould from a BAL specimen was identified as<jats:italic>Verruconis gallopava<\/jats:italic>. The patient was discharged on voriconazole awaiting minimal inhibitory concentrations for<jats:italic>V. gallopava<\/jats:italic>but was readmitted 2\u2009days later with high fevers and died from acute respiratory failure.<\/jats:p>","DOI":"10.1136\/bcr-2017-222527","type":"journal-article","created":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T13:50:14Z","timestamp":1518097814000},"page":"bcr-2017-222527","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Double invasive fungal infection due to dematiaceous moulds in a renal transplant patient"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8787-5624","authenticated-orcid":false,"given":"Guy","family":"El Helou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Palavecino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Nunez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,8]]},"reference":[{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1212617"},{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.2","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myv018"},{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.3","doi-asserted-by":"publisher","DOI":"10.1086\/504490"},{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.4","doi-asserted-by":"crossref","first-page":"333.e9","DOI":"10.1016\/j.cmi.2016.12.024","article-title":"Melanized fungal infections in kidney transplant recipients: contributions to optimize clinical management","volume":"23","author":"Santos","year":"2017","journal-title":"Clin Microbiol Infect"},{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2008.02024.x"},{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.6","first-page":"289","article-title":"Epidemiology of alternaria alternata allergy: a prospective study in 6840 Italian asthmatic children","volume":"8","author":"Cantani","year":"2004","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2009.00482.x"},{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.8","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.mmcr.2016.12.006","article-title":"Verruconis gallopava cardiac and endovascular infection with dissemination after renal transplantation: case report and lessons learned","volume":"15","author":"Jennings","year":"2017","journal-title":"Med Mycol Case Rep"},{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.9","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-015-0757-y"},{"key":"2025042702500628000_2018.feb08_1.bcr-2017-222527.10","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00002-14"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-222527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T09:50:15Z","timestamp":1745747415000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-222527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,8]]},"references-count":10,"alternative-id":["10.1136\/bcr-2017-222527"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-222527","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,8]]}}}