Disseminated Pseudallescheria boydii infection successfully treated with voriconazole

Abstract

Upon arrival his temperature was 36.4°C, pulse was 80 beats per minute and regular, respiratory rate was 25 per minute, and blood pressure was 106/76 mm Hg on the right and 160/83 mm Hg on the left. On auscultation a II/VI holosystolic murmur over the apex and bibasilar rales were heard. His left leg was cold with pulses detectable only by Doppler. He was alert and oriented to person and place only, and recalled 1/3 items after short delay. His speech was fluent and well articulated. He had light perception on the right and was only able to count fingers centrally on the left. He displayed mild left leg weakness, normal reflexes and flexor plantar responses, mild right pronator drift, and diminished left sided proprioception. Ophthalmological examination disclosed dense bilateral vitreous infiltrates, retinal lesions, segmental retinal detachments, and scattered choroidal inflammation worse on the right. Flucytosine was added.