A patient has an unidentified fungal infection that resembles Alternaria on microscopic examination and is resistant to multiple topical fungicides. The infection may be related to chronic contact with sheepskin furniture covers. What do you advise?
—Barbara A. Fannin, MD, Benbrook, Tex.
Begin by establishing the nature of the infection. Alternaria identified by culture may represent a contaminant. I would obtain a tissue specimen for histopathologic examination and tissue culture. If the diagnosis is substantiated, oral itraconazole would be appropriate.
—Jeffrey M. Weinberg, MD (111-7)