Successful treatment of 40-year chronic auricular cutaneous infection caused by multidrug-resistant Fusarium proliferatum via 5-aminolevulinic acid photodynamic therapy: A case report

We report the case of a 66-year-old woman with a 40-year history of a chronic <i>Fusarium proliferatum</i> infection on the right auricle. In vitro susceptibility testing showed resistance to common antifungals, including voriconazole and amphotericin B. Following the failure of conventional antifungal therapies, 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) was initiated as monotherapy. The patient underwent 10 treatment sessions, with the ALA concentration and light parameters adjusted based on the auricle's anatomy. Post-treatment follow-up demonstrated complete resolution of the lesions, with no recurrence or scar formation observed. This case highlights the efficacy and safety of ALA-PDT for multidrug-resistant <i>Fusarium proliferatum</i> infections in specific anatomical sites, providing a valuable alternative for clinical management of refractory superficial fungal infections.