1
|
Treadwell S, Green M, Gowda G, Levetin E, Carlson JC. Fungal Sensitization and Human Allergic Disease. Curr Allergy Asthma Rep 2024; 24:281-288. [PMID: 38575791 DOI: 10.1007/s11882-024-01144-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE OF THE REVIEW Fungal sensitizations have been associated with hypersensitivity reactions with variable levels of evidence available to link types of fungi with human disease. We conducted systematic reviews of the literature to identify the strength of evidence linking lesser-studied fungi for which there are commercially available extracts to identify populations in which they were useful in clinical practice. RECENT FINDINGS Excluding five fungi for which hundreds of articles were identified, there are 54 articles on the remaining fungi with clinical data. For 12 of the fungi, the prevalence of fungal sensitization varies in different hypersensitivity disorders due to factors related to geographic areas, age, and other underlying medical conditions. There were no studies linking seven genera to human disease. Most of the commercially available fungal extracts are uncommonly associated with hypersensitivity reactions in humans. Specific extracts may be useful in particular disease states such as allergic fungal sinusitis or allergic bronchopulmonary mycosis, or when routine testing fails to identify a cause of uncontrolled disease, such as in asthma.
Collapse
Affiliation(s)
- Scout Treadwell
- Tulane University School of Medicine, 1430 Tulane Avenue New, Orleans, LA, 70112, USA
| | - Maxwell Green
- Tulane University School of Medicine, 1430 Tulane Avenue New, Orleans, LA, 70112, USA
| | - Geetha Gowda
- Tulane University School of Medicine, 1430 Tulane Avenue New, Orleans, LA, 70112, USA
| | - Estelle Levetin
- University of Tulsa, 800 S. Tucker Drive, Tulsa, OK, 74104, USA
| | - John C Carlson
- Ochsner Health Center, 1401 Jefferson Hwy, New Orleans, LA, 70121, USA.
| |
Collapse
|
2
|
Non- Aspergillus Hyaline Molds: A Host-Based Perspective of Emerging Pathogenic Fungi Causing Sinopulmonary Diseases. J Fungi (Basel) 2023; 9:jof9020212. [PMID: 36836326 PMCID: PMC9964096 DOI: 10.3390/jof9020212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
The incidence of invasive sino-pulmonary diseases due to non-Aspergillus hyaline molds is increasing due to an enlarging and evolving population of immunosuppressed hosts as well as improvements in the capabilities of molecular-based diagnostics. Herein, we review the following opportunistic pathogens known to cause sinopulmonary disease, the most common manifestation of hyalohyphomycosis: Fusarium spp., Scedosporium spp., Lomentospora prolificans, Scopulariopsis spp., Trichoderma spp., Acremonium spp., Paecilomyces variotii, Purpureocillium lilacinum, Rasamsonia argillacea species complex, Arthrographis kalrae, and Penicillium species. To facilitate an understanding of the epidemiology and clinical features of sino-pulmonary hyalohyphomycoses in the context of host immune impairment, we utilized a host-based approach encompassing the following underlying conditions: neutropenia, hematologic malignancy, hematopoietic and solid organ transplantation, chronic granulomatous disease, acquired immunodeficiency syndrome, cystic fibrosis, and healthy individuals who sustain burns, trauma, or iatrogenic exposures. We further summarize the pre-clinical and clinical data informing antifungal management for each pathogen and consider the role of adjunctive surgery and/or immunomodulatory treatments to optimize patient outcome.
Collapse
|
3
|
Ranjbar‐Mobarake M, Nowroozi J, Badiee P, Mostafavi SN, Mohammadi R. Fatal disseminated infection due to Sarocladium kiliense in a diabetic patient with COVID-19. Clin Case Rep 2021; 9:e04596. [PMID: 34631100 PMCID: PMC8474008 DOI: 10.1002/ccr3.4596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
Sarocladium kiliense is a soil saprophytic mold with worldwide distribution, which can infect humans and other mammals, sporadically. The clinical manifestations include mycetoma, onychomycosis, keratomycosis, pneumonia, and arthritis. Here, we present a disseminated infection due to S. kiliense in a diabetic patient infected to coronavirus disease 2019 (COVID-19) from Isfahan, Iran.
Collapse
Affiliation(s)
| | - Jamileh Nowroozi
- Department of MicrobiologyNorth branch Islamic Azad UniversityTehranIran
| | - Parisa Badiee
- Clinical Microbiology Research CenterShiraz University of Medical SciencesShirazIran
| | | | - Rasoul Mohammadi
- Department of Medical Parasitology and MycologySchool of Medicine, Infectious Diseases and Tropical Medicine Research CenterIsfahan University of Medical SciencesIsfahanIran
| |
Collapse
|
4
|
Pérez-Cantero A, Guarro J. Sarocladium and Acremonium infections: New faces of an old opportunistic fungus. Mycoses 2020; 63:1203-1214. [PMID: 33090564 DOI: 10.1111/myc.13169] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/05/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022]
Abstract
The genera Acremonium and Sarocladium comprise a high diversity of morphologically and genetically related fungi generally found in the environment, although a few species, mainly Sarocladium kiliense and Acremonium egyptiacum, can also be involved in many human infections. Clinical management of opportunistic infections caused by these fungi is very complex, since their correct identification is unreliable, and they generally show poor antifungal response. More than 300 clinical cases involving a broad range of Acremonium/Sarocladium infections have so far been published, and with this review we aim to compile and provide a detailed overview of the current knowledge on Acremonium/Sarocladium human infections in terms of presentation, diagnosis, treatments and prognoses. We also aim to summarise and discuss the data currently available on their antifungal susceptibility, emphasising the promising results obtained with voriconazole as well as their impact in terms of animal infections.
Collapse
Affiliation(s)
- Alba Pérez-Cantero
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Josep Guarro
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| |
Collapse
|
5
|
Virgilio E, Mercantini P, Samra SA, Vitali M, Cavallini M. Pleuritis caused by Acremonium strictum in a patient with metastatic testicular teratocarcinoma. Braz J Infect Dis 2015; 19:336-7. [PMID: 26042869 PMCID: PMC9425442 DOI: 10.1016/j.bjid.2015.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 03/02/2015] [Indexed: 11/27/2022] Open
|
6
|
Candoni A, Aversa F, Busca A, Cesaro S, Girmenia C, Luppi M, Rossi G, Venditti A, Nosari AM, Pagano L. Combination antifungal therapy for invasive mould diseases in haematologic patients. An update on clinical data. J Chemother 2014; 27:1-12. [DOI: 10.1179/1973947814y.0000000224] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
7
|
Fernández-Silva F, Capilla J, Mayayo E, Sutton D, Guarro J. Experimental murine acremoniosis: an emerging opportunistic human infection. Med Mycol 2014; 52:29-35. [PMID: 24577339 DOI: 10.3109/13693786.2013.797610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Acremonium is an emerging fungal pathogen causing severe infections. We evaluated the virulence of three clinically relevant species within the genus, i.e., Acremonium kiliense (currently Sarocladium kiliense), Acremonium sclerotigenum-A. egyptiacum complex and Acremonium implicatum in a murine model of disseminated infection. Both immunocompetent and immunosuppresssed mice were infected with two inocula concentrations (2 × 10(6) and 2 × 10(8) conidia/animal) of two strains of each species. Tissue burden, mortality rate, histopathology and levels of (1→3)-β-D-glucan were used as virulence markers. None of the species of Acremonium tested was able to cause infection in immunocompetent mice. Conversely, severe infections were produced in immunocompromised mice, the spleen being the most affected organ. In general, the virulence of the Acremonium species tested was low, S. kiliense being the most virulent species.
Collapse
|
8
|
Sharma A, Hazarika NK, Barua P, Shivaprakash MR, Chakrabarti A. Acremonium strictum: Report of a Rare Emerging Agent of Cutaneous Hyalohyphomycosis with Review of Literatures. Mycopathologia 2013; 176:435-441. [PMID: 24121988 DOI: 10.1007/s11046-013-9709-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 09/30/2013] [Indexed: 10/26/2022]
Abstract
We present a case of cutaneous hyalohyphomycosis due to Acremonium strictum in an immunocompetent individual along with an overview of fungal infections caused by A. strictum. The diagnosis was confirmed by the presence of hyphae in microscopic examination of cutaneous biopsy and discharge, positive culture for A. strictum and sequencing of the isolate at reference centre. The infection resolved with itraconazole and terbinafine. Cutaneous or subcutaneous infections of A. strictum have rarely been reported. Fungemia or disseminated infection often with fatal outcome in immunocompromised patients was the most common presentation of A. strictum infection found in the literatures. The studies also reveal worldwide variation in the treatment regime and outcome of the treatment.
Collapse
Affiliation(s)
- Ajanta Sharma
- Department of Microbiology, Gauhati Medical College, Guwahati, 781032, Assam, India,
| | | | | | | | | |
Collapse
|
9
|
Evaluation of the efficacies of Amphotericin B, Posaconazole, Voriconazole, and Anidulafungin in a murine disseminated infection by the emerging opportunistic Fungus Sarocladium (Acremonium) kiliense. Antimicrob Agents Chemother 2013; 57:6265-9. [PMID: 24100490 DOI: 10.1128/aac.01484-13] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
We evaluated and compared the efficacies of different antifungal drugs against Sarocladium kiliense (formerly Acremonium kiliense), a clinically relevant opportunistic fungus, in a murine model of systemic infection. Three clinical strains of this fungus were tested, and the therapy administered was as follows: posaconazole at 20 mg/kg of body weight (twice daily), voriconazole at 40 mg/kg, anidulafungin at 10 mg/kg, or amphotericin B at 0.8 mg/kg. The efficacy was evaluated by prolonged animal survival, tissue burden reduction, and (1→3)-β-d-glucan serum levels. In general, the four antifungal drugs showed high MICs and poor in vitro activity. The efficacy of the different treatments was only modest, since survival rates were never higher than 40% and no drug was able to reduce fungal load in all the organs for the three strains tested. Posaconazole, in spite of its high MICs (≥16 μg/ml), showed the highest efficacy. The (1→3)-β-d-glucan serum levels were equally reduced by all drugs evaluated.
Collapse
|
10
|
Júnior MC, de Moraes Arantes A, Silva HM, Costa CR, Silva MDRR. Acremonium kiliense: case report and review of published studies. Mycopathologia 2013; 176:417-21. [PMID: 24002104 DOI: 10.1007/s11046-013-9700-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 08/17/2013] [Indexed: 11/28/2022]
Abstract
Changes in the spectrum of clinically important fungal infection have been observed in recent years. Acremonium species has been responsible for eumycotic mycetomas but has also been increasingly implicated in systemic fungal diseases. A case of Acremonium kiliense fungemia with proven involvement of the lungs in an allogeneic hematopoietic stem cell patient is reported. A high-resolution computed tomography scan of the lungs showed nodules in both lungs. Multiple cultures of blood demonstrated narrow septate hyphae, cylindrical conidia, and solitary tapering phialides and microconidia that remained grouped in slimy heads. The isolate was identified as A. kiliense based on its morphological characteristics and DNA sequence analysis. Susceptibility testing of the clinical isolate was performed to four antifungal agents. Amphotericin B, fluconazole and itraconazole were found to be inactive in vitro against the isolate; however, it was found to be sensitive to voriconazole. This last drug was indicated, and a high-resolution computed tomography scan of the lungs was normal after 10 days. One year later, the patient was free of symptoms and her blood culture was negative for fungi. Thus, voriconazole was effective in treatment for life-threatening A. kiliense infections. In this work, we performed an overview of worldwide clinical infections caused by A. kiliense.
Collapse
|
11
|
Guitard J, Degulys A, Buot G, Aline-Fardin A, Dannaoui E, Rio B, Marie JP, Lapusan S, Hennequin C. Acremonium sclerotigenum-Acremonium egyptiacum: a multi-resistant fungal pathogen complicating the course of aplastic anaemia. Clin Microbiol Infect 2013; 20:O30-2. [PMID: 23991697 DOI: 10.1111/1469-0691.12319] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/06/2013] [Accepted: 06/27/2013] [Indexed: 11/30/2022]
Abstract
A patient with aplastic anaemia, successively treated with caspofungin then liposomal amphotericin, developed a disseminated infection due to Acremonium, further confirmed as resistant in vitro to these drugs. Successful treatment was achieved with voriconazole. Multiple antifungal treatments may expose to the risk of breakthrough of multi-resistant pathogens in haematology patients.
Collapse
Affiliation(s)
- J Guitard
- Department of Parasitology and Mycology, Saint-Antoine Hospital, AP-HP, Paris, France
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Weng TF, Ho MW, Lin HC, Lu MY, Peng CT, Wu KH. Successful treatment of disseminated mixed invasive fungal infection after hematopoietic stem cell transplantation for severe aplastic anemia. Pediatr Transplant 2012; 16:E35-8. [PMID: 20946236 DOI: 10.1111/j.1399-3046.2010.01406.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Concomitant infections are frequent and usually the causes of death in patients with severe AA. HSCT can restore hematopoiesis in AA, but it is usually life threatening when patients simultaneously have an IFI. Mixed IFIs have been reported on rare occasions. The exact diagnosis of IFIs is difficult because of low fungus culture rate, difficultly obtaining tissue specimens in severely immunocompromised patients or those with bleeding tendencies. Otherwise, treatment with anti-fungal drugs alone for DMIFI was always lethal in previous reports. Surgical resection is crucial for invasive zygomycosis, but severe pancytopenia and bleeding tendency make therapy difficult. Herein, we report that with a combination of aggressive anti-fungal drugs, HSCT, and surgery, we successfully treated a 10-yr-old boy with severe AA and pulmonary zygomycosis before HSCT and disseminated mixed invasive zygomycosis and aspergillosis after HSCT.
Collapse
Affiliation(s)
- Te-Fu Weng
- Departments of Pediatrics, China Medical University Hospital, Taichung City, Taiwan
| | | | | | | | | | | |
Collapse
|
13
|
Mayayo E, Klock C, Goldani LZ, Zanella Monteiro AC, Capilla J. Infección múltiple fúngica en un paciente diabético. Rev Iberoam Micol 2010; 27:140-3. [DOI: 10.1016/j.riam.2010.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 03/31/2010] [Accepted: 04/12/2010] [Indexed: 10/19/2022] Open
|
14
|
Das S, Saha R, Dar SA, Ramachandran VG. Acr emonium Species: A Review of the Etiological Agents of Emerging Hyalohyphomycosis. Mycopathologia 2010; 170:361-75. [DOI: 10.1007/s11046-010-9334-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 06/09/2010] [Indexed: 11/28/2022]
|
15
|
Hitoto H, Pihet M, Weil B, Chabasse D, Bouchara JP, Rachieru-Sourisseau P. Acremonium strictum fungaemia in a paediatric immunocompromised patient: diagnosis and treatment difficulties. Mycopathologia 2010; 170:161-4. [PMID: 20340045 DOI: 10.1007/s11046-010-9306-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Accepted: 03/13/2010] [Indexed: 11/24/2022]
Abstract
During the past two decades, an increasing number of unusual moulds has been reported as responsible for septicaemia and systemic or disseminated infections in immunocompromised patients. Investigation of fever in a 10-year-old boy with acute myeloblastic leukaemia, including blood cultures on selective media, allowed the diagnosis of a fungaemia due to the slow-growing fungus Acremonium strictum. The patient recovered with liposomal amphotericin B (AmB) and voriconazole, followed by voriconazole alone due to AmB resistance. Facing a neutropenic patient with fever, clinicians usually suspect bacterial or viral aetiologies. This case, however, illustrates the need for mycological analysis of blood samples in febrile neutropenic patients and for antifungal susceptibility testing.
Collapse
Affiliation(s)
- Hikombo Hitoto
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Angers, France.
| | | | | | | | | | | |
Collapse
|
16
|
Abstract
The incidence of invasive mycoses is increasing, especially among patients who are immunocompromised or hospitalized with serious underlying diseases. Such infections may be broken into two broad categories: opportunistic and endemic. The most important agents of the opportunistic mycoses are Candida spp., Cryptococcus neoformans, Pneumocystis jirovecii, and Aspergillus spp. (although the list of potential pathogens is ever expanding); while the most commonly encountered endemic mycoses are due to Histoplasma capsulatum, Coccidioides immitis/posadasii, and Blastomyces dermatitidis. This review discusses the epidemiologic profiles of these invasive mycoses in North America, as well as risk factors for infection, and the pathogens' antifungal susceptibility.
Collapse
|
17
|
Guarro J, del Palacio A, Gené J, Cano J, González CG. A case of colonization of a prosthetic mitral valve by Acremonium strictum. Rev Iberoam Micol 2009; 26:146-8. [DOI: 10.1016/s1130-1406(09)70025-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Accepted: 07/23/2008] [Indexed: 11/30/2022] Open
|
18
|
|
19
|
Gamze Sener A, Yucesoy M, Senturkun S, Afsar I, Gul Yurtsever S, Turk M. A case ofAcremonium strictumperitonitis. Med Mycol 2008; 46:495-7. [DOI: 10.1080/13693780701851729] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|