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Thambugala KM, Daranagama DA, Tennakoon DS, Jayatunga DPW, Hongsanan S, Xie N. Humans vs. Fungi: An Overview of Fungal Pathogens against Humans. Pathogens 2024; 13:426. [PMID: 38787278 PMCID: PMC11124197 DOI: 10.3390/pathogens13050426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
Human fungal diseases are infections caused by any fungus that invades human tissues, causing superficial, subcutaneous, or systemic diseases. Fungal infections that enter various human tissues and organs pose a significant threat to millions of individuals with weakened immune systems globally. Over recent decades, the reported cases of invasive fungal infections have increased substantially and research progress in this field has also been rapidly boosted. This review provides a comprehensive list of human fungal pathogens extracted from over 850 recent case reports, and a summary of the relevant disease conditions and their origins. Details of 281 human fungal pathogens belonging to 12 classes and 104 genera in the divisions ascomycota, basidiomycota, entomophthoromycota, and mucoromycota are listed. Among these, Aspergillus stands out as the genus with the greatest potential of infecting humans, comprising 16 species known to infect humans. Additionally, three other genera, Curvularia, Exophiala, and Trichophyton, are recognized as significant genera, each comprising 10 or more known human pathogenic species. A phylogenetic analysis based on partial sequences of the 28S nrRNA gene (LSU) of human fungal pathogens was performed to show their phylogenetic relationships and clarify their taxonomies. In addition, this review summarizes the recent advancements in fungal disease diagnosis and therapeutics.
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Affiliation(s)
- Kasun M. Thambugala
- Genetics and Molecular Biology Unit, Faculty of Applied Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda 10250, Sri Lanka; (K.M.T.); (D.P.W.J.)
- Center for Biotechnology, Department of Zoology, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
- Center for Plant Materials and Herbal Products Research, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
| | - Dinushani A. Daranagama
- Department of Plant and Molecular Biology, Faculty of Science, University of Kelaniya, Kelaniya 11300, Sri Lanka;
| | - Danushka S. Tennakoon
- Bioengineering and Technological Research Centre for Edible and Medicinal Fungi, Jiangxi Agricultural University, Nanchang 330045, China;
| | - Dona Pamoda W. Jayatunga
- Genetics and Molecular Biology Unit, Faculty of Applied Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda 10250, Sri Lanka; (K.M.T.); (D.P.W.J.)
- Center for Biotechnology, Department of Zoology, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
- Center for Plant Materials and Herbal Products Research, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
| | - Sinang Hongsanan
- Shenzhen Key Laboratory of Microbial Genetic Engineering, College of Life Science and Oceanography, Shenzhen University, Shenzhen 518060, China
| | - Ning Xie
- Shenzhen Key Laboratory of Microbial Genetic Engineering, College of Life Science and Oceanography, Shenzhen University, Shenzhen 518060, China
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Kruschewsky WLL, Patricio SA, Bahiense IC, Maifrede SB, Pôssa AP, de Camargo ZP, Rodrigues AM, Peçanha PM, Falqueto A, Grão-Velloso TR, Gonçalves SS. Paracoccidioidomycosis cases by Paracoccidioides lutzii in southeastern Brazil. Braz J Microbiol 2023; 54:1761-1767. [PMID: 37289316 PMCID: PMC10485217 DOI: 10.1007/s42770-023-01019-w] [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] [Received: 01/22/2023] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Paracoccidioidomycosis (PCM) is a systemic fungal disease caused by the thermodimorphic fungi Paracoccidioides spp. Their distribution is highly variable. Paracoccidioides lutzii is predominantly found in North and Middle-West Brazil and Ecuador. This study evaluated the clinicopathological characteristics of 10 patients diagnosed with PCM caused by P. lutzii in a reference center located in southeastern Brazil. DESIGN Double immunodiffusion assay (DID) was used to investigate 35 patients' sera with negative serology for P. brasiliensis against a P. lutzii CFA (cell-free antigen). RESULTS Out of the 35 retested patients, 10 (28.6%) were positive for P. lutzii CFA. Four patients did not report any displacement to P. lutzii endemic areas. Our results reinforce the importance of using different antigens when testing patients with clinical manifestations of PCM and negative serological tests for P. brasiliensis, primarily in cases of the report of displacement to or former residence in P. lutzii endemic regions. CONCLUSIONS The availability of tests for different Paracoccidioides species antigens is fundamental for reaching an adequate diagnosis, patient follow-up, and definition of prognosis.
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Affiliation(s)
- Wdson Luis Lima Kruschewsky
- Cassiano Antônio Moraes University Hospital (HUCAM), Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Suzana Alves Patricio
- Department of General and Specialized Surgery, Federal Fluminense University (UFF), Niterói, Rio de Janeiro, Brazil
| | - Isabela Cruz Bahiense
- Infectious Diseases Postgraduate Program, Center for Research in Medical Mycology, Federal University of Espírito Santo (UFES), Espírito Santo, Brazil
| | - Simone Bravim Maifrede
- Center for Research in Medical Mycology, Department of Pathology, Federal University of Espírito Santo (UFES), Vitoria - ES, Brazil
| | - Ana Paula Pôssa
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Zoilo Pires de Camargo
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Paulo Mendes Peçanha
- Cassiano Antônio Moraes University Hospital (HUCAM), Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
- Department of Clinical Medicine, Espírito Santo Federal University – UFES, Avenue Marechal Campos, 1468, Maruípe, Espírito Santo, Vitória CEP 29047-105 Brazil
| | - Aloísio Falqueto
- Cassiano Antônio Moraes University Hospital (HUCAM), Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
- Department of Social Medicine, Espírito Santo Federal University – UFES, Avenue Marechal Campos, Maruípe, Vitória, Espírito Santo 1468, CEP 29047-105 Brazil
| | - Tânia Regina Grão-Velloso
- Department of Clinical Dentistry Federal, University of Espírito Santo - UFES, Marechal Campos Avenue, CEP 29, Vitória-ES, 1468040-090 Brazil
| | - Sarah Santos Gonçalves
- Infectious Diseases Postgraduate Program, Center for Research in Medical Mycology, Federal University of Espírito Santo (UFES), Espírito Santo, Brazil
- Center for Research in Medical Mycology, Department of Pathology, Federal University of Espírito Santo (UFES), Vitoria - ES, Brazil
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de Oliveira VF, Magri MMC, Levin AS, Silva GD. Systematic review of neuroparacoccidioidomycosis: The contribution of neuroimaging. Mycoses 2023; 66:168-175. [PMID: 36062632 DOI: 10.1111/myc.13525] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Advanced neuroimaging demonstrated that neurological involvement occurs in up to 30% of paracoccidioidomycosis (PCM) cases. Current knowledge of neuroparacoccidioidomycosis (NPCM) is based on a 2009 systematic review. However, in the last decade, several new cases have been published, with modern neuroimaging techniques. OBJECTIVES We believe a new systematic review is needed to summarise these advances. METHODS We searched PubMed/MEDLINE, Embase and LILACS for studies from January 2010 to May 2022. Case series and case reports of NPCM were included. We performed a metaproportion to estimate a summary proportion with 95% confidence intervals (CI). RESULTS Thirty-four studies including 104 patients were evaluated. We combined our data with the results from the previous review that included 257 cases, totalling 361 patients. We found no new important demographic, clinical or laboratory characteristics. On magnetic resonance imaging (MRI), we found that 72% (95%CI: 38-91) had hyperintensity on T1-weighted image; 84% (95%CI: 71%-92%) had hypointensity on T2-weighted image; 80% (95%CI: 66-89) had contrast enhancement with the classical ring-enhancing pattern. All 8 patients undergoing spectroscopy presented lipid peaks. We found a 16% mortality, lower than in the previous review (44%). CONCLUSION NPCM presents a characteristic pattern on MRI that may help to differentiate it from other causes of single or multiple brain lesions. Albeit there is a frequent pattern, it is not specific, as other granulomatous diseases may show similar findings. Advances in neuroimaging with early diagnosis and appropriate management of the disease may have contributed to reducing its mortality.
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Affiliation(s)
- Vítor Falcão de Oliveira
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marcello Mihailenko Chaves Magri
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Anna S Levin
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Guilherme Diogo Silva
- Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Pinheiro BG, Pôssa AP, Della Terra PP, de Carvalho JA, Ricci G, Nishikaku AS, Hahn RC, de Camargo ZP, Rodrigues AM. A New Duplex PCR-Assay for the Detection and Identification of Paracoccidioides Species. J Fungi (Basel) 2021; 7:169. [PMID: 33652623 PMCID: PMC7996757 DOI: 10.3390/jof7030169] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 12/18/2022] Open
Abstract
Paracoccidioidomycosis (PCM) is a life-threatening systemic fungal infection caused by members of the Paracoccidioides brasiliensis complex and P. lutzii. Routine diagnoses of PCM down to the species level using classical mycological approaches are unspecific due to overlapping phenotypes. There is an urgent need for specific, sensitive, and cost-effective molecular tools to diagnose PCM. Variation among the exon-2 of the gp43 gene was exploited to design species-specific primer pairs to discriminate between members of the P. brasiliensis complex and P. lutzii in a duplex PCR assay. Primer-BLAST searches revealed highly species-specific primers, and no significant region of homology was found against DNA databases except for Paracoccidioides species. Primers PbraCx-F and PbraCx-R targeting P. brasiliensis DNA produced an amplicon of 308 bp, while primers Plu-F and Plu-R targeting P. lutzii DNA generated an amplicon of 142 bp. The lower limit of detection for our duplex PCR assay was 1 pg of gDNA. A panel of 62 Paracoccidioides revealed 100% specificity (AUC = 1.000, 95%CI 0.972-1.000, p < 0.0001) without cross-reacting with other medically relevant fungi or human DNA. As a proof of concept, we demonstrated the accurate identification of the P. brasiliensis complex (n = 7) or P. lutzii (n = 6) from a broad range of formalin-fixed, paraffin-embedded (FFPE) tissues of PCM patient's organs. In four cases, FFPE PCR results confirmed, for the first time, co-infection due to P. brasiliensis (S1) and P. lutzii in the same biopsy. Our duplex PCR assay is useful to detect and differentiate members of the P. brasiliensis complex and P. lutzii, providing clinical laboratories with an important tool to be applied routinely, especially in atypical cases such as those featuring negative serology and positive mycological examination of clinical specimens as well as for the investigation of putative co-infection cases. This will likely benefit thousands of infected patients every year in a wide area of the Americas.
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Affiliation(s)
- Breno Gonçalves Pinheiro
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil; (B.G.P.); (A.P.P.); (P.P.D.T.); (J.A.d.C.); (Z.P.d.C.)
| | - Ana Paula Pôssa
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil; (B.G.P.); (A.P.P.); (P.P.D.T.); (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of infectious Diseases, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Paula Portella Della Terra
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil; (B.G.P.); (A.P.P.); (P.P.D.T.); (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of infectious Diseases, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Jamile Ambrósio de Carvalho
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil; (B.G.P.); (A.P.P.); (P.P.D.T.); (J.A.d.C.); (Z.P.d.C.)
| | - Giannina Ricci
- Centro de Diagnóstico e Pesquisa em Biologia Molecular Dr. Ivo Ricci, São Paulo 13561020, Brazil; (G.R.); (A.S.N.)
| | - Angela Satie Nishikaku
- Centro de Diagnóstico e Pesquisa em Biologia Molecular Dr. Ivo Ricci, São Paulo 13561020, Brazil; (G.R.); (A.S.N.)
| | - Rosane Christine Hahn
- Laboratory of Mycology/Research, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá 78060900, Brazil;
- Júlio Muller University Hospital, Federal University of Mato Grosso, Cuiabá 78048902, Brazil
| | - Zoilo Pires de Camargo
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil; (B.G.P.); (A.P.P.); (P.P.D.T.); (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of infectious Diseases, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Anderson Messias Rodrigues
- Laboratory of Emerging Fungal Pathogens, Department of Microbiology, Immunology, and Parasitology, Discipline of Cellular Biology, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil; (B.G.P.); (A.P.P.); (P.P.D.T.); (J.A.d.C.); (Z.P.d.C.)
- Department of Medicine, Discipline of infectious Diseases, Federal University of São Paulo (UNIFESP), São Paulo 04023062, Brazil
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