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Al-Odaini N, Pan KS, Liao LW, Mo NF, Jiang ZW, Li TT, Li XY, He XJ, Zheng DY, Cao CW. Experimental Phaeohyphomycosis of Curvularia lunata. J Clin Med 2022; 11:jcm11185393. [PMID: 36143037 PMCID: PMC9505888 DOI: 10.3390/jcm11185393] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 12/02/2022] Open
Abstract
Originally considered to be a plant pathogen, reports of phaeohyphomycosis due to Curvularia lunata (C. lunata) in animals and humans are increasing. However, studies on the pathogenesis, virulence, and epidemiology of C. lunata have rarely been discussed. In the present study, BALB/c mice were experimentally inoculated with C. lunata suspension by different routes and the course of infection was evaluated. In addition, the in vitro antifungal susceptibility of C. lunata against six commonly used antifungals was evaluated using the microdilution method. Inoculation resulted in skin lesions in animals inoculated intraperitonially and subcutaneously. Infection was confirmed by both mycological and histopathologic examination. C. lunata spores and hyphae were detected in the histopathologic sections stained with hexamine silver staining. In addition, voriconazole (VRC) demonstrated greater activity against C. lunata when compared to the other antifungals, whereas fluconazole (FLC) was the least active antifungal with a minimum inhibitory concentration (MIC) range of 8–16 μg/mL. Further studies are necessary to understand the pathogenicity of C. lunata and uncover the mystery of this fungus.
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Affiliation(s)
- Najwa Al-Odaini
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
| | - Kai-su Pan
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
| | - Liu-wei Liao
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
| | - Nan-fang Mo
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
| | - Zhi-wen Jiang
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
| | - Tian-tian Li
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
| | - Xiu-ying Li
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
| | - Xiao-juan He
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
| | - Dong-yan Zheng
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
| | - Cun-wei Cao
- Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Guangxi Health Commission Key Lab of Fungi and Mycosis Research and Prevention, Nanning 530021, China
- Correspondence: ; Tel.: +86-771-5356514; Fax: +86-21-64085875
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Park GH, Shin K, Kim HS, Ko HC, Kim BS, Kim MB, Ha DL. Cutaneous Aspergillosis As a First Manifestation of Systemic Infection in Patient After Kidney Transplantation. Ann Dermatol 2022; 34:233-234. [PMID: 35721341 PMCID: PMC9171187 DOI: 10.5021/ad.2022.34.3.233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/24/2020] [Accepted: 12/05/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Geun-Hwi Park
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Dae-Lyong Ha
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea
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3
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Zeng X, Peng M, Liu G, Huang Y, Zhang T, Wen J, Lai W, Zheng Y. Strain Distribution and Drug Susceptibility of Invasive Fungal Infection in Clinical Patients With Systemic Internal Diseases. Front Bioeng Biotechnol 2021; 8:625024. [PMID: 33644009 PMCID: PMC7906281 DOI: 10.3389/fbioe.2020.625024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/31/2020] [Indexed: 11/29/2022] Open
Abstract
Background Patients with systemic internal diseases present high risks for invasive fungal infections, which results in increased morbidity and mortality. Identification of high-risk departments and susceptibility systems could help to reduce the infective rate clinically. Correct selection of sensitive anti-fungal drugs not only could improve the cure rate but also could reduce the adverse reactions and complications caused by long-term antifungal drug treatment, which can be especially important in patients with serious systemic diseases. Therefore, the distribution changes of invasive fungal strains in patients with systemic internal diseases and the choice of antifungal drugs in clinical practice should be updated. Objective This work aimed to investigate the incidence, strain distributions, and drug susceptibility of invasive fungal strains isolated from patients with systemic internal diseases. Methods Samples were collected from 9,430 patients who were diagnosed with internal diseases in our hospital from January to December 2018. We then cultured and identified the fungal strains using API 20C AUX. We performed drug sensitivity analysis via the ATB Fungus-3 fungal susceptibility strip. Resistance was defined using the revised Clinical Laboratory Standardization Committee of United States breakpoints/epidemiological cutoff values to assign susceptibility or wild-type status to systemic antifungal agents. Results A total of 179 patients (49 female, 130 male) with fungal infection were included. The high-incidence departments were determined to be the respiratory department (34.64%), intensive care unit (ICU; 21.79%), and hepatology department (9.50%). The susceptible systems for infection were the respiratory tract (sputum, 68.72%, 123/179; secretion retained in the tracheal catheter, 3.35%, 6/179), urinary tract (urine, 9.50%, 17/179), and gastrointestinal tract (feces, 9.50%, 17/179). The major pathogens were Candida (90.50%), Aspergillus (8.93%), and Cryptococcus neoformans (0.56%). The infective candida subgroups were Candida albicans (70.95%), Candida krusei (6.15%), Candida glabrata (5.59%), Candida parapsilosis (3.91%), and Candida tropicalis (3.91%). The susceptibility of non-Aspergillus fungi for amphotericin B was 100.0%. The susceptibility rates of 5-fluorocytocine (5-FC) and voriconazole were 72.73 and 81.82%, respectively, for C. krusei, 98.43 and 100% for C. albicans, and 100% for both drugs for C. glabrata, C. parapsilosis, and C. tropicalis. The susceptibility rates of fluconazole and itraconazole were 0 and 54.55%, respectively, for C. krusei, 20 and 20% for C. glabrata, and 57.14 and 57.14% for C. tropicalis. The resistance rate of C. tropicalis for both fluconazole and itraconazole was 41.43%. Conclusion Patients in the respiratory department, ICU, and hepatology department presented high rates of invasive fungal infections and should include special attention during clinical treatment. The respiratory tract, urinary tract, and gastrointestinal tract were the susceptible systems. Candida, especially C. albicans, was the main pathogen. From the perspective of drug sensitivity, amphotericin B should be given priority in treating the non-Aspergillus fungi infection in patients with systemic internal diseases, while the susceptibility of invasive fungal strains to azoles was variant. These data might provide clinical evidence for the prevention and treatment of invasive fungal infection in patients with systemic internal diseases.
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Affiliation(s)
- Xuehua Zeng
- Clinical Laboratory, The Third Affiliated Hospital of Sun Yat-sen University-Yuedong Hospital, Meizhou, China
| | - Mengran Peng
- Department of Dermatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Guirong Liu
- Clinical Laboratory, The Third Affiliated Hospital of Sun Yat-sen University-Yuedong Hospital, Meizhou, China
| | - Yongqing Huang
- Clinical Laboratory, The Third Affiliated Hospital of Sun Yat-sen University-Yuedong Hospital, Meizhou, China
| | - Tingting Zhang
- Department of Traditional Chinese Medicine, The Third Affiliated Hospital of Sun Yat-sen University-Yuedong Hospital, Meizhou, China
| | - Jing Wen
- Department of Dermatology, The Third Affiliated Hospital of Sun Yat-sen University-Yuedong Hospital, Meizhou, China
| | - Wei Lai
- Department of Dermatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Department of Dermatology, The Third Affiliated Hospital of Sun Yat-sen University-Yuedong Hospital, Meizhou, China
| | - Yue Zheng
- Department of Dermatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Department of Dermatology, The Third Affiliated Hospital of Sun Yat-sen University-Yuedong Hospital, Meizhou, China
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Rolfe R, Schell WA, Smith B, Klapper J, Perfect JR, Messina JA. Black mold takes hold and story told. Med Mycol Case Rep 2020; 29:12-14. [PMID: 32528839 PMCID: PMC7281360 DOI: 10.1016/j.mmcr.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/09/2020] [Accepted: 05/15/2020] [Indexed: 11/25/2022] Open
Abstract
We present a case of an invasive Curvularia infection in a patient who developed following bilateral orthotopic lung transplantation despite receiving post-transplant antifungal prophylaxis. This infection presented as mold colonies studding the interior surface of his chest tubes. Despite surgical washout of his bilateral pleural cavities and antifungal treatment with liposomal amphotericin B, micafungin, and isavuconazonium sulfate, the patient died.
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Affiliation(s)
- Robert Rolfe
- Duke University Department of Medicine, Division of Infectious Diseases, 315 Trent Drive, Hanes House, Durham, NC, 27710, USA
| | - Wiley A Schell
- Duke University Department of Medicine, Division of Infectious Diseases, 315 Trent Drive, Hanes House, Durham, NC, 27710, USA
| | - Becky Smith
- Duke University Department of Medicine, Division of Infectious Diseases, 315 Trent Drive, Hanes House, Durham, NC, 27710, USA
| | - Jacob Klapper
- Duke University Department of Surgery, Division of Cardiovascular and Thoracic Surgery, DUMC Box 3442 Durham, NC, 27710, USA
| | - John R Perfect
- Duke University Department of Medicine, Division of Infectious Diseases, 315 Trent Drive, Hanes House, Durham, NC, 27710, USA
| | - Julia A Messina
- Duke University Department of Medicine, Division of Infectious Diseases, 315 Trent Drive, Hanes House, Durham, NC, 27710, USA
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5
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Seidel D, Hassler A, Salmanton-García J, Koehler P, Mellinghoff SC, Carlesse F, Cheng MP, Falces-Romero I, Herbrecht R, Jover Sáenz A, Klimko N, Mareş M, Lass-Flörl C, Soler-Palacín P, Wisplinghoff H, Cornely OA, Pana Z, Lehrnbecher T. Invasive Scedosporium spp. and Lomentospora prolificans infections in pediatric patients: Analysis of 55 cases from FungiScope® and the literature. Int J Infect Dis 2019; 92:114-122. [PMID: 31863876 DOI: 10.1016/j.ijid.2019.12.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/10/2019] [Accepted: 12/12/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Current knowledge on infections caused by Scedosporium spp. and Lomentospora prolificans in children is scarce. We therefore aim to provide an overview of risk groups, clinical manifestation and treatment strategies of these infections. METHODS Pediatric patients (age ≤18 years) with proven/probable Scedosporium spp. or L. prolificans infection were identified in PubMed and the FungiScope® registry. Data on diagnosis, treatment and outcome were collected. RESULTS Fifty-five children (median age 9 years [IQR: 5-14]) with invasive Scedosporium spp. (n = 33) or L. prolificans (n = 22) infection were identified between 1990 and 2019. Malignancy, trauma and near drowning were the most common risk factors. Infections were frequently disseminated. Most patients received systemic antifungal therapy, mainly voriconazole and amphotericin B, plus surgical treatment. Overall, day 42 mortality was 31%, higher for L. prolificans (50%) compared to Scedosporium spp. (18%). L. prolificans infection was associated with a shorter median survival time compared to Scedosporium spp. (6 days [IQR: 3-28] versus 61 days [IQR: 16-148]). Treatment for malignancy and severe disseminated infection were associated with particularly poor outcome (HR 8.33 [95% CI 1.35-51.40] and HR 6.12 [95% CI 1.52-24.66], respectively). Voriconazole use at any time and surgery for antifungal treatment were associated with improved clinical outcome (HR 0.33 [95% CI 0.11-0.99] and HR 0.09 [95% CI 0.02-0.40], respectively). CONCLUSIONS Scedosporium spp. and L. prolificans infections in children are associated with high mortality despite comprehensive antifungal therapy. Voriconazole usage and surgical intervention are associated with successful outcome.
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Affiliation(s)
- Danila Seidel
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine, Department I of Internal Medicine, European Excellence Center for Medical Mycology (ECMM), Cologne, Germany.
| | - Angela Hassler
- Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital, Goethe University, Frankfurt, Germany
| | - Jon Salmanton-García
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine, Department I of Internal Medicine, European Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Philipp Koehler
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine, Department I of Internal Medicine, European Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Sibylle C Mellinghoff
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine, Department I of Internal Medicine, European Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Fabianne Carlesse
- Instituto de Oncologia Pediátrica - GRAACC/UNIFESP, São Paulo, SP, Brazil
| | - Matthew P Cheng
- Montreal, McGill University, Department Microbiology and Immunology, Montreal, Canada
| | - Iker Falces-Romero
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - Raoul Herbrecht
- University Hospital of Strasbourg, Hôpital de Hautepierre, Department of Oncology and Hematology, Strasbourg, France
| | - Alfredo Jover Sáenz
- Territorial Unit of Nosocomial Infection and antibiotic policy (TUNI). University Hospital Arnau de Vilanova, Lleida, Spain
| | - Nikolai Klimko
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
| | - Mihai Mareş
- Laboratory of Antimicrobial Chemotherapy, Ion Ionescu de la Brad University, Iași, Romania
| | - Cornelia Lass-Flörl
- Medical University of Innsbruck, Institute of Hygiene und Medical Microbiology (HMM), Innsbruck, Austria
| | - Pere Soler-Palacín
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
| | - Hilmar Wisplinghoff
- Wisplinghoff Laboratories, Cologne, Germany; Institute for Virology and Microbiology, University Witten/Herdecke, Witten, Germany; Institute for Medical Microbiology, University of Cologne, Cologne, Germany
| | - Oliver A Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine, Department I of Internal Medicine, European Excellence Center for Medical Mycology (ECMM), Cologne, Germany; Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
| | - Zoi Pana
- Department of Medicine, European University of Cyprus (EUC), Cyprus
| | - Thomas Lehrnbecher
- Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital, Goethe University, Frankfurt, Germany
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Shields BE, Rosenbach M, Brown-Joel Z, Berger AP, Ford BA, Wanat KA. Angioinvasive fungal infections impacting the skin. J Am Acad Dermatol 2019; 80:869-880.e5. [DOI: 10.1016/j.jaad.2018.04.059] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 04/17/2018] [Accepted: 04/19/2018] [Indexed: 01/19/2023]
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7
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Chang YC, Graf E, Green AM. Invasive Curvularia Infection in Pediatric Patients With Hematologic Malignancy Identified by Fungal Sequencing. J Pediatric Infect Dis Soc 2019; 8:87-91. [PMID: 30265347 DOI: 10.1093/jpids/piy092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 08/31/2018] [Indexed: 11/13/2022]
Abstract
Curvularia is a saprophytic dematiaceous mold and a rare human pathogen. Here, we report three severely immunocompromised pediatric patients who developed invasive Curvularia infection. Diagnosis was achieved or confirmed in all cases by fungal ribosome sequencing, which hastened species identification and targeted treatment for the patients reported. There are no treatment guidelines for invasive Curvularia infection, though we report three patients who were cured of their infection through a combination of surgical resection and various anti-fungal therapies, indicating a relatively low virulence and good prognosis in comparison to other angioinvasive molds.
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Affiliation(s)
- Yeh-Chung Chang
- Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine.,Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
| | - Erin Graf
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine
| | - Abby M Green
- Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Pennsylvania
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8
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Vineetha M, Palakkal S, Sobhanakumari K, Celine MI, Letha V. Verrucous Onychomycosis Caused by Curvularia in a Patient with Congenital Pterygium. Indian J Dermatol 2016; 61:701. [PMID: 27904208 PMCID: PMC5122305 DOI: 10.4103/0019-5154.193717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A 57 year healthy farmer with congenital nail pterygium presented with a verrucous growth on nail bed since 8 months. He was not diabetic and HIV rapid card test negative. Our clinical diagnosis was chromoblastomycosis but culture showed growth of curvularia species on two occasions and histopathology showed hyphal and yeast forms of the pigmented fungus. After excision biopsy patient was started on oral itraconazole. This case is reported due to rarity of verrucous cutaneous lesions caused by curvularia in immunocompetent individuals.
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Affiliation(s)
- Mary Vineetha
- Department of Dermatology, Government Medical College, Kottayam, Kerala, India
| | - Seena Palakkal
- Department of Dermatology, Government Medical College, Kottayam, Kerala, India
| | - K Sobhanakumari
- Department of Dermatology, Government Medical College, Kottayam, Kerala, India
| | - M I Celine
- Department of Dermatology, Government Medical College, Kottayam, Kerala, India
| | - V Letha
- Department of Pathology, Government Medical College, Kottayam, Kerala, India
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9
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Subcutaneous phaeohyphomycosis due to Curvularia lunata in a renal transplant patient. Rev Iberoam Micol 2013; 30:116-8. [DOI: 10.1016/j.riam.2012.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 10/07/2012] [Accepted: 10/22/2012] [Indexed: 11/17/2022] Open
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10
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Serda Kantarcioglu A, Sybren de Hoog G, Guarro J. Clinical characteristics and epidemiology of pulmonary pseudallescheriasis. Rev Iberoam Micol 2012; 29:1-13. [DOI: 10.1016/j.riam.2011.04.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 03/20/2011] [Accepted: 04/01/2011] [Indexed: 01/15/2023] Open
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11
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Cutaneous phaeohyphomycosis in renal allograft recipients: report of 2 cases and review of the literature. Diagn Microbiol Infect Dis 2010; 68:177-80. [DOI: 10.1016/j.diagmicrobio.2010.06.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 06/02/2010] [Accepted: 06/04/2010] [Indexed: 11/16/2022]
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12
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Beier F, Kittan N, Holzmann T, Schardt K, Andreesen R, Holler E, Hildebrandt G. Successful treatment of Scedosporium apiospermum soft tissue abscess with caspofungin and voriconazole in a severely immunocompromised patient with acute myeloid leukemia. Transpl Infect Dis 2010; 12:538-42. [DOI: 10.1111/j.1399-3062.2010.00537.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Badgwell Doherty C, Doherty SD, Rosen T. Thermotherapy in dermatologic infections. J Am Acad Dermatol 2010; 62:909-27; quiz 928. [PMID: 20466169 DOI: 10.1016/j.jaad.2009.09.055] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 08/30/2009] [Accepted: 09/20/2009] [Indexed: 10/19/2022]
Abstract
The use of local induced hyperthermia or thermotherapy for dermatologic infections has not been fully explored in the more recent medical literature. Herein, we discuss the rationale behind the use of thermotherapy and review reported clinical experience with its use in the management of cutaneous infections.
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14
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Tiny keratotic brown lesions on the interdigital web between the toes of a healthy man caused by Curvularia species infection and a review of cutaneous Curvularia infections. MYCOSCIENCE 2010. [DOI: 10.1007/s10267-009-0030-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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15
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Hiromoto A, Nagano T, Nishigori C. Cutaneous infection caused by Curvularia species in an immunocompetent patient. Br J Dermatol 2008; 158:1374-5. [DOI: 10.1111/j.1365-2133.2008.08528.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Abstract
Scedosporium spp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients. Scedosporium spp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sinopulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain. Scedosporium apiospermum and Scedosporium prolificans are the two principal medically important species of this genus. Pseudallescheria boydii, the teleomorph of S. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genus Scedosporium and have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response to Scedosporium spp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis of Scedosporium spp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection of Scedosporium spp. are currently investigational. Infections caused by S. apiospermum and P. boydii in patients and animals may respond to antifungal triazoles. By comparison, infections caused by S. prolificans seldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused by S. prolificans.
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Ouchi T, Sato T, Yoshizawa N, Sugiura M, Nagao K, Yaguchi T, Hata Y. [Case of cutaneous Pseudallescheria boydii infection caused by trauma]. NIHON ISHINKIN GAKKAI ZASSHI = JAPANESE JOURNAL OF MEDICAL MYCOLOGY 2008; 49:119-123. [PMID: 18451593 DOI: 10.3314/jjmm.49.119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Pseudallescheria boydii is a ubiquitous filamentous fungus. We report a case of cutaneous P. boydii infection of the left knee in a 79-year-old Japanese man who was receiving oral predonisolone (25 mg/day) for radiation pneumonitis after radiation therapy on left breast cancer. He presented with a 2-week-history of a lesion on the left knee. A biopsy specimen from the skin lesion revealed granulomatous inflammation with hyphae. Culture of the pus from the skin specimen confirmed the diagnosis of cutaneous P. boydii infection. rDNA ITS sequence was analyzed to confirm the mycological diagnosis. The patient was treated orally with 200 mg/day of itraconazole. The lesion was gradually cured and left a hypertrophic scar. Cutaneous injury may be responsible for an incidence of localized infection. Such rare fungus infection in immunocompromised patients who have a persistent traumatic skin ulcer needs to be ruled out. An opportunistic infection in immunocompromised patients can be life-threatening and prompt treatment based on accurate diagnosis is important.
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Affiliation(s)
- Takeshi Ouchi
- Shizuoka Municipal Shimizu Hosipital, Shizuoka, Japan
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Uenotsuchi T, Moroi Y, Urabe K, Tsuji G, Koga T, Matsuda T, Furue M. Cutaneous Scedosporium apiospermum Infection in an Immunocompromised Patient and a Review of the Literature. Acta Derm Venereol 2005; 85:156-9. [PMID: 15823912 DOI: 10.1080/00015550410024553] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Scedosporium apiospermum (also known as Pseudallescheria boydii) is a ubiquitous filamentous fungus. This fungus is known as a cause of mycetoma, which may occur in a normally immune host following trauma. However, in an immunocompromised host, S. apiospermum may cause a life-threatening infection. We describe a case of S. apiospermum infection of the right hand in a patient who was receiving long-term immunosuppressants for adult Still's disease. We also review the cases of S. apiospermum infection with cutaneous manifestations reported between 1998 and 2003.
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Affiliation(s)
- Takeshi Uenotsuchi
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
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Husain S, Muñoz P, Forrest G, Alexander BD, Somani J, Brennan K, Wagener MM, Singh N. Infections Due to Scedosporium apiospermum and Scedosporium prolificans in Transplant Recipients: Clinical Characteristics and Impact of Antifungal Agent Therapy on Outcome. Clin Infect Dis 2005; 40:89-99. [PMID: 15614697 DOI: 10.1086/426445] [Citation(s) in RCA: 271] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Accepted: 09/01/2004] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Unique characteristics, impact of therapy with antifungal agents, and outcome of infections with Scedosporium species were assessed in transplant recipients. METHODS The patients comprised a total of 80 transplant recipients with Scedosporium infections, including 13 patients from our institutions (University of Pittsburgh Medical Center [Pittsburgh, PA], University of Maryland [Baltimore], Duke University Medical Center [Durham, NC], Emory University [Atlanta, GA], and Hospital Gregorio Maranon [Madrid, Spain]) and 67 reported in the literature. The transplant recipients were compared with 190 non-transplant recipients with scedosporiosis who were described in the literature. RESULTS Overall, 69% of the infections in hematopoietic stem cell transplant (HSCT) recipients and 53% of the infections in organ transplant recipients were disseminated. HSCT recipients, compared with organ transplant recipients, were more likely to have infections caused by Scedosporium prolificans (P=.045), to have an earlier onset of infection (P=.007), to be neutropenic (P<.0001), and to have fungemia (P=.04). Time elapsed from transplantation to Scedosporium infection in transplant recipients has increased in recent years (P=.002). The mortality rate among transplant recipients with scedosporiosis was 58%. In a logistic regression model using amphotericin B as comparison treatment, voriconazole was associated with a trend towards better survival (odds ratio [OR], 10.40; P=.08). Presence of disseminated infection (OR, 0.20; P=.03) predicted lower survival, and receipt of adjunctive surgery as treatment (OR, 5.52; P=.02) independently predicted a better survival in this model. CONCLUSIONS Scedosporium infections in transplant recipients were associated with a high rate of dissemination and a poor outcome overall. The use of newer triazole agents warrants consideration as a therapeutic modality for these infections.
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Affiliation(s)
- Shahid Husain
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Abstract
Ecthyma gangrenosum is a cutaneous infection associated most commonly with pseudomonal sepsis in the patient who is immunocompromised. We describe an 8-month-old girl with acute myelocytic leukemia who developed perineal ecthyma gangrenosum caused by Citrobacter freundii, a gram-negative pathogen that has been rarely associated with cutaneous disease. We also review the literature to categorize the range of pseudomonal and nonpseudomonal pathogens associated with ecthyma gangrenosum.
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Affiliation(s)
- Hilary L Reich
- Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
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Safdar A. Curvularia—favorable response to oral itraconazole therapy in two patients with locally invasive phaeohyphomycosis. Clin Microbiol Infect 2003; 9:1219-23. [PMID: 14686987 DOI: 10.1111/j.1469-0691.2003.00791.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Curvularia species are ubiquitous and occasionally lead to infections in humans. In immunosuppressed patients, infections are often serious, and systemic dissemination is not uncommon. The optimal antifungal therapy is unclear. I here present two cases, a healthy man with locally invasive, mulicentric paranasal fungal sinusitis, and a case of progressive verrucal distal onychomycosis that developed while the patient was undergoing accelerated chemotherapy for non-Hodgkin's lymphoma. Both patients showed excellent responses to treatment with itraconazole suspension. Oral itraconazole may provide a safe and effective alternative for patients with locally invasive non-disseminated mycoses due to Curvularia species.
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Affiliation(s)
- A Safdar
- Department of Infectious Diseases, Infection Control and Employee Health, 402, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4095, USA.
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Tessari G, Forni A, Ferretto R, Solbiati M, Faggian G, Mazzucco A, Barba A. Lethal systemic dissemination from a cutaneous infection due to Curvularia lunata in a heart transplant recipient. J Eur Acad Dermatol Venereol 2003; 17:440-2. [PMID: 12834456 DOI: 10.1046/j.1468-3083.2003.00674.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 69-year-old male heart transplant recipient, being treated with Cell Cept, FK 506 and methylprednisolone had multiple deep brown skin nodules and nodes, on the upper right arm. Skin biopsy and culture detected a strain of Curvularia lunata. The infection disseminated to the whole skin surface, oral mucosa, upper third of the oesophagus and to the lungs. Therapy with antibiotics and antifungal drugs was ineffective. The patient died of sepsis. We did not find any other case of systemic dissemination from a skin infection due to C. lunata among heart transplant recipients. We feel that heart transplant recipients need adequate education to prevent situations that would put them at risk for infection and to seek medical advice immediately for an early diagnosis and an effective therapy.
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Affiliation(s)
- G Tessari
- Department of Biomedical and Surgical Sciences, Section of Dermatology and Venereal Disease, Institute of Cardiac Surgery, University of Verona, Verona Italy.
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