Production of capsule and conidia by yeast-like cells of Phialophora spinifera and Phialophora jeanselmei

Cutaneous and mucosal phaeohyphomycosis caused by Exophiala spinifera in a pregnant patient: case report and literature review

We report a case of mucocutaneous phaeohyphomycosis caused by Exophiala spinifera. Crusty plaques and nodules were major clinical features. Histological examination revealed brown yeast-like cells and hyphae. Mycological and molecular data identified E. spinifera as etiologic agent. Oral itraconazole was effective, which was in accordance with the results of in vitro susceptibility testing. We speculated that her pregnancy may play a role of risk factor in the infection by E. spinifera.

Exophiala spinifera and its allies: diagnostics from morphology to DNA barcoding

Diagnostic features of morphology, physiology, serology and genetics of species belonging to the Exophiala spinifera clade (including 11 species: Exophiala oligosperma, E. spinifera, E. xenobiotica, E. jeanselmei, E. exophialae, E. nishimurae, E. bergeri, E. nigra, Rhinocladiella similis, Ramichloridium basitonum and Phaeoannellomyces elegans), comprising a large number of human-associated Exophiala species, are summarized. Several species have closely similar morphological characters and physiological profiles. Taxonomy is therefore primarily based on sequence diversity of the Internal Transcribed Spacer (ITS) region of ribosomal DNA (rDNA). Multilocus sequencing has shown that ITS is reliable for identification of the species in this clade, and is a therefore a good candidate for barcoding species of Exophiala. Species-specific fragments were searched in the ITS region of species in the Exophiala spinifera clade and can be used to design probes for diagnosis by hybridization.

Phaeohyphomycosis caused by Exophiala spinifera in India

The second case of phaeohyphomycosis due to Exophiala spinifera in India has been diagnosed 46 years after the initial case. The present case involved a 12-year-old female patient with no known immunocompromising conditions. She presented with multiple verrucous, well-defined plaques encompassing phaeohyphomycotic lesions of varying sizes on her face, chest, arms and thighs. Lymph node involvement in dissemination was confirmed by demonstrating pigmented fungal elements in histopathology of the left axillary node. The infection responded positively to prolonged administration of itraconazole. The original case involved a young boy and was similarly disseminated but was more severe, with bone involvement, and had a fatal outcome. It is likely that other such cases have occurred in the intervening time but have not been reported.

Exopolysaccharides and capsules in human pathogenic Exophiala species

The black yeasts Exophiala spinifera and E. dermatitidis produce extracellular slimes, which may be either in the form of a well-delimited capsule or of diffusely exuded exopolysaccharides (EPS). The optimal conditions for their production were studied. The presence or absence of polysaccharide material can be used for recognition of the two species. Five-day-old cultures grown on potato glucose agar at 24 degrees C were observed in India ink, and positive identification for E. spinifera was obtained when significant halos were seen around yeast cells. In contrast, E. dermatitidis had irregular EPS with a fibrillar substructure made visible by alcian blue staining. Other Exophiala species produce insignificant amounts of extracellular mucus or none at all. The diagnostic method is particularly useful with yeast-like primary cultures, which often consist entirely of budding cells and lack the characteristic structures of the filamentous Exophiala synanamorph.

Isolation of fungi from nature in the region of Botucatu, state of São Paulo, Brazil, an endemic area of paracoccidioidomycosis

In an attempt to isolate Paracoccidioides brasiliensis from nature 887 samples of soil from Botucatu, SP, Brazil, were collected cultured in brain heart infusion agar supplemented with dextrose, in potato dextrose agar and in yeast extract starch dextrose agar, all with antibiotics, at 25 degrees and 37 degrees C. Five thermo-dependent dimorphic fungi morphologically resembling P. brasiliensis were isolated; two from armadillo holes; further studies of the biology, antigenicity and genetic features of the five dimorphic fungi are necessary to clarify their taxonomy and their possible relation to P. brasiliensis. In addition, 98 dematiaceous fungi and 581 different species of Aspergillus spp. were also isolated. Our findings emphasize that armadillos and their environment are associated with thermo-dimorphic fungi and confirm the ubiquity of pathogenic dematiaceous fungi and Aspergillus spp.

The medically important dematiaceous fungi and their identification

Dematiaceous fungi include a large group of organisms that are darkly pigmented (dark brown, olivaceous, or black). In most cases the pigment is melanin, and specifically, dihydroxynaphthalene melanin. The diseases produced include chromoblastomycosis, eumycotic mycetoma, and phaeohyphomycosis. Phaeohyphomycosis is a new classification for a diverse group of previously known entities grouped together on the basis of finding dematiaceous hyphal and/or yeast-like forms in tissue; tissue involvement may be superficial, cutaneous and corneal, subcutaneous, or systemic. Identification of these fungi is based mostly upon morphology. Important structures include annellides (Phaeoannellomyces, Exophiala), phialides (Phialophora, Wangiella), adelophialides (Phialemonium without collarettes, Lecythophora with collarettes), differentiation of conidiophores (Xylohypha versus Cladosporium) and conidial hilum, septation and germination (Bipolaris, Drechslera, Exserohilum). Useful laboratory tests include the 12% gelatin test (controversial), nitrate assimilation (W. dermatitidis is negative, most other species are positive), and determination of temperature maxima (especially 37 degrees C for E. jeanselmei, 40 degrees C for W. dermatitidis and B. spicifera, 42 degrees C for X. bantiana, and 45 degrees C for Dactylaria constricta var. gallopava and Scedosporium inflatum).

Evaluation of proteolytic activity to differentiate some dematiaceous fungi

A total of 123 isolates of Cladosporium spp., Exophiala spp., Fonsecaea spp., Lecythophora hoffmannii, Phaeoannellomyces werneckii, Phialophora spp., Wangiella dermatitidis, and Xylohypha bantiana were tested for proteolytic activity by using 26 different formulations of gelatin, milk, casein, and Loeffler media. Other physiological properties examined included hydrolysis of tyrosine and xanthine, sodium nitrate utilization in Czapek Dox agar, and thermotolerance. Isolates of Exophiala jeanselmei, Fonsecaea compacta, Fonsecaea pedrosoi, W. dermatitidis, and X. bantiana lacked proteolytic activity. Proteolytic activity was variable among the remaining species, depending on the type of medium used. Thermotolerance had value in distinguishing some taxa.

Fungi in bathwater and sludge of bathroom drainpipes. 1. Frequent isolation of Exophiala species

Samples of bathwater from 14 homes and 22 public bathhouses and sludge in drainpipes from 19 household bathrooms were plated out onto potato dextrose agar supplemented with chloramphenicol. Several media were used to study colony morphology of the isolates and the thermotolerance and alkaline tolerance of each isolate were examined. Eleven sludge samples produced 12 isolates of Exophiala jeanselmei, 2 of E. dermatitidis and 1 of E. moniliae. Five household bathwater samples produced 2 isolates of E. jeanselmei, 4 of E. dermatitidis and 1 of E. alcalophila. One isolate of E. jeanselmei, 2 of E. dermatitidis, 3 of E. moniliae and 2 of unidentified Exophiala species were recovered from 6 samples of the bathwater dissolving 'Chinese medicine' in the bathtubs of public bathhouses. One isolate of E. jeanselmei was recovered from the 15 samples of bathwater from public bathhouses. Bathwater and sludge in bathroom drainpipes may be an important habitat of Exophiala species.

Parasitic adaptation of pathogenic fungi to mammalian hosts

Pathogenic fungi involved in medical and veterinary mycology can be classified in three different groups according to their level of adaptation to parasitism. Only a few species belonging to dermatophytes can be considered genuine parasites as opposed to molds or fungi involved in systemic mycoses. Ecological, ethological, biochemical, and immunological factors can play a role in preadaptation or adaptation to parasitic life and are discussed.