Sarcinomyces phaeomuriformis: a new dematiaceous hyphomycete

Black yeasts and their filamentous relatives: principles of pathogenesis and host defense

Among the melanized fungi, the so-called "black yeasts" and their filamentous relatives are particularly significant as agents of severe phaeohyphomycosis, chromoblastomycosis, and mycetoma in humans and animals. The pathogenicity and virulence of these fungi may differ significantly between closely related species. The factors which probably are of significance for pathogenicity include the presence of melanin and carotene, formation of thick cell walls and meristematic growth, presence of yeast-like phases, thermo- and perhaps also osmotolerance, adhesion, hydrophobicity, assimilation of aromatic hydrocarbons, and production of siderophores. Host defense has been shown to rely mainly on the ingestion and elimination of fungal cells by cells of the innate immune system, especially neutrophils and macrophages. However, there is increasing evidence supporting a role of T-cell-mediated immune responses, with increased interleukin-10 (IL-10) and low levels of gamma interferon (IFN-γ) being deleterious during the infection. There are no standardized therapies for treatment. It is therefore important to obtain in vitro susceptibilities of individual patients' fungal isolates in order to provide useful information for selection of appropriate treatment protocols. This article discusses the pathogenesis and host defense factors for these fungi and their severity, chronicity, and subsequent impact on treatment and prevention of diseases in human or animal hosts.

Molecular typing and antifungal susceptibility of Exophiala isolates from patients with cystic fibrosis

The black yeast Exophiala dermatitidis is a frequent agent of colonization of the lungs of patients with cystic fibrosis (CF). A total of 71 clinical isolates of Exophiala from 13 patients were identified at the species level by sequencing the internal transcribed spacer (ITS) regions 1 and 2 of the rDNA genes and typed by random amplification of polymorphic DNA (RAPD), using two different primers, BG-2 and ERIC-1. In vitro susceptibility of these isolates to some systemic antifungal drugs was investigated using the CLSI method. Almost all the isolates were identified as E. dermatitidis, but long-term colonization with the closely related species E. phaeomuriformis was observed in one patient. No clustering was found according to the geographical origin of the isolates, the isolation date or the antifungal susceptibility. Variations were seen in the susceptibility of studied isolates to antifungals but most of them exhibited low susceptibility to amphotericin B and although some patients were successively colonized by two distinct genotypes, most of the isolates were distributed in patient-specific clusters. This phenomenon may be due to genomic variations of E. dermatitidis in the lung environment of CF patients. These results are typical of colonization of the airways of patients by a poorly distributed environmental fungus, which occupies particular reservoirs that need to be defined.

[A brief history of time: 1945-2008--studies, manuscripts, and publications]

I (the author), Tadahiko Matsumoto, who is a winner of the 2008 Japanese Society for Medical Mycology (JSMM) Award, was born in 1945 and graduated in 1969 from Kyushu University in Fukuoka, Japan with an M.D. degree. At the Department of Dermatology, Kyushu University I studied dermatology and medical mycology. In Tokyo (1970-1971) at the Department of Microbiology, National Institute of Hygienic Sciences I learned general mycology. During the period from 1981 to 1983 I further studied medical mycology at the Division of Mycotic Diseases (Director: Dr. Libero Ajello), Center for Infectious Diseases, Centers for Disease Control (CDC) in Atlanta, Georgia in the United States. During the period from 1991 to 2005 while working as Director of Dermatology of Toshiba Hospital in Tokyo I was affiliated with several medical schools as a clinical and adjunct professor. Being a unique physician-scientist eager to publish my manuscripts in highly-regarded mycology journals, my studies were accurately reported as to description, taxonomy, and identification. My articles were published in journals carefully chosen for my purposes. As I became better known, I was frequently invited to contribute review articles in leading journals and chapters in authoritative textbooks of dermatology, infectious diseases, and microbiology. I was also invited to be a member and/or chairperson of various symposia in international congresses and one of the lecturers in seminars. I have established many friendly personal relationships among scientists, and we are always ready to help each other whenever necessary.

Stationary phase development of Trimmatostroma abietis

Processes of anamorph cell replication in Trimmatostroma abietis are described. Growth and conidiation are delimited on the basis of morphological, ultrastructural and ecological criteria. Cellular expansion shifts from bidirectional intercalary in exponential phase cells to isodiametric in late stationary phase cells, in the latter case with endogenous asexual reproduction. Ultrastructural similarities to dothideaceous black yeasts are discussed.

Phylogenetic analysis of ten black yeast species using nuclear small subunit rRNA gene sequences

The nuclear small subunit rRNA genes of authentic strains of the black yeasts Exophiala dermatitidis, Wangiella dermatitidis, Sarcinomyces phaemuriformis, Capronia mansonii, Nadsoniella nigra var. hesuelica, Phaeoannellomyces elegans, Phaeococcomyces exophialae, Exophiala jeanselmei var. jeanselmei and E. castellanii were amplified by PCR and directly sequenced. A putative secondary structure of the nuclear small subunit rRNA of Exophiala dermatitidis was predicted from the sequence data. Alignment with corresponding sequences from Neurospora crassa and Aureobasidium pullulans was performed and a phylogenetic tree was constructed using the neighbor-joining method. The obtained topology of the tree was confirmed by bootstrap analysis. Based upon this analysis all fungi studied formed a well-supported monophyletic group clustering as a sister group to one group of the Plectomycetes (Trichocomaceae and Onygenales). The analysis confirmed the close relationship postulated between Exophiala dermatitidis, Wangiella dermatitidis and Sarcinomyces phaeomuriformis. This monophyletic clade also contains the telemorph species Capronia mansonii thus confirming the concept of a teleomorph connection of the genus Exophiala to a member of the herpotrichiellaceae. However, Exophiala castellanii did not belong to this clade. Therefore, this species is not the anamorph of Capronia mansonii as it was postulated.

Nutritional physiology of type isolates of currently accepted species of Exophiala and Phaeococcomyces

Nutritional physiological and tolerance tests were performed for all type strains of species currently classified in the black yeast genera Exophiala and Phaeococcomyces, including some additional type strains of taxa recently reidentified as Exophiala species. Most described Exophiala species can be distinguished by physiological characters. Exophiala jeanselmei with its varieties, and E. castellanii should all be retained as separate taxa. The pairs of strains Mycotorula schawii/Exophiala dermatitidis, Hormodendrum negronii/Exophiala jeanselmei var. lecaniicorni and Sporotrichum gougerotii/Torulabergeri were found to be conspecific. Phenetic analyses of physiological data support the identity of Phaeococcomyces exophialae as a yeast-like synanamorph of Exophiala spinifera. The taxonomic positions of the genera Nadsoniella, Phaeoannellomyces and Wangiella are discussed. The genera Exophiala and Phaeococcomyces are unrelated.

Clinical and mycological spectra of Wangiella dermatitidis infections

The article reviews 37 cases of phaeohyphomycosis from the world literature up to 1992 accepted as being caused by Wangiella dermatitidis. The various clinical aspects of these infections are characterized, and the nomenclatural implications in the history of this emerging pathogen are discussed.

Nutritional physiology and selective isolation of Exophiala dermatitidis

The nutritional physiology of ten strains of Exophiala dermatitidis was investigated. The growth reactions to lactose, citrate, nitrate, nitrite, lysine, creatine and creatinine differ from those found in closely related black yeasts. In addition, it is the only Exophiala species which is able to grow at 40 degrees C. A selective medium containing meso-erythritol as sole carbon source was evaluated. This medium is particularly useful for the isolation of black yeasts from lungs of patients with cystic fibrosis as well as from the environment.

Fungal melanonychia: ungual phaeohyphomycosis caused by Wangiella dermatitidis

A 51-year-old female Japanese patient developed black pigmentation affecting both big toe-nails. Direct potassium hydroxide examination of the nail tissue demonstrated clusters of spherical dematiaceous cells, toruloid hyphae, and septate hyphae. Wangiella dermatitidis was repeatedly isolated from the affected toe-nail lesions. This case represents the first documented case of ungual phaeohyphomycosis, 'fungal melanonychia,' caused by the dematiaceous fungus W. dermatitidis. The patient was successfully treated with a topical solution of bifonazole.

Potential pathogenicity of Cladosporium tennuisimum, Phaeoisaria clematidis and Ramichloridium subulatum in a mouse model

The potential pathogenicity of one isolate each of Cladosporium tennuisimum, Phaeoisaria clematidis and Ramichloridium subulatum for mice was investigated by intravenous, intraperitoneal and subcutaneous routes of inoculation with saline and mucin suspensions of the organisms. No mice died during the experimental period. Dark nodular lesions were formed in the liver, spleen, kidneys, intestine, stomach, omentum and diaphragm after inoculation through the intravenous and intraperitoneal routes. Gross lesions were produced in the lungs of one mouse inoculated intravenously with R. subulatum. Localised nodular lesions were formed in the subcutis following the subcutaneous route. Tissue response was characterised by granulomatous inflammatory reaction. Fungal elements were confined within the granulomata. Though the fungi showed limited pathogenic potential, they may represent a hazard under conditions of compromised host immunity.

Deoxyribonucleic acid hybridization studies of Exophiala dermatitidis and Exophiala jeanselmei

Exophiala dermatitidis and Exophiala jeanselmei share similar morphological features and have been confused with each other. To clarify the relationship between the two fungi, we conducted a deoxyribonucleic acid (DNA)-DNA hybridization study using a dot blot method. Between E. dermatitidis and E. jeanselmei, only a very low level of DNA relatedness was seen and it was confirmed that these two fungi are distinct species based on DNA similarity. Close correspondence of DNA from the isolates of E. dermatitidis was obtained, whereas the isolates of E. jeanselmei were divided into 6 groups according to their DNA similarity and a possibility was shown that E. jeanselmei is composed of genetically heterogeneous groups. The subdivision of the species E. jeanselmei by the DNA-DNA hybridization method was in agreement with serotyping exoantigens. This result suggests that DNA-DNA hybridization studies provide an excellent tool for the identification and grouping of pathogenic dematiaceous fungi.

Hyalohyphomycosis and phaeohyphomycosis: two global disease entities of public health importance

Two relatively new opportunistic diseases--hyalohyphomycosis and phaeohyphomycosis--are the byproduct, in most cases, of the progress being made in combating microbial and non-microbial diseases. Immunologically impaired hosts have become vulnerable to infection by fungi that were long considered to be innocuous. The currently known etiologic agents of these two diseases are listed and pertinent literature references are cited. The basic histologic differences between phaeohyphomycosis and chromoblastomycosis was emphasized and illustrated.