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Nevez G, Guillerm G, Talarmin JP, Quinio D, Iriart X, Lissillour PL, Rezig S, Fangous MS, Ranty M, Bodenes L, Aubron C, Couturier MA, Le Gal S. Hormographiella aspergillata pulmonary infections: Detection and identification of the fungus using pan-fungal PCR assays and DNA sequencing. J Mycol Med 2024; 34:101463. [PMID: 38342037 DOI: 10.1016/j.mycmed.2024.101463] [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: 10/23/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/13/2024]
Abstract
Hormographiella aspergillata is a basidiomycete exceptionally involved in invasive fungal infections (IFI). We report a case of H. aspergillata pulmonary infection in a 30-year-old female in a context of pancytopenia and relapsed of acute myeloid leukemia (AML). She presented with fever, thoracic pain, left pleural effusion and pneumonia, diagnosed on chest X-ray and CT-scan. Direct examination of a bronchoalveolar lavage (BAL) specimen performed on day (d) 10 was negative, while the culture was positive on d30. H. aspergillata was suspected, considering macroscopic and microscopic examination. Its identification was confirmed using Microflex® Bruker mass spectrometry and pan-fungal (PF)-PCR assay followed by DNA sequencing. After this initial diagnosis, the patient was monitored for 2.8 years. She was treated with liposomal amphotericin B and/or voriconazole until switching to isavuconazole on d298 due to side-effects. This antifungal treatment was maintained until d717 and then discontinued, the patient being considered as cured. Over this follow-up period, the patient was submitted to recurrent pulmonary sampling. Each time, cultures were negative, while PF - PCR assays and DNA sequencing confirmed the presence of H. aspergillata. The present case-report is the 32nd observation of H. aspergillata invasive infection showing that this IFI is still infrequent. Fifteen have occurred in patients with AML, which appears as the most frequent underlying disease favoring this IFI. Six recent case-reports in addition to ours highlight PF-PCR assays and DNA sequencing as relevant diagnostic tools that must be included in routine diagnosis and monitoring of IFI, specifically those due to rare basidiomycetes.
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Affiliation(s)
- Gilles Nevez
- Laboratory of Parasitology and Mycology, Brest University Hospital, F-29609 Brest, France; Fungal Respiratory Infections (FRI) Research Unit, UNIV Angers, UNIV Brest, F-29238 Brest, France.
| | - Gaelle Guillerm
- Hematology, Brest University Hospital, F-29609 Brest, France
| | - Jean-Philippe Talarmin
- Infectious Diseases and Tropical Medicine, Cornouaille Hospital, Quimper, France, F-29000 Quimper, France
| | - Dorothée Quinio
- Laboratory of Parasitology and Mycology, Brest University Hospital, F-29609 Brest, France; Fungal Respiratory Infections (FRI) Research Unit, UNIV Angers, UNIV Brest, F-29238 Brest, France
| | - Xavier Iriart
- Parasitology and Mycology Unit, Toulouse University Hospital, F-31059 Toulouse, France; Toulouse Institute for Infectious and Inflammatory Diseases (UMR "Infinity" Inserm/ CNRS/ Toulouse III University), F-31024 Toulouse, France
| | | | - Schéhérazade Rezig
- Infectious Diseases and Tropical Medicine, Brest University Hospital, F-29609 Brest, France
| | | | - Marion Ranty
- Pneumology, Brest University Hospital, F-29609 Brest, France
| | - Laetitia Bodenes
- Intensive care unit, Brest University Hospital, F-29609 Brest, France
| | - Cécile Aubron
- Intensive care unit, Brest University Hospital, F-29609 Brest, France
| | | | - Solène Le Gal
- Laboratory of Parasitology and Mycology, Brest University Hospital, F-29609 Brest, France; Fungal Respiratory Infections (FRI) Research Unit, UNIV Angers, UNIV Brest, F-29238 Brest, France
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Wang Q, Song Y, Han D, Cai H, Yan Q, Liu W, Wang H, Zheng X, Ding L, Yuan X. The first suspected disseminated Hormographiella aspergillata infection in China, diagnosed using metagenomic next-generation sequencing: a case report and literature review. Emerg Microbes Infect 2023; 12:2220581. [PMID: 37254739 PMCID: PMC10259343 DOI: 10.1080/22221751.2023.2220581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/01/2023]
Abstract
Hormographiella aspergillata is a rare and emerging cause of invasive mould infections in patients with haematological malignancies, with a mortality rate of approximately 70%. Here, we present the first reported case of suspected disseminated H. aspergillata infection in China. The patient experienced a second relapse of acute myeloid leukaemia and developed neutropenia, fever, discrepant blood pressure between limbs, and cutaneous lesions limited to the left upper extremity. Since lung tissue biopsy was not feasible, metagenomic next-generation sequencing (mNGS) and panfungal polymerase chain reaction (PCR) analysis of bronchoalveolar lavage fluid and blood samples were performed, which indicated probable H. aspergillata pulmonary infection. Histopathology of cutaneous lesions revealed numerous fungal hyphae within dermal blood vessels. mNGS of a skin biopsy sample identified H. aspergillata sequences, and the fungi was subsequently recovered from fungal culture, proving cutaneous H. aspergillata infection. Despite combined antifungal therapy, the patient died owing to disease progression. Additionally, 22 previously reported cases of invasive H. aspergillata infection were reviewed in patients with haematological malignancies. Thus, mNGS is a powerful diagnostic tool for the early and effective detection of invasive H. aspergillata infections, with the advantage of sequencing all potential pathogens, and providing results within 24 h.
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Affiliation(s)
- Qian Wang
- Department of Dermatology, Air Force Medical Center, Fourth Military Medical University, Beijing, People’s Republic of China
| | - Yinggai Song
- Department of Dermatology, Peking University First Hospital, Research Center for Medical Mycology, Peking University, Beijing, People’s Republic of China
| | - Dongmei Han
- Department of Haematology, Air Force Medical Center, Fourth Military Medical University, Beijing, People’s Republic of China
| | - Hong Cai
- Department of Dermatology, Air Force Medical Center, Fourth Military Medical University, Beijing, People’s Republic of China
| | - Qiuhong Yan
- Department of Dermatology, Air Force Medical Center, Fourth Military Medical University, Beijing, People’s Republic of China
| | - Wei Liu
- Department of Dermatology, Air Force Medical Center, Fourth Military Medical University, Beijing, People’s Republic of China
| | - Hengxiang Wang
- Department of Haematology, Air Force Medical Center, Fourth Military Medical University, Beijing, People’s Republic of China
| | - Xiaoli Zheng
- Department of Haematology, Air Force Medical Center, Fourth Military Medical University, Beijing, People’s Republic of China
| | - Li Ding
- Department of Haematology, Air Force Medical Center, Fourth Military Medical University, Beijing, People’s Republic of China
| | - Xiaoying Yuan
- Department of Dermatology, Air Force Medical Center, Fourth Military Medical University, Beijing, People’s Republic of China
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Yu U, Cao K, Yang C, Wang C, Li Y, Zhou X, Zhang Q, Wang Y, Wen F, Liu S, Wang X. Successful Treatment of Rare Pulmonary Coprinopsis cinerea Infection in a 17-Year-Old Female After Hematopoietic Stem Cell Transplantation: A Case Report. Infect Drug Resist 2023; 16:1567-1572. [PMID: 36969940 PMCID: PMC10032218 DOI: 10.2147/idr.s397233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/16/2023] [Indexed: 03/19/2023] Open
Abstract
Invasive fungal infections (IFIs) are among the most severe complications in recipients of hematopoietic stem cell transplantation (HSCT) recipients and in patients with hematological malignancies. An increasing number of uncommon fungal infections have been reported in this era of antifungal prophylaxis. Coprinopsis cinerea is a rare pathogen that causes opportunistic infections in the immunocompromised patients, including HSCT recipients and is associated with very high mortality rates. Herein, we present a successfully treated pediatric HSCT patient with breakthrough pulmonary IFI caused by Coprinopsis cinerea despite posaconazole, prophylaxis using multidisciplinary approaches.
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Affiliation(s)
- Uet Yu
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Ke Cao
- Department of Laboratory Medicine, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Chunlan Yang
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Chunjing Wang
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Yue Li
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Xiaohui Zhou
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Qian Zhang
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Yuanxiang Wang
- Department of Cardiothoracic Surgery, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Feiqiu Wen
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Sixi Liu
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
| | - Xiaodong Wang
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, People’s Republic of China
- Correspondence: Xiaodong Wang; Sixi Liu, Email ;
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Hounchonou FH, Runge J, Ganser A, Hartmann C, Raab P, Krauss JK. Stereotactic biopsy of a brain lesion caused by hormographiella aspergillata. Surg Neurol Int 2022; 13:596. [PMID: 36761261 PMCID: PMC9899447 DOI: 10.25259/sni_576_2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 11/30/2022] [Indexed: 01/01/2023] Open
Abstract
Background Invasive fungal infections are an increasing problem in immunosuppressed patients. In patients with the central nervous system involvement, there is a high case fatality rate. There is a very limited experience with infections caused by Hormographiella aspergillata (HA) in such cases and most often diagnosis is only confirmed postmortem. Case Description We report the case of a 53-year-old woman with acute myeloid leukemia. After primary therapy with daunorubicin, cytarabine, and gemtuzumab ozogamicin, the patient developed pneumonia and later neurological symptoms caused by multiple gadolinium-enhancing brain lesions in magnetic resonance imaging (MRI). Stereotactic biopsy of a frontal precentral lesion was performed and revealed HA infection. The patient died in the further course secondary to cardiopulmonary problems. Conclusion Stereotactic biopsy is a safe way to establish the diagnosis of unclear lesions such as HA infection. We recommend to perform stereotactic biopsy early in immunocompromised patients with brain lesions to guide further treatment.
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Affiliation(s)
- F. H. Hounchonou
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany.,Corresponding author: F. H. Hounchonou, Department of Neurosurgery, Hannover Medical School, Hannover, Germany.
| | - Joachim Runge
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | - Arnold Ganser
- Department of Haematology, Haemostaseology, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Christian Hartmann
- Department of Neuropathology, Hannover Medical School, Hannover, Germany
| | - Peter Raab
- Department of Institute for Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Joachim K. Krauss
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
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Chong E, Yu HJ, Kim TY, Yoo KH, Kim YJ, Huh HJ, Lee NY. Invasive Hormographiella aspergillata Infection Identified Using DNA Sequencing. Ann Lab Med 2022; 42:370-372. [PMID: 34907109 PMCID: PMC8677475 DOI: 10.3343/alm.2022.42.3.370] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/19/2021] [Accepted: 11/29/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Eunbin Chong
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hui-Jin Yu
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Yeul Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keon Hee Yoo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nam Yong Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Tschopp J, Perentes JY, Beigelman-Aubry C, Berezowska S, Lovis A, Spertini O, Bochud PY, Lamoth F. Invasive Hormographiella aspergillata infection in patients with acute myeloid leukemia: Report of two cases successfully treated and review of the literature. Med Mycol Case Rep 2021; 32:68-72. [PMID: 33996425 PMCID: PMC8095099 DOI: 10.1016/j.mmcr.2021.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/24/2021] [Accepted: 03/28/2021] [Indexed: 11/30/2022] Open
Abstract
Hormographiella aspergillata is a rare cause of invasive mold infection, mostly described in patients with hematological malignancies. We describe two cases of invasive H. aspergillata infections in patients with acute myeloid leukemia, successfully managed with complete surgical resection of the lesions and antifungal therapy of voriconazole alone or liposomal amphotericin B, followed by voriconazole, highlighting the key role of a multidisciplinary approach for the treatment of this rare and severe invasive mold infection.
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Affiliation(s)
- Jonathan Tschopp
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
| | - Jean Yannis Perentes
- Department of Thoracic Surgery, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
| | - Catherine Beigelman-Aubry
- Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
| | - Sabina Berezowska
- Institute of Pathology, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
| | - Alban Lovis
- Department of Pulmonology, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
| | - Olivier Spertini
- Department of Hematology, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
| | - Pierre-Yves Bochud
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
| | - Frederic Lamoth
- Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland.,Institute of Microbiology, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland
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Moniot M, Lavergne RA, Morel T, Guieze R, Morio F, Poirier P, Nourrisson C. Hormographiella aspergillata: an emerging basidiomycete in the clinical setting? A case report and literature review. BMC Infect Dis 2020; 20:945. [PMID: 33308180 PMCID: PMC7731474 DOI: 10.1186/s12879-020-05679-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/02/2020] [Indexed: 12/03/2022] Open
Abstract
Background Filamentous basidiomycetes are mainly considered to be respiratory tract colonizers but the clinical significance of their isolation in a specimen is debatable. Hormographiella aspergillata was first reported as a human pathogen in 1971. We discuss the role of this mold as a pathogen or colonizer and give an update on diagnostic tools and in vitro antifungal susceptibility. Case presentation We identified three cases of H. aspergillata with respiratory symptoms in a short period of time. One invasive infection and two colonizations were diagnosed. Culture supernatants showed that H. aspergillata can produce galactomannan and β-D-glucan but not glucuronoxylomannan. For the first time, isavuconazole susceptibility was determined and high minimum inhibitory concentrations (MICs) were found. Liposomal amphotericin B and voriconazole have the lowest MICs. Conclusion To date, 22 invasive infections involving H. aspergillata have been reported. On isolation of H. aspergillata, its pathogenic potential in clinical settings can be tricky. Molecular identification and antifungal susceptibility testing are essential considering high resistance against several antifungal therapies.
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Affiliation(s)
- Maxime Moniot
- Laboratoire de Parasitologie-Mycologie, CHU Clermont-Ferrand, CHU Gabriel Montpied, 58 rue Montalembert, 3IHP, 63003, Clermont-Ferrand Cedex 1, France. .,Equipe Interactions Hôte-Parasite, Laboratoire Microorganismes : Génome et Environnement, CNRS, Université Clermont-Auvergne, Clermont-Ferrand, France.
| | - Rose-Anne Lavergne
- Laboratoire de Parasitologie-Mycologie, Département de Mycologie Médicale, Hôpitaux Universitaires de Nantes, Universités Nantes Atlantique, EA1155-IICiMed, Institut de Recherche en Santé 2, Nantes, France
| | - Thomas Morel
- Laboratoire de Parasitologie-Mycologie, CHU Clermont-Ferrand, CHU Gabriel Montpied, 58 rue Montalembert, 3IHP, 63003, Clermont-Ferrand Cedex 1, France
| | - Romain Guieze
- Service d'Hématologie Clinique, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Florent Morio
- Laboratoire de Parasitologie-Mycologie, Département de Mycologie Médicale, Hôpitaux Universitaires de Nantes, Universités Nantes Atlantique, EA1155-IICiMed, Institut de Recherche en Santé 2, Nantes, France
| | - Philippe Poirier
- Laboratoire de Parasitologie-Mycologie, CHU Clermont-Ferrand, CHU Gabriel Montpied, 58 rue Montalembert, 3IHP, 63003, Clermont-Ferrand Cedex 1, France.,Equipe Interactions Hôte-Parasite, Laboratoire Microorganismes : Génome et Environnement, CNRS, Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Céline Nourrisson
- Laboratoire de Parasitologie-Mycologie, CHU Clermont-Ferrand, CHU Gabriel Montpied, 58 rue Montalembert, 3IHP, 63003, Clermont-Ferrand Cedex 1, France.,Equipe Interactions Hôte-Parasite, Laboratoire Microorganismes : Génome et Environnement, CNRS, Université Clermont-Auvergne, Clermont-Ferrand, France
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Isabel Cristina RS, Diana A, Karen A. Breakthrough Hormographiella aspergillata Infection in a Patient with Acute Myeloid Leukemia Receiving Posaconazole Prophylaxis: A Case Report and Review. Mycopathologia 2020; 185:1069-1076. [PMID: 32880829 DOI: 10.1007/s11046-020-00488-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 08/19/2020] [Indexed: 10/20/2022]
Abstract
Breakthrough invasive infections occur in immunosuppressed patients while they are receiving antifungal agents for both prophylaxis and therapy. Under such conditions, unusual fungal infections emerge. Hormographiella aspergillata is considered an uncommon human pathogen and causes devastating infections. Here, we present a case report of necrotizing pneumonia caused by H. aspergillata as a breakthrough infection in a neutropenic patient and review all previous cases of H. aspergillata infection reported in the literature.
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Affiliation(s)
- Ramírez-Sanchez Isabel Cristina
- Infectious Diseases Section, Internal Medicine Department, Hospital Pablo Tobón Uribe, Universidad de Antioquia Medical School, calle 78B#69-240, Medellín, Colombia.
| | - Agredo Diana
- Infectious Diseases Section, Internal Medicine Department, Universidad de Antioquia Medical School, Medellín, Colombia
| | - Arango Karen
- Unidad de Micología Medica y Experimental, Corporación Para Investigaciones Biológicas, Universidad de Antioquia, Universidad Pontificia Bolivariana, Medellín, Colombia
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