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Kurata K, Nishimura S, Ichikawa H, Sakai R, Mizutani Y, Takenaka K, Kakiuchi S, Miyata Y, Kitao A, Yakushijin K, Kawamoto S, Yamamoto K, Ito M, Matsuoka H, Tokimatsu I, Kamei K, Minami H. Invasive Scopulariopsis alboflavescens infection in patient with acute myeloid leukemia. Int J Hematol 2018; 108:658-664. [PMID: 29987744 DOI: 10.1007/s12185-018-2496-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/29/2018] [Accepted: 06/29/2018] [Indexed: 11/28/2022]
Abstract
Scopulariopsis alboflavescens is a soil saprophyte that is widely distributed in nature. Recently, there have been increasing number of reports of invasive infections with Scopulariopsis species in immunocompromised patients. In this report, we described an adult woman with acute myeloid leukemia and who developed S. alboflavescens pneumonia. Liposomal amphotericin B and voriconazole combination therapy was unsuccessful and the patient died because of pneumonia. Scopulariopsis is highly resistant to available antifungal agents and almost invariably fatal. This case report should alert clinicians to the importance of listing Scopulariopsis as a pathogenic fungus in immunocompromised patients.
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Affiliation(s)
- Keiji Kurata
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Sho Nishimura
- Division of Infectious Diseases, Kobe University Hospital, Kobe, Japan
| | - Hiroya Ichikawa
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Rina Sakai
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yu Mizutani
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kei Takenaka
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Seiji Kakiuchi
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yoshiharu Miyata
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Akihito Kitao
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shinichiro Kawamoto
- Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Kobe, Japan
| | - Katsuya Yamamoto
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Mitsuhiro Ito
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroshi Matsuoka
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Issei Tokimatsu
- Department of Infection Control and Prevention, Kobe University Hospital, Kobe, Japan
| | - Katsuhiko Kamei
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Hironobu Minami
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Rapid Assays for Specific Detection of Fungi of Scopulariopsis and Microascus Genera and Scopulariopsis brevicaulis Species. Mycopathologia 2016; 181:465-74. [PMID: 27255522 PMCID: PMC4937093 DOI: 10.1007/s11046-016-0008-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 04/06/2016] [Indexed: 11/30/2022]
Abstract
Purpose Fungi of Scopulariopsis and Microascus genera cause a wide range of infections, with S. brevicaulis being the most prevalent aetiological agent of mould onychomycosis. Proper identification of these pathogens requires sporulating culture, which considerably delays the diagnosis. So far, sequencing of rDNA regions of clinical isolates has produced ambiguous results due to the lack of reference sequences in publicly available databases. Thus, there is a clear need for the development of new molecular methods that would provide simple, rapid and highly specific identification of Scopulariopsis and Microascus species. The objective of this study was to develop simple and fast assays based on PCR and real-time PCR for specific detection of fungi from Scopulariopsis and Microascus genera, and separately, S. brevicaulis species. Methods On the basis of alignment of β-tubulin gene sequences, Microascus/Scopulariopsis-specific primers were designed and S. brevicaulis-specific primers were reevaluated. DNA from cultured fungal isolates, extracted in a two-step procedure, was used in Microascus/Scopulariopsis-specific and S. brevicaulis-specific PCR and real-time PCR followed by electrophoresis or melting temperature analysis, respectively. Results The specificity of the assays was confirmed, as positive results were obtained only for Scopulariopsis spp. and Microascus spp. isolates tested in Microascus/Scopulariopsis-specific assay, and only for S. brevicaulis and S. koningii (syn. S. brevicaulis) isolates in a S. brevicaulis-specific assay, respectively, and no positive results were obtained neither for other moulds, dermatophytes, yeast-like fungi, nor for human DNA. Conclusions The developed assays enable fast and unambiguous identification of Microascus spp. and Scopulariopsis spp. pathogens.
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Invasive Microascus trigonosporus Species Complex Pulmonary Infection in a Lung Transplant Recipient. Case Rep Transplant 2015; 2015:745638. [PMID: 26075134 PMCID: PMC4446491 DOI: 10.1155/2015/745638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/30/2015] [Indexed: 11/17/2022] Open
Abstract
Because of the high incidence of morbidity and mortality associated with invasive fungal infections, antifungal prophylaxis is often used in solid organ transplant recipients. However, this prophylaxis is not universally effective and may contribute to the selection of emerging, resistant pathogens. Here we present a rare case of invasive infection caused by Microascus trigonosporus species complex in a human, which developed during voriconazole prophylaxis in a lung transplant recipient. Nebulized liposomal amphotericin B was used in addition to systemic therapy in order to optimize antifungal drug exposure; this regimen appeared to reduce the patient's fungal burden. Despite this apparent improvement, the patient's pulmonary status progressively declined in the setting of multiple comorbidities, ultimately leading to respiratory failure and death.
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A Case of Scopulariopsis brevicaulis Endocarditis with Mycotic Aneurysm in an Immunocompetent Host. Case Rep Med 2015; 2015:872871. [PMID: 25866512 PMCID: PMC4381573 DOI: 10.1155/2015/872871] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 11/30/2022] Open
Abstract
Scopulariopsis is a genus of mold that is usually associated with onychomycosis and rarely causes complicated infection in immunocompetent persons. We describe a case of an immunocompetent 65-year-old male with a history of mitral valve repair with prosthetic ring placement who developed acute left posterior knee pain. Imaging showed a left popliteal artery aneurysm and thrombus, and further evaluation with transesophageal echocardiogram demonstrated two large, mobile mitral valve vegetations. He underwent debridement and replacement of the mitral valve, followed by debridement of the left popliteal artery with peroneal artery bypass. The intraoperative cultures grew Scopulariopsis brevicaulis. Due to the resistant nature of the organism, he was initially treated with combination antifungals including liposomal amphotericin B, caspofungin, and voriconazole and was continued on chronic suppression with posaconazole with no evidence of recurrence. Scopulariopsis is a rare cause of fungal endocarditis. Treatment of Scopulariopsis endocarditis is challenging and is not well understood due to its rarity.
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Sattler L, Sabou M, Ganeval-Stoll A, Dissaux C, Candolfi E, Letscher-Bru V. Sinusitis caused by Scopulariopsis brevicaulis: Case report and review of the literature. Med Mycol Case Rep 2014; 5:24-7. [PMID: 25003024 PMCID: PMC4081977 DOI: 10.1016/j.mmcr.2014.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/28/2014] [Accepted: 05/28/2014] [Indexed: 11/01/2022] Open
Abstract
We report a case of non-invasive sinusitis caused by Scopulariopsis brevicaulis in a 70-year-old immunocompetent patient who had an antibiotic-resistant suppurative tooth infection evolving for seven months. The sinus endoscopy highlighted a foreign body at the bottom of the sinus, which led to the hypothesis of fungal ball sinusitis. Culture of excised tissue was positive for S. brevicaulis.
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Affiliation(s)
- Laurent Sattler
- Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France
| | - Marcela Sabou
- Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France ; Institut de Parasitologie et de Pathologie Tropicale, 3 Rue Koeberlé, 67000 Strasbourg, France
| | - Amina Ganeval-Stoll
- Service de Chirurgie Maxillo-Faciale et Réparatrice, Pavillon Chirurgie B, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France
| | - Caroline Dissaux
- Service de Chirurgie Maxillo-Faciale et Réparatrice, Pavillon Chirurgie B, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France
| | - Ermanno Candolfi
- Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France ; Institut de Parasitologie et de Pathologie Tropicale, 3 Rue Koeberlé, 67000 Strasbourg, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France ; Institut de Parasitologie et de Pathologie Tropicale, 3 Rue Koeberlé, 67000 Strasbourg, France
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Miossec C, Morio F, Lepoivre T, Le Pape P, Garcia-Hermoso D, Gay-Andrieu F, Haloun A, Treilhaud M, Leclair F, Miegeville M. Fatal invasive infection with fungemia due to Microascus cirrosus after heart and lung transplantation in a patient with cystic fibrosis. J Clin Microbiol 2011; 49:2743-7. [PMID: 21543579 PMCID: PMC3147864 DOI: 10.1128/jcm.00127-11] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 04/20/2011] [Indexed: 11/20/2022] Open
Abstract
Scopulariopsis species are rarely but increasingly recognized as opportunistic pathogens in immunocompromised patients. We report on a patient suffering from cystic fibrosis who developed disseminated fungal infection due to a rare Scopulariopsis species, Microascus cirrosus, after heart and lung transplantation. Despite antifungal combination therapy with voriconazole and caspofungin, the patient died 4 weeks after transplantation. Diagnostic difficulties and optimal management of disseminated Scopulariopsis/Microascus infections are discussed.
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Affiliation(s)
- Charline Miossec
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
| | - Florent Morio
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
- Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155–IICiMed, Faculté de Pharmacie, Nantes, France
| | - Thierry Lepoivre
- Unité de Transplantation Thoracique, CHU de Nantes, Nantes, France
| | - Patrice Le Pape
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
- Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155–IICiMed, Faculté de Pharmacie, Nantes, France
| | - Dea Garcia-Hermoso
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France
- CNRS URA3012, Paris, France
| | - Françoise Gay-Andrieu
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
- Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155–IICiMed, Faculté de Pharmacie, Nantes, France
| | - Alain Haloun
- Unité de Transplantation Thoracique, CHU de Nantes, Nantes, France
| | | | | | - Michel Miegeville
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
- Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155–IICiMed, Faculté de Pharmacie, Nantes, France
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