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Kodama Y, Matsuura A, Shirahige A, Hiroshima M, Tsushima Y, Tanaka M, Inagaki M, Ito R, Yokoyama T. Recurrent Verruconis gallopava Infection at One Year after Excision of a Solitary Pulmonary Lesion. Intern Med 2024; 63:1499-1503. [PMID: 37661451 PMCID: PMC11157328 DOI: 10.2169/internalmedicine.2263-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/18/2023] [Indexed: 09/05/2023] Open
Abstract
We herein report a case of recurrent infection caused by Verruconis gallopava, which is known to cause fatal phaeohyphomycosis. A 71-year-old man presented with a fever, and computed tomography revealed right chest wall thickening. Eleven years earlier, he had undergone autologous peripheral blood stem cell transplantation for a hematological malignancy. One year earlier, he had undergone excision of a solitary pulmonary nodule, from which had been detected V. gallopava. On this occasion, right chest wall surgery was performed to investigate the cause of the fever, which led to the diagnosis of recurrent infection. Even if a localized lesion is excised, additional antifungal therapy should be performed.
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Affiliation(s)
- Yuta Kodama
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Japan
| | - Akihiko Matsuura
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Japan
| | - Aya Shirahige
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Japan
| | - Masao Hiroshima
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Japan
| | - Yusuke Tsushima
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Japan
| | - Mari Tanaka
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Japan
| | - Masayasu Inagaki
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Japan
| | - Ryota Ito
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Japan
| | - Toshihiko Yokoyama
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Japan
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Moran Viacava F, Bandres MV, Mishkin A. A case of skin and soft tissue infection in a lung transplant recipient. Transpl Infect Dis 2024; 26:e14210. [PMID: 38041498 DOI: 10.1111/tid.14210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 12/03/2023]
Affiliation(s)
- Flavia Moran Viacava
- Department of Internal Medicine at Temple University Hospital, Philadelphia, Pennsylvania, USA
| | | | - Aaron Mishkin
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
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3
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Jirawat N, Leelayuwatanakul N. Unusual manifestation of pulmonary Verruconis gallopava infection with synchronous reactive pericardial effusion in a non-transplanted patient. BMJ Case Rep 2023; 16:e251835. [PMID: 37474138 PMCID: PMC10360439 DOI: 10.1136/bcr-2022-251835] [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] [Indexed: 07/22/2023] Open
Abstract
Verruconis gallopava is an emerging causative agent in solid organ transplant patients, increasing in prevalence both in non-transplanted patients and also in immunocompetent ones, albeit rarely. In this case report, we describe an unusual V. gallopava infection in a patient with steroid-dependent autoimmune haemolytic anaemia. The chest CT scan revealed a mass-like consolidation in the superior segment of the right lower lobe, and bronchoscopic examination confirmed V. gallopava from bronchoalveolar lavage. The histopathology showed non-necrotising granulomatous inflammation concurrent with septate-pigmented hyphae, which is compatible with dematiaceous fungi. After 3 weeks of posaconazole treatment, the patient developed a new pericardial effusion. Further investigations, including culture, cytology and histopathology, yielded negative results, leading to suspicion of reactive pericardial effusion associated with V. gallopava pulmonary infection. The patient received antifungal therapy for 9 months, after which a follow-up chest CT scan showed complete resolution of consolidation and pericardial effusion.
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Affiliation(s)
- Napat Jirawat
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nophol Leelayuwatanakul
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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4
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Tsai YT, Lu PL, Lee KM, Kuo YR. Lung and Brain Abscesses in an Upper Extremity Allotransplantation Recipient. Clin Infect Dis 2022; 75:545-548. [PMID: 36041231 DOI: 10.1093/cid/ciab831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yu Te Tsai
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po Liang Lu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun Mu Lee
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yur Ren Kuo
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Orthopaedic Research Center, Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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5
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Radcliffe C, Radcliffe AJ, Azar MM, Grant M. Dematiaceous fungal infections in solid organ transplantation: systematic review and bayesian meta-analysis. Transpl Infect Dis 2022; 24:e13819. [PMID: 35253959 DOI: 10.1111/tid.13819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/03/2022] [Accepted: 02/19/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Dematiaceous fungi cause a number of infectious syndromes referred to as phaeohyphomycosis among both immunocompetent and immunocompromised hosts. We performed a systematic review to characterize these infections in solid organ transplant recipients (SOTR). METHODS We searched PubMed database (last searched 1/6/2022) for English-language reports on dematiaceous fungal infections in SOTR. Included reports needed individualized demographic, treatment, and outcome data; pediatric reports were excluded. A universally applicable bias assessment was performed on reports. Models for infection type and outcome were created using the Bayesian paradigm. RESULTS We included 149 reports on 201 cases of dematiaceous fungal infections in SOTR. The mean age was 54 years, 72% were men, and kidney recipients accounted for 61% of cases. Skin and soft tissue infection (SSTI) was the most common infectious syndrome (73%). Death from infection occurred in 7% of cases (14/201), with disseminated (32%) cases having the highest mortality. Our model for infection type predicted the relative probability of central nervous system infection to be highest in liver recipients. Across all transplant types, higher relative probabilities of disseminated and pulmonary infections occur in the early post-transplant period, and the predicted probabilities for these infection types decreased after 100 months post-transplantation. DISCUSSION We identified SSTI as the most common dematiaceous fungal infections in SOTR. Disseminated infections carried the worst prognosis. The evidence in this review is limited by the heterogeneity of included cases. No funding source was used, and this review's protocol was not registered. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | - Marwan M Azar
- Yale University School of Medicine, New Haven, CT, USA.,Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA
| | - Matthew Grant
- Yale University School of Medicine, New Haven, CT, USA.,Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA
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Martin M, Hobbs ALV, Baird M. Successful treatment of disseminated Verruconis gallopava infection in a heart transplant recipient: A case report. Am J Health Syst Pharm 2022; 79:1066-1069. [PMID: 35245929 DOI: 10.1093/ajhp/zxac063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE To describe a case of disseminated Verruconis gallopava infection in a cardiac transplant recipient that was successfully treated with oral posaconazole and intravenous anidulafungin. SUMMARY A 51-year-old male initially presented with pulmonary manifestations, but subsequently developed cutaneous lesions, fungemia, osteomyelitis of the hip requiring excision, and eventually brain abscesses over the course of 3 months. The patient was successfully treated with various antifungal agents throughout his treatment course and was eventually discharged on oral posaconazole and intravenous anidulafungin. He remained on oral posaconazole suppressive therapy and had had no recurrence of fungal infection after 31 months of follow-up. CONCLUSION On the basis of this case report, intravenous anidulafungin and chronic suppressive therapy with oral posaconazole can successfully treat disseminated V. gallopava infections.
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Murata K, Ogawa Y, Kusama K, Yasuhara Y. Disseminated Verruconis gallopava infection in a patient with systemic lupus erythematosus in Japan: A case report, literature review, and autopsy case. Med Mycol Case Rep 2022; 35:35-38. [PMID: 35096522 PMCID: PMC8783064 DOI: 10.1016/j.mmcr.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/24/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022] Open
Abstract
Disseminated Verruconis gallopava infection is often reported in patients with severe immunodeficiency, such as those who have received an organ transplant or have hematological malignancies. The present report describes the first case of disseminated V. gallopava in a patient with systemic lupus erythematosus who used FK506 (Tacrolimus). In this case, β-D glucan was useful for diagnosis.
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Affiliation(s)
- Kenya Murata
- Department of Internal Medicine, Sakai City Medical Hospital, Ebaraji 1-1-1, Sakai, Osaka, Japan
- Corresponding author.
| | - Yoshihiko Ogawa
- Department of Infectious Disease, Sakai City Medical Hospital, Ebaraji 1-1-1, Sakai, Osaka, Japan
| | - Kayo Kusama
- Department of Respiratory Medicine, Sakai City Medical Hospital, Ebaraji 1-1-1, Sakai, Osaka, Japan
| | - Yumiko Yasuhara
- Department of Pathology, Sakai City Medical Hospital, Ebaraji 1-1-1, Sakai, Osaka, Japan
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Adelman MW, Dean CL, Friedman-Moraco RJ. A Brain Abscess and Pulmonary Nodules in a Heart/Kidney Transplant Recipient. Clin Infect Dis 2021; 71:1795-1797. [PMID: 33095258 DOI: 10.1093/cid/ciaa106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Max W Adelman
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christina L Dean
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Rachel J Friedman-Moraco
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Muthu V, Gandra RR, Dhooria S, Sehgal IS, Prasad KT, Kaur H, Gupta N, Bal A, Ram B, Aggarwal AN, Chakrabarti A, Agarwal R. Role of flexible bronchoscopy in the diagnosis of invasive fungal infections. Mycoses 2021; 64:668-677. [PMID: 33719109 DOI: 10.1111/myc.13263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND There are sparse data on the role of flexible bronchoscopy (FB) in diagnosing invasive mould infections (IMIs). OBJECTIVE To investigate the safety and usefulness of FB in IMI. We evaluate the factors associated with a successful diagnosis of IMI using FB. Further, we compare subjects of invasive pulmonary aspergillosis (IPA) with pulmonary mucormycosis (PM). METHODS We retrospectively reviewed the clinical features, imaging data, bronchoscopy, microbiology and pathology details of subjects who underwent FB for suspected IMI. We categorised FB as diagnostic if it contributed to the diagnosis of IMI. We performed a multivariate analysis to identify the factors associated with a diagnostic bronchoscopy. RESULTS Of the 3521 FB performed over 18 months, 132 (3.7%) were done for suspected IMIs. We included 107 subjects for the final analysis. The risk factors for IMI included renal transplantation (29.0%), diabetes (27.1%), haematological malignancy (10.3%) and others. We found bronchoscopic abnormalities in 33 (30.8%) subjects, and these were more frequent in those with confirmed PM (67%) than IPA (27%). IMI was confirmed in 79 (14 proven, 48 probable and 17 possible) subjects. FB was diagnostic in 71%. We experienced major complications in three cases (2.7%), including one death. On multivariate analysis, the visualisation of endobronchial abnormalities during FB (OR [95%, CI], 8.5 [1.4-50.4]) was the only factor associated with a diagnostic FB after adjusting for age and various risk factors. CONCLUSIONS Flexible bronchoscopy is a useful and safe procedure in diagnosing IMIs. The presence of endobronchial abnormalities predicts a successful diagnostic yield on FB.
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Affiliation(s)
- Valliappan Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Raghava Rao Gandra
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Inderpaul Singh Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kuruswamy Thurai Prasad
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Harsimran Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nalini Gupta
- Department of Cytology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Amanjit Bal
- Department of Histopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Babu Ram
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ashutosh N Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Moran C, Delafield NL, Kenny G, Asbury KL, Larsen BT, Lambert KL, Patron RL. A case ofVerruconis gallopavainfection in a heart transplant recipient successfully treated with posaconazole. Transpl Infect Dis 2019; 21:e13044. [DOI: 10.1111/tid.13044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/06/2018] [Accepted: 12/16/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Conor Moran
- Department of Medicine Mater Misericordiae University Hospital Dublin Ireland
| | | | - Grace Kenny
- Department of Medicine Mater Misericordiae University Hospital Dublin Ireland
| | - Kara L. Asbury
- Division of Infectious Diseases Mayo Clinic Hospital Phoenix Arizona
| | - Brandon T. Larsen
- Department of Laboratory Medicine and Pathology Mayo Clinic Scottsdale Arizona
| | - Karen L. Lambert
- Department of Laboratory Medicine and Pathology Mayo Clinic Hospital Phoenix Arizona
| | - Roberto L. Patron
- Division of Infectious Diseases Mayo Clinic Hospital Phoenix Arizona
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12
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Zhang TY, Yu Y, Zhang MY, Cheng J, Chen ZJ, Zhang JY, Zhang YX. Verruconis panacis sp. nov., an endophyte isolated from Panax notoginseng. Int J Syst Evol Microbiol 2018; 68:2499-2503. [PMID: 29923818 DOI: 10.1099/ijsem.0.002862] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
An endophytic strain (designated as strain SYPF 8337T) was isolated from the root of 3-year-old Panax notoginseng in Yunnan province of China. Strain SYPF 8337T grew slowly and formed pale brown to brown colonies. Phylogenetic analyses indicated that strain SYPF 8337T was placed in the Verruconis clade. Different from other Verruconis species, strain SYPF 8337T produced four-cell conidia. Furthermore, strain SYPF 8337T is the first fungus isolated as an endophyte of P. notoginseng in the genus Verruconis. Combined with the morphology and molecular analyses, a new species named Verruconis panacis sp. nov. is proposed.
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Affiliation(s)
- Tian-Yuan Zhang
- 1School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, PR China
| | - Ying Yu
- 1School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, PR China
| | - Meng-Yue Zhang
- 1School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, PR China
| | - Juan Cheng
- 1School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, PR China
| | - Zhong-Jian Chen
- 2Wenshan Sanqi Research Institute, Wenshan University, Wenshan 663000, PR China
| | - Jin-Yu Zhang
- 3Institute of Medicinal Plants, Yunnan Academy of Agricultural Sciences, Kunming 650200, PR China
| | - Yi-Xuan Zhang
- 1School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, PR China
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13
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Messina JA, Wolfe CR, Hemmersbach-Miller M, Milano C, Todd JL, Reynolds J, Alexander BD, Schell WA, Cuomo CA, Perfect JR. Genomic characterization of recurrent mold infections in thoracic transplant recipients. Transpl Infect Dis 2018; 20:e12935. [PMID: 29851203 DOI: 10.1111/tid.12935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 04/16/2018] [Accepted: 04/18/2018] [Indexed: 12/18/2022]
Abstract
Invasive mold disease in thoracic organ transplant recipients is a well-recognized complication, but the long-term persistence of molds within the human body and evasion of host defenses has not been well-described. We present 2 cases of invasive mold disease (Verruconis gallopava and Aspergillus fumigatus) in thoracic transplant recipients who had the same mold cultured years prior to the invasive disease presentation. The paired isolates from the index and recurrent infections in both patients were compared using whole-genome sequencing to determine if the same strain of mold caused both the index and recurrent infections. In Case 1, the isolates were found to be of the same strain indicating that the initial colonizing isolate identified pre-transplant eventually caused invasive mold disease post-transplant while in Case 2, the 2 isolates were not of the same strain. These results demonstrate the distinct possibility of molds both persisting within the human body for years prior to invasive mold disease or the long-term risk of recurrent, persistent infection with more than one strain. Further studies of long-term molecular epidemiology of IMD and risk factors for mold persistence in transplant recipients are encouraged.
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Affiliation(s)
- Julia A Messina
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA
| | - Cameron R Wolfe
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA
| | | | - Carmelo Milano
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University, Durham, NC, USA
| | - Jamie L Todd
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Duke University, Durham, NC, USA
| | - John Reynolds
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Duke University, Durham, NC, USA
| | - Barbara D Alexander
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA
| | - Wiley A Schell
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA
| | - Christina A Cuomo
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - John R Perfect
- Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA
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14
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De La Cruz O, Silveira FP. Respiratory Fungal Infections in Solid Organ and Hematopoietic Stem Cell Transplantation. Clin Chest Med 2017; 38:727-739. [PMID: 29128021 DOI: 10.1016/j.ccm.2017.07.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Respiratory fungal infections are associated with high morbidity and mortality in hematopoietic stem cell (HSCT) and solid organ (SOT) transplant recipients, and are caused primarily by molds. Aspergillus is the most common pathogen. The net state of immunosuppression plays a major role in the risk of respiratory fungal infections after transplantation. Clinical presentation can be atypical and diagnosis can be delayed due to low sensitivity of diagnostic methods or inability to obtain adequate specimens. Fungal infections in HSCT and SOT carry a higher risk of dissemination. New prophylaxis strategies have changed the epidemiology of fungal infections in this patient population.
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Affiliation(s)
- Oveimar De La Cruz
- Department of Medicine, Division of Infectious Diseases, Virginia Commonwealth University, VMI Building, Suite 205, 1000 East Marshall Street, Richmond, VA 23298, USA
| | - Fernanda P Silveira
- Department of Medicine, Division of Infectious Diseases, University of Pittsburgh, 3601 Fifth Avenue, Suite 3A, Pittsburgh, PA 15213, USA.
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15
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Jennings Z, Kable K, Halliday CL, Nankivell BJ, Kok J, Wong G, Chen SCA. Verruconis gallopava cardiac and endovascular infection with dissemination after renal transplantation: Case report and lessons learned. Med Mycol Case Rep 2016; 15:5-8. [PMID: 28053851 PMCID: PMC5198741 DOI: 10.1016/j.mmcr.2016.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/12/2016] [Accepted: 12/12/2016] [Indexed: 11/22/2022] Open
Abstract
Verruconis gallopava is an uncommon cause of phaeohyphomycosis. We describe an unusual case of disseminated V. gallopava infection in a renal transplant recipient involving the endocardium but without endocarditis, associated with fungaemia and infection in the skin, oral cavity, brain and lung. The isolate was first detected from blood cultures which is rare. Surgical resection of cardiac fungal mass was not possible. The patient died despite resolution of fungaemia and combination antifungal therapy.
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Affiliation(s)
- Zoe Jennings
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR – Pathology West, Westmead Hospital, Sydney, Australia
- Corresponding author.
| | - Kathy Kable
- Deparment of Renal Medicine, Westmead Hospital, Sydney, Australia
| | - Catriona L. Halliday
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR – Pathology West, Westmead Hospital, Sydney, Australia
| | | | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR – Pathology West, Westmead Hospital, Sydney, Australia
| | - Germaine Wong
- Deparment of Renal Medicine, Westmead Hospital, Sydney, Australia
- Centre for Transplant and Renal Research, Westmead Hospital and Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Sharon C.-A. Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR – Pathology West, Westmead Hospital, Sydney, Australia
- Marie Bashir Institute for Infectious Diseases & Biosecurity, The University of Sydney, Sydney, Australia
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16
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McCarthy MW, Walsh TJ. PCR methodology and applications for the detection of human fungal pathogens. Expert Rev Mol Diagn 2016; 16:1025-36. [PMID: 27484841 DOI: 10.1080/14737159.2016.1219253] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Polymerase chain reaction (PCR) has emerged as a promising technology for the rapid and reliable detection and identification of medical mycoses. Recent technological advancements - including microarray, multiplex PCR with magnetic resonance, and beacon probes - have mitigated the technical difficulties of performing nucleic amplification in fungi, thereby improving the sensitivity and specificity of PCR-based assays. In this paper, we examine current applications of PCR in the diagnosis of human fungal infections and look ahead to emerging techniques that may play a larger role in molecular diagnostics in the future. AREAS COVERED This review includes a brief overview of the advantages and disadvantages of PCR using various clinical specimens, manual versus automated DNA extraction procedures, panfungal versus specific targets, and spectrum of pathogens detected. This is followed by a brief synopsis of species-specific PCR approaches and a more in-depth look at the obstacles to widespread implementation. Expert commentary: The review concludes with a short perspective for the next five years, including the hurdles to standardization and validation, as well as the role of PCR coupled with electrospray-ionization mass spectrometry (PCR/ESI-MS) or nuclear magnetic resonance for the diagnosis of medical mycoses.
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Affiliation(s)
- Matthew William McCarthy
- a Hospital Medicine , Joan and Sanford I Weill Medical College of Cornell University Ringgold Standard Institution , New York , NY , USA
| | - Thomas J Walsh
- b Transplantation-Oncology Infectious Diseases Program , Weill Cornell Medical Center , New York , NY , USA
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17
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Shi D, Lu G, Mei H, de Hoog GS, Samerpitak K, Deng S, Shen Y, Liu W. Subcutaneous infection by Ochroconis mirabilis in an immunocompetent patient. Med Mycol Case Rep 2016; 11:44-7. [PMID: 27182484 PMCID: PMC4857222 DOI: 10.1016/j.mmcr.2016.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 04/25/2016] [Accepted: 04/25/2016] [Indexed: 12/04/2022] Open
Abstract
Recently, the taxonomy of Ochroconis (Ascomycota, Pezizomycotina, Venturiales, Sympoventuriaceae) has been revised with the recognition of an additional genus, Verruconis. Ochroconis comprises mesophilic saprobes that occasionally infect vertebrates which mostly are cold-blooded, while Verruconis contains thermophilic species which is a neurotrope in humans and birds. On the basis of molecular data it is noted that only a single Ochroconis species regularly infects immunocompetent human hosts. Here we report a subcutaneous infection due to Ochroconis mirabilis in a 50-year-old immunocompetent female patient. In vitro antifungal susceptibility tests revealed that terbinafine was the most effective drug. The patient was successfully cured with oral administration of terbinafine 250 mg daily in combination with 3 times of topical ALA-photodynamic therapy for 9 months.
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Affiliation(s)
- Dongmei Shi
- Department of Dermatology, Jining No.1 People's Hospital, Shandong, China; Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
| | - Guixia Lu
- Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
| | - Huan Mei
- Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
| | | | | | - Shuwen Deng
- Shanghai Institute of Medical Mycology, Changzheng Hospital of Second Military University, Shanghai, China
| | - Yongnian Shen
- Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
| | - Weida Liu
- Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, Jiangsu, China
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Douglas AP, Chen SCA, Slavin MA. Emerging infections caused by non-Aspergillus filamentous fungi. Clin Microbiol Infect 2016; 22:670-80. [PMID: 26812445 DOI: 10.1016/j.cmi.2016.01.011] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/02/2016] [Accepted: 01/09/2016] [Indexed: 12/25/2022]
Abstract
There are three broad groups of non-Aspergillus moulds: the mucormycetes, the hyalohyphomycetes and the phaeohyphomycetes. Infections with these pathogens are increasingly reported, particularly in the context of increasing use of immunosuppressant agents and improved diagnostics. The epidemiology of non-Aspergillus mould infections varies with geography, climate and level of immunosuppression. Skin and soft-tissue infections are the predominant presentation in the immunocompetent host and pulmonary and other invasive infections in the immunocompromised host. The more common non-Aspergillus moulds include Rhizopus, Mucor, Fusarium and Scedosporium species; however, other emerging pathogens are Rasamsonia and Verruconis species, which are discussed in this article. Outbreaks of non-Aspergillus mould infections have been increasingly reported, with contaminated medical supplies and natural disasters as common sources. Currently culture and other conventional diagnostic methods are the cornerstone of diagnosis. Molecular methods to directly detect and identify mould pathogens in tissue and body fluids are increasingly used.
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Affiliation(s)
- A P Douglas
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - S C-A Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR-Pathology West, Westmead Hospital, University of Sydney, New South Wales, Australia
| | - M A Slavin
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; University of Melbourne, Melbourne, Victoria, Australia.
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19
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Slavin M, van Hal S, Sorrell T, Lee A, Marriott D, Daveson K, Kennedy K, Hajkowicz K, Halliday C, Athan E, Bak N, Cheong E, Heath C, Orla Morrissey C, Kidd S, Beresford R, Blyth C, Korman T, Owen Robinson J, Meyer W, Chen SA. Invasive infections due to filamentous fungi other than Aspergillus: epidemiology and determinants of mortality. Clin Microbiol Infect 2015; 21:490.e1-10. [DOI: 10.1016/j.cmi.2014.12.021] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 12/18/2014] [Accepted: 12/30/2014] [Indexed: 11/30/2022]
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20
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Geltner C, Sorschag S, Willinger B, Jaritz T, Saric Z, Lass-Flörl C. Necrotizing mycosis due to Verruconis gallopava in an immunocompetent patient. Infection 2015; 43:743-6. [PMID: 25744338 DOI: 10.1007/s15010-015-0757-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 02/24/2015] [Indexed: 11/28/2022]
Abstract
Verruconis gallopava is a dematiaceous mould usually causing saprophytic infection in immunosuppressed host. Only a few cases have been published even in immunocompromised states. We present a rare case of pulmonary involvement in an immunocompetent patient with recurrent disease. The mid-aged woman had no evidence of any disease causing impaired immune response. Recurrent disease shows pulmonary infiltrates and symptoms of allergic bronchopulmonary mycosis. We describe an emerging pathogen that has been found in an immunocompetent host. Eradication was not possible despite the use of several different antifungal drugs. Further recurrence of infection in the described patient is probable.
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Affiliation(s)
- Christian Geltner
- Department of Pulmonology, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, AT 9020, Klagenfurt, Austria.
| | - Sieglinde Sorschag
- Institute of Laboratory Diagnostics and Microbiology, Klinikum Klagenfurt, Klagenfurt, Austria
| | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Jaritz
- Department of Pulmonology, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, AT 9020, Klagenfurt, Austria
| | - Zoran Saric
- Department of Pulmonology, Klinikum Klagenfurt am Wörthersee, Feschnigstr. 11, AT 9020, Klagenfurt, Austria
| | - Cornelia Lass-Flörl
- Division of Hygiene and Microbiology, Medical University Innsbruck, Innsbruck, Austria
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21
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Niessen L. Current state and future perspectives of loop-mediated isothermal amplification (LAMP)-based diagnosis of filamentous fungi and yeasts. Appl Microbiol Biotechnol 2014; 99:553-74. [PMID: 25492418 DOI: 10.1007/s00253-014-6196-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/22/2014] [Accepted: 10/23/2014] [Indexed: 11/30/2022]
Abstract
Loop-mediated isothermal amplification is a rather novel method of enzymatic deoxyribonucleic acid amplification which can be applied for the diagnosis of viruses, bacteria, and fungi. Although firmly established in viral and bacterial diagnosis, the technology has only recently been applied to a noteworthy number of species in the filamentous fungi and yeasts. The current review gives an overview of the literature so far published on the topic by discussing the different groups of fungal organisms to which the method has been applied. Moreover, the method is described in detail as well as the different possibilities available for signal detection and quantification and sample preparation. Future perspective of loop-mediated isothermal amplification-based assays is discussed in the light of applicability for fungal diagnostics.
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Affiliation(s)
- Ludwig Niessen
- Technische Universität München, Lehrstuhl für Technische Mikrobiologie, Gregor-Mendel-Straße 4, 85354, Freising, Germany,
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22
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Occurrence of Ochroconis and Verruconis species in clinical specimens from the United States. J Clin Microbiol 2014; 52:4189-201. [PMID: 25232157 DOI: 10.1128/jcm.02027-14] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Ochroconis is a dematiaceous fungus able to infect immunocompetent people. Recently, the taxonomy of the genus has been reevaluated, and the most relevant species, Ochroconis gallopava, was transferred to the new genus Verruconis. Due to the important clinical implications of these fungi and based on the recent classification, it was of interest to know the spectra of Ochroconis and Verruconis species in clinical samples received in a reference laboratory in the United States. A set of 51 isolates was identified morphologically and molecularly based on sequence analyses of the nuclear ribosomal RNA (nrRNA), actin, and β-tubulin genes. Verruconis gallopava was the most common species (68.6%), followed by Ochroconis mirabilis (21.5%). One isolate of Ochroconis cordanae was found, being reported for the first time in a clinical setting. The most common anatomical site of isolation was the lower respiratory tract (58.8%), followed by superficial and deep tissues at similar frequencies (21.6 and 19.6%, respectively). Interestingly, three new species were found, which are Ochroconis olivacea and Ochroconis ramosa from clinical specimens and Ochroconis icarus of an environmental origin. The in vitro antifungal susceptibilities of eight antifungal drugs against the Ochroconis isolates revealed that terbinafine and micafungin were the most active drugs.
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23
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Abstract
The recent outbreak of exserohilum rostratum meningitis linked to epidural injections of methylprednisolone acetate has brought renewed attention to mold infections of the central nervous system (CNS). Although uncommon, these infections are often devastating and difficult to treat. This focused review of the epidemiologic aspects, clinical characteristics, and treatment of mold infections of the CNS covers a group of common pathogens: aspergillus, fusarium, and scedosporium species, molds in the order Mucorales, and dematiaceous molds. Infections caused by these pathogen groups have distinctive epidemiologic profiles, clinical manifestations, microbiologic characteristics, and therapeutic implications, all of which clinicians should understand.
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Affiliation(s)
- Matthew McCarthy
- From the Transplantation-Oncology Infectious Diseases Program, Departments of Medicine, Pediatrics, and Microbiology and Immunology (M.M., T.J.W.), and the Departments of Neurology, Neuroscience, and Neurosurgery (A.R.) and Pathology and Laboratory Medicine (A.N.S.), Weill Cornell Medical Center of Cornell University, New York; and the Infectious Diseases Department and Division of Internal Medicine, University of Texas M.D. Anderson Cancer Center, Houston (D.P.K.)
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24
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Duarte APM, Attili-Angelis D, Baron NC, Forti LC, Pagnocca FC. Leaf-cutting ants: an unexpected microenvironment holding human opportunistic black fungi. Antonie van Leeuwenhoek 2014; 106:465-73. [PMID: 24969946 DOI: 10.1007/s10482-014-0215-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 06/11/2014] [Indexed: 11/26/2022]
Abstract
Fungus-growing ants of the genus Atta are known for their leaf-cutting habit, a lifestyle they have maintained since their 50-million-year-old co-evolution with a mutualistic fungus, cultivated as food. Recent studies have highlighted that, in addition to the mutualistic fungus, nests of ants harbor a great diversity of microbial communities. Such microorganisms include the dematiaceous fungi, which are characterized by their melanized cell walls. In order to contribute to the knowledge of fungal ecology, as well as opportunistic strains that may be dispersed by these social insects, we isolated and identified fungi carried by gynes of Atta capiguara and Atta laevigata, collected from colonies located in Fazenda Santana, Botucatu (São Paulo, Brazil). The isolation was carried out using the oil flotation technique, which is suitable for the growth of black fungi. Inoculated plates were incubated at 25 and 35 °C until black cultures were visible (20-45 days). Isolates were identified based on microscopic and molecular characteristics. Some isolated genera were: Cladophialophora, Cladosporium, Exophiala, Ochroconis, Phaeococcomyces, Phialophora and Penidiella. Hyaline species were also found. The results obtained from this work showed that leaf-cutting gynes may contribute to the dispersal of opportunistic dematiaceous fungi. It is suggested that more attention should be paid to this still unexplored subject.
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Affiliation(s)
- A P M Duarte
- Center for the Study of Social Insects, UNESP - São Paulo State University, Rio Claro, SP, Brazil
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25
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Kaur H, Rudramurthy SM, Mohindra S, Gupta S, Chakrabarti A. Ochroconis humicola coexisting with esthesioneuroblastoma: an incidental coloniser or allergen? Mycopathologia 2014; 178:79-83. [PMID: 24952014 DOI: 10.1007/s11046-014-9759-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 05/10/2014] [Indexed: 10/25/2022]
Abstract
Ochroconis humicola, a fish pathogen, is rarely reported to cause disease in human. We report its first isolation from nasal tissue of a human immunodeficiency virus-positive young female patient. Histopathologically, the nasal mass was diagnosed as esthesioneuroblastoma. She presented with right-sided nasal obstruction and bleeding for two and half months. Computed tomography scan showed the nasal mass filling the whole right nasal cavity, maxillary, ethmoid and sphenoid sinuses. The direct microscopy of the nasal tissue and mucin demonstrated the presence of septate hyphae. On culture, O. humicola was isolated from the same tissue and the fungus was identified by morphologic, physiologic and molecular data including sequencing of ITS and 28S rDNA regions. No antifungal was prescribed, and the whole mass was resected out by endoscopic surgery. The patient was treated further by radical radiotherapy. After 1 year of follow-up, patient is stable with no recurrence of tumour. The role of this fungus was not clear, as it may be bystander or producing allergic fungal rhinosinusitis.
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Affiliation(s)
- Harsimran Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
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26
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Chowdhary A, Meis J, Guarro J, de Hoog G, Kathuria S, Arendrup M, Arikan-Akdagli S, Akova M, Boekhout T, Caira M, Guinea J, Chakrabarti A, Dannaoui E, van Diepeningen A, Freiberger T, Groll A, Hope W, Johnson E, Lackner M, Lagrou K, Lanternier F, Lass-Flörl C, Lortholary O, Meletiadis J, Muñoz P, Pagano L, Petrikkos G, Richardson M, Roilides E, Skiada A, Tortorano A, Ullmann A, Verweij P, Cornely O, Cuenca-Estrella M. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi. Clin Microbiol Infect 2014; 20 Suppl 3:47-75. [DOI: 10.1111/1469-0691.12515] [Citation(s) in RCA: 216] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 12/13/2013] [Accepted: 12/16/2013] [Indexed: 11/28/2022]
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27
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Antifungal susceptibility patterns of opportunistic fungi in the genera Verruconis and Ochroconis. Antimicrob Agents Chemother 2014; 58:3285-92. [PMID: 24687495 DOI: 10.1128/aac.00002-14] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Species of Verruconis and species of Ochroconis are dematiaceous fungi generally found in the environment but having the ability to infect humans, dogs, cats, poultry, and fish. This study presents the antifungal susceptibility patterns of these fungi at the species level. Forty strains originating from clinical and environmental sources were phylogenetically identified at the species level by using sequences of the ribosomal DNA internal transcribed spacer (rDNA ITS). In vitro antifungal susceptibility testing was performed against eight antifungals, using the Clinical and Laboratory Standards Institute (CLSI) broth microdilution method. The geometric mean MICs for amphotericin B (AMB), flucytosine (5FC), fluconazole (FLC), itraconazole (ITC), voriconazole (VRC), and posaconazole (POS) and minimum effective concentrations (MECs) for caspofungin (CAS) and anidulafungin (AFG) across the Ochroconis and Verruconis species were as follows, in increasing order. For Verruconis species, the values (μg/ml) were as follows: AFG, 0.04; POS, 0.25; ITC, 0.37; AMB, 0.50; CAS, 0.65; VRC, 0.96; 5FC, 10.45; and FLC, 47.25. For Ochroconis species, the values (μg/ml) were as follows: AFG, 0.06; POS, 0.11; CAS, 0.67; VRC, 2.76; ITC, 3.94; AMB, 5.68; 5FC, 34.48; and FLC, 61.33. Antifungal susceptibility of Ochroconis and Verruconis was linked with phylogenetic distance and thermotolerance. Echinocandins and POS showed the greatest in vitro activity, providing possible treatment options for Ochroconis and Verruconis infections.
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28
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Abstract
A presence of black pigmentation involving the endobronchial tree is not uncommon. It was first described in the literature in association with occupational exposure in the early 1940s. However, in 2003, Packham and Yeow formally used the term black bronchoscopy to describe endobronchial metastasis from a malignant melanoma. Hyperpigmentation of the airway, however, is associated with multiple etiologies such as congenital disease, inborn errors of metabolism, infections, environmental exposures, neoplasm, and iatrogenic causes. Although the majority of these conditions are benign, a proper diagnosis is important for optimal management. In this article, we review the etiology of black bronchoscopy and discuss its presentations and current management guidelines.
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Affiliation(s)
| | - Tanmay S Panchabhai
- Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Danai Khemasuwan
- Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH
| | - Atul C Mehta
- Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH.
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Kumaran MS, Bhagwan S, Savio J, Rudramurthy SM, Chakrabarti A, Tirumalae R, Abraham A. Disseminated cutaneousOchroconis gallopavainfection in an immunocompetent host: an unusual concurrence - a case report and review of cases reported. Int J Dermatol 2013; 54:327-31. [DOI: 10.1111/j.1365-4632.2012.05841.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Shuba Bhagwan
- Department of Dermatology; St Johns Medical College Hospital; Bangalore India
| | - Jayanthi Savio
- Department of Microbiology; St Johns Medical College Hospital; Bangalore India
| | | | | | | | - Anil Abraham
- Department of Dermatology; St Johns Medical College Hospital; Bangalore India
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30
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Cardeau-Desangles I, Fabre A, Cointault O, Guitard J, Esposito L, Iriart X, Berry A, Valentin A, Cassaing S, Kamar N. Disseminated Ochroconis gallopavainfection in a heart transplant patient. Transpl Infect Dis 2013; 15:E115-E118. [DOI: 10.1111/tid.12084] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- I. Cardeau-Desangles
- Department of Nephrology, Dialysis and Organ Transplantation; Rangueil University Hospital; Toulouse; France
| | - A. Fabre
- Department of Parasitology and Mycology; Rangueil University Hospital; Toulouse; France
| | - O. Cointault
- Department of Nephrology, Dialysis and Organ Transplantation; Rangueil University Hospital; Toulouse; France
| | - J. Guitard
- Department of Nephrology, Dialysis and Organ Transplantation; Rangueil University Hospital; Toulouse; France
| | - L. Esposito
- Department of Nephrology, Dialysis and Organ Transplantation; Rangueil University Hospital; Toulouse; France
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31
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Abstract
The most important emerging and rare fungal pathogens in solid organ transplant recipients are the Zygomycetes, Scedosporium, Fusarium, and the dark molds. Factors affecting the emergence of these fungi include the combination of intensive immunosuppressive regimens with increasingly widespread use of long-term azole antifungal therapy; employment of aggressive diagnostic approaches (eg, sampling of bronchoalveolar lavage fluid); and changes in patients' interactions with the environment. This article reviews the epidemiology, microbiology, and clinical impact of emerging fungal infections in solid organ transplant recipients, and provides up-to-date recommendations on their treatment.
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Affiliation(s)
- Shmuel Shoham
- Transplant and Oncology Infectious Diseases Program, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
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