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IRIE M, KITA C, YAMAGAMI T, MIYOSHI T, FUJIKI N, KURIYAGAWA Y, HANAFUSA Y, CHAMBERS JK, UCHIDA K. A case of Exophiala dermatitidis-induced phaeohyphomycosis in a cat with multiple intra-abdominal masses. J Vet Med Sci 2024; 86:550-554. [PMID: 38631889 PMCID: PMC11144537 DOI: 10.1292/jvms.23-0410] [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: 10/27/2023] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
Pus discharge containing black granular materials (1-2 mm in diameter) was found in the abdominal skin of a 13-year-old sterilized female cat. Abdominal ultrasonography revealed a large intra-abdominal mass with abundant blood flow beneath the skin lesion. Laparotomy revealed a large mass that adhered to the spleen and left kidney. Similar small lesions were found in the abdominal wall and mesentery. The masses were surgically removed along with the spleen and kidney. Histopathologically, the mass lesions consisted of granulomas with lesional pigmented fungi, and the cat was diagnosed with phaeohyphomycosis. Uisng genetic analysis, the Exophiala dermatitidis was identified as the causative pathogen.
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Affiliation(s)
| | - Chiaki KITA
- Shikoku Cytopathological Laboratory, Kagawa, Japan
| | | | | | | | | | - Yasuko HANAFUSA
- Enteric Pathogen Group, Division of Zoonosis Research, National Institute of Animal Health, National Agriculture and Food Research Organization, Ibaraki, Japan
| | - James Kenn CHAMBERS
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Kazuyuki UCHIDA
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
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Won EJ, Park SJ, Jo U, Sung H, Choi EJ, Kim MN. Phaeohyphomycosis due to Pleurostomophora richardsiae in a Patient with a Hematological Malignancy. MYCOBIOLOGY 2023; 51:468-470. [PMID: 38179113 PMCID: PMC10763908 DOI: 10.1080/12298093.2023.2275500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/20/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Eun Jeong Won
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sook-Ja Park
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Uiree Jo
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eun-Ji Choi
- Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Mi-Na Kim
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Molecular identification, phylogeny and antifungal susceptibilities of dematiaceous fungi isolated from human keratomycosis. J Infect Public Health 2022; 16:25-33. [PMID: 36459708 DOI: 10.1016/j.jiph.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/05/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the dematiaceous fungal profile of patients with ocular mycoses attending a tertiary eye care hospital in Coimbatore, India METHODS: The identification of dematiaceous fungus based on their morphology, their genotypes, and the measurement of the minimum inhibitory concentrations (MICs) using microdilution method of routinely used antifungal drugs were all compared. RESULTS A total of 148 dematiaceous fungi were isolated during a study period of 27 months. Isolates were confirmed as Curvularia spp. (n = 98), Exserohilum spp. (n = 32), Alternaria spp. (n = 14), Exophiala spp. (n = 2), Cladosporium sp. (n = 1) and Aureobasidium sp. (n = 1). Out of 50 well grown isolates characterized genotypically based on the amplification and sequencing of the ITS region of the ribosomal RNA gene cluster and subsequent BLAST analysis, Curvularia lunata (n = 24), C. aeria (n = 1), C. spicifera (n = 8), C. hawaiiensis (n = 1), C. maydis (n = 2), C. papendorfii (n = 2), C. geniculata (n = 3), C. tetramera (n = 2) and Exs. rostratum (n = 7) were identified. In vitro antifungal susceptibilities of the most tested dematiaceous isolates showed that voriconazole had a MIC50 of 0.25 μg ml-1, while amphotericin B had a MIC50 of 0.25 μg ml-1 for Curvularia spp. and Alternaria spp. CONCLUSION Voriconazole proved to be the most effective drug against the pigmented filamentous fungi, followed by amphotericin B, itraconazole and econazole.
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The Brief Case: Encephalitis in a West Texas Woman. J Clin Microbiol 2022; 60:e0227121. [PMID: 36383011 PMCID: PMC9667773 DOI: 10.1128/jcm.02271-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Alami S, Sekkal I, Aoufi S, Lyagoubi M, Benzekri L, Senouci K. Subcutaneous phaeohyphomycosis caused by Aureobasidium Pullulans in an immunocompetent carpenter. Med Mycol Case Rep 2022; 36:1-4. [PMID: 35242507 PMCID: PMC8861328 DOI: 10.1016/j.mmcr.2022.02.003] [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: 01/21/2022] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 01/19/2023] Open
Abstract
Phaeohyphomycosis refers to uncommon infections due to a large group of heterogeneous organisms called “dematiaceous fungi”. Here, we report a rare case of subcutaneous phaeohyphomycosis in an immunocompetent carpenter, presenting as multiple verrucous and confluent papulo-nodules of the right leg, and likely due to traumatic inoculation. The pathogenic fungal species was identified as Aureobasidium pullulans, according to macroscopic and microscopic morphological characteristics of the colonies. Surgical excision of the entire lesion and adjunctive antifungal therapy was curative.
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Does DHN-Melanin Always Protect Fungi against Antifungal Drugs? The Fonsecaea/Micafungin Paradigm. MICROBIOLOGY RESEARCH 2022. [DOI: 10.3390/microbiolres13020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Several human pathogenic fungi produce melanin. One of its properties during parasitism is the protection against antifungal drugs. This occurs with the agents of chromoblastomycosis, in which DHN-melanin reduces antifungal susceptibility to terbinafine and itraconazole. Since these agents are resistant to some antifungal drugs, we investigated the role of DHN-melanin on the Fonsecaea susceptibility to amphotericin B, micafungin, fluconazole, and flucytosine, drugs that usually present high minimal inhibitory concentrations (MIC) to this genus. Seven strains from three Fonsecaea human pathogenic species were treated with tricyclazole, a DHN-melanin inhibitor, and the MIC of the treated and untreated cells were compared. A survival assay was performed to confirm the alterations in the susceptibility of strains with reduced melanization, and the chitin levels of the strains were estimated by fluorescence. Tricyclazole did not affect fluconazole and flucytosine MIC, while melanin inhibition increased susceptibility to amphotericin B. Surprisingly, DHN-melanin inhibition decreased the susceptibility to micafungin. Survival assays confirmed this result on five strains. Cell wall chitin levels of the strains were not associated with the decrease in micafungin susceptibility. The results show that DHN-melanin does not have a role in the intrinsic resistance of Fonseacaea spp. to amphotericin B, fluconazole, and flucytosine, and its inhibition may promote micafungin resistance.
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Invasive Rhinosinusitis Caused by Alternaria infectoria in a Patient with Autosomal Recessive CARD9 Deficiency and a Review of the Literature. J Fungi (Basel) 2022; 8:jof8050446. [PMID: 35628702 PMCID: PMC9144991 DOI: 10.3390/jof8050446] [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: 02/28/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 11/29/2022] Open
Abstract
Phaeohyphomycoses comprise a heterogeneous group of fungal infections caused by dematiaceous fungi and have primarily been reported in patients with underlying acquired immunodeficiencies, such as hematological malignancies or solid-organ transplants. Over the past decade, a growing number of patients with phaeohyphomycosis but otherwise healthy were reported with autosomal recessive (AR) CARD9 deficiency. We report a 28-year-old woman who presented with invasive rhinosinusitis caused by Alternaria infectoria. Following a candidate gene sequencing approach, we identified a biallelic loss-of-function mutation of CARD9, thereby further broadening the spectrum of invasive fungal diseases found in patients with inherited CARD9 deficiency. In addition, we reviewed 17 other cases of phaeohyphomycosis associated with AR CARD9 deficiency. Physicians should maintain a high degree of suspicion for inborn errors of immunity, namely CARD9 deficiency, when caring for previously healthy patients with phaeohyphomycosis, regardless of age at first presentation.
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Tang M, Li J, Xia F, Min C, Liu Z, Hu Y, Wang H, Xu H, Zou M. Acute Post-Cataract Endophthalmitis Due to Phialemoniopsis curvata: A Rare Case Report. Infect Drug Resist 2022; 15:1651-1657. [PMID: 35422644 PMCID: PMC9004724 DOI: 10.2147/idr.s359481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/26/2022] [Indexed: 11/23/2022] Open
Abstract
Phialemonium species are a class of opportunistic pathogenic fungi widely present in the environment that cause invasive diseases in hosts with normal or weak immune functions. Common infections include peritonitis, endocarditis, osteomyelitis, and skin infections of wounds after burns, whereas endophthalmitis is rarely reported. Here, we report acute post-cataract endophthalmitis caused by Phialemoniopsis curvata in China. The isolated pathogen was identified using microscopy, culture, and sequencing. After vitrectomy, intraocular lens removal surgery, voriconazole injection, and topical voriconazole treatment, the patient’s symptoms were alleviated.
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Affiliation(s)
- Mengli Tang
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Jun Li
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Fengjun Xia
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Changhang Min
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Zhaojun Liu
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Yongmei Hu
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Haichen Wang
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Heping Xu
- Department of Clinical Laboratory, the First Affiliated Hospital of Xiamen University, Xiamen, Fujian, People’s Republic of China
| | - Mingxiang Zou
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- Correspondence: Mingxiang Zou, Department of Clinical Laboratory, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha, 410008, Hunan, People’s Republic of China, Tel +86 13907496278, Email
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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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Kortei NK, Tetteh RA, Wiafe-Kwagyan M, Amon DNK, Odamtten GT. Mycobiota profile, phenology, and potential toxicogenic and pathogenic species associated with stored groundnuts ( Arachis hypogaea L.) from the Volta Region, Ghana. Food Sci Nutr 2022; 10:888-902. [PMID: 35311164 PMCID: PMC8907750 DOI: 10.1002/fsn3.2719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/02/2021] [Accepted: 12/13/2021] [Indexed: 11/12/2022] Open
Abstract
This study updates the mycobiota resident in groundnut seeds, their phenology during storage with the view to ascertain their occurrence, potential toxigenic species, and pathologically important species in the stored samples. The moisture content of the seeds ranged from 5.7% to 6.5% within the stipulated safe moisture content of 8% for extension of shelf life. Culturing the seeds on mycological media (Sabouraud's Dextrose Agar SDA; Oxytetracycline Glucose Yeast Extract OGYE, Potato Dextrose Agar, PDA) caused a de novo growth of the quiescent spores at 28-30°C for 7-14 days. Fungal population counts on the three media ranged from 2.01 to 2.16 log10 CFU/g samples to a final 6-month count of 1.67-2.60 log10 CFU/g. Eighteen different fungal species belonging to ten genera were encountered on the media, namely Aspergillus, Cladosporium, Curvularia, Fusarium, Penicillium, Trichoderma, Rhizopus, Rhodotorula, Sporendonema, and Paecilomyces. Aspergillus spp. (A. niger, A. flavus, A. fumigatus, and A. terreus) were the most frequently isolated, followed by Fusarium species (F. oxysporum, F. solani, and F. verticillioides), Trichoderma (T. harzianum and T. viride), Rhizopus spp (R. oligosporus and R. stolonifer), and Penicillium verrucosum. The species which were seed borne (A. niger, A. flavus, A. terreus, A. fumigatus, F. solani, F. verticillioides, T. viride, C. herbarum, and Curvularia lunata) were isolated on both surface sterilized and non-surface sterilized seeds. The phenology of the encountered fungal species generally followed five patterns. The most frequently isolated Aspergillus niger, A. flavus, and A. fumigatus predominated throughout the 6 months sampling period, while A. ustus and A. terreus appeared sporadically and disappeared. The early colonizers (R. oligosporus, R. stolonifer, and Paecilomyces) could not be isolated after 2-3 months owing presumably to stronger antibiosis competition from the Aspergillus species. The most predominant Aspergillus species initially constituted 36%-48% of the total population but declined to 10%-36% in 6 months. Mycobiota encountered with mycotoxigenic potential and human health importance were A. niger, A. flavus, A. fumigatus, F. verticillioides, and Penicillium verrucosum. Other species of pathological importance to plants were Curvularia lunata and Fusarium oxysporum. The practical implications of these findings are discussed.
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Affiliation(s)
- Nii Korley Kortei
- Department of Nutrition and Dietetics School of Allied Health Sciences University of Health and Allied Sciences Ho Ghana
| | - Rachel Adinorkie Tetteh
- Department of Nutrition and Dietetics School of Allied Health Sciences University of Health and Allied Sciences Ho Ghana
| | - Michael Wiafe-Kwagyan
- Department of Plant and Environmental Biology College of Basic and Applied Sciences University of Ghana Legon Ghana
| | - Denick Nii Kotey Amon
- Department of Plant and Environmental Biology College of Basic and Applied Sciences University of Ghana Legon Ghana
| | - George Tawia Odamtten
- Department of Plant and Environmental Biology College of Basic and Applied Sciences University of Ghana Legon Ghana
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Liu B, Fu R, Wu B, Liu X, Xiang M. Rock-inhabiting fungi: terminology, diversity, evolution and adaptation mechanisms. Mycology 2022; 13:1-31. [PMID: 35186410 PMCID: PMC8856086 DOI: 10.1080/21501203.2021.2002452] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Rock-inhabiting fungi (RIF) constitute an ecological group associated with terrestrial rocks. This association is generally restricted to the persistent colonisation of rocks and peculiar morphological features based on melanisation and slow growth, which endow RIF with significance in eukaryotic biology, special status in ecology, and exotic potential in biotechnology. There is a need to achieve a better understanding of the hidden biodiversity, antistress biology, origin and convergent evolution of RIF, which will facilitate cultural relic preservation, exploitation of the biogeochemical cycle of rock elements and biotechnology applications. This review focuses on summarising the current knowledge of rock-inhabiting fungi, with particular reference to terminology, biodiversity and geographic distribution, origin and evolution, and stress adaptation mechanisms. We especially teased out the definition through summing up the terms related to rock-inhabting fungi, and also provided a checklist of rock-inhabiting fungal taxa recorded following updated classification schemes.
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Affiliation(s)
- Bingjie Liu
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Rong Fu
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Bing Wu
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Xingzhong Liu
- Department of Microbiology, College of Life Science, Nankai University, Tianjin, China
| | - Meichun Xiang
- State Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
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Superficial Suppurative Granulomatous Folliculitis and Pigmented Infundibular Spores and Hyphae: Answer. Am J Dermatopathol 2021; 43:840-841. [PMID: 34651594 DOI: 10.1097/dad.0000000000001937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sharma B, Nonzom S. Novel cases of cutaneous phaeohyphomycosis by Alternaria alstromeriae, Epicoccum tritici and Phialemonium obovatum from North India. Mycoses 2021; 64:1489-1497. [PMID: 34601740 DOI: 10.1111/myc.13378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/02/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND A growing number of non-dermatophytic moulds and yeasts with the ability to act as human pathogens are reported every year. Dematiaceous fungi cause phaeohyphomycosis which encompasses a broad spectrum of diseases ranging from superficial (cutaneous and subcutaneous) to disseminated infections. Such fungal infections are responsible for causing significant morbidity and mortality, frequently in immunocompromised patients and rarely in immunocompetent patients. OBJECTIVES To investigate the prevalence of cutaneous mycosis in Jammu district (India) and to isolate and identify the recovered causal agents from the affected skin of the patients. METHODS For direct microscopy, 10% KOH was used. Skin samples were collected carefully from the affected areas of suspected patients, followed by the isolation and identification of the causal agents by cultural examination, morphological examination and ITS sequencing. RESULTS Herein, we report and describe three new cases of cutaneous phaeohyphomycosis from District Jammu of Union Territory Jammu and Kashmir, India. The age of the patients under study ranged from 17 to 42 years and the duration of infection from 1 to 2 years. The etiological agents that were recovered from the patients under study were Alternaria alstromeriae, Epicoccum tritici and Phialemonium obovatum. These dematiaceous fungal species were isolated from the skin specimen of immunocompetent hosts. CONCLUSION Among the three isolated etiological agents, two (Alternaria alstromeriae, Epicoccum tritici) represent new global records and one (Phialemonium obovatum) new record to India as causal agents of cutaneous phaeohyphomycosis. Careful microscopic and mycological examination form the basis of correct diagnosis of such fungal infections in the absence of simple and reliable laboratory tests (serologic or antigen tests).
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Affiliation(s)
- Bharti Sharma
- Department of Botany, University of Jammu, Jammu, India
| | - Skarma Nonzom
- Department of Botany, University of Jammu, Jammu, India
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Ribeiro SR, Garcia MV, Copetti MV, Brackmann A, Both V, Wagner R. Effect of controlled atmosphere, vacuum packaging and different temperatures on the growth of spoilage fungi in shelled pecan nuts during storage. Food Control 2021. [DOI: 10.1016/j.foodcont.2021.108173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hoenigl M, Salmanton-García J, Walsh TJ, Nucci M, Neoh CF, Jenks JD, Lackner M, Sprute R, Al-Hatmi AMS, Bassetti M, Carlesse F, Freiberger T, Koehler P, Lehrnbecher T, Kumar A, Prattes J, Richardson M, Revankar S, Slavin MA, Stemler J, Spiess B, Taj-Aldeen SJ, Warris A, Woo PCY, Young JAH, Albus K, Arenz D, Arsic-Arsenijevic V, Bouchara JP, Chinniah TR, Chowdhary A, de Hoog GS, Dimopoulos G, Duarte RF, Hamal P, Meis JF, Mfinanga S, Queiroz-Telles F, Patterson TF, Rahav G, Rogers TR, Rotstein C, Wahyuningsih R, Seidel D, Cornely OA. Global guideline for the diagnosis and management of rare mould infections: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology and the American Society for Microbiology. THE LANCET. INFECTIOUS DISEASES 2021; 21:e246-e257. [PMID: 33606997 DOI: 10.1016/s1473-3099(20)30784-2] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 01/12/2023]
Abstract
With increasing numbers of patients needing intensive care or who are immunosuppressed, infections caused by moulds other than Aspergillus spp or Mucorales are increasing. Although antifungal prophylaxis has shown effectiveness in preventing many invasive fungal infections, selective pressure has caused an increase of breakthrough infections caused by Fusarium, Lomentospora, and Scedosporium species, as well as by dematiaceous moulds, Rasamsonia, Schizophyllum, Scopulariopsis, Paecilomyces, Penicillium, Talaromyces and Purpureocillium species. Guidance on the complex multidisciplinary management of infections caused by these pathogens has the potential to improve prognosis. Management routes depend on the availability of diagnostic and therapeutic options. The present recommendations are part of the One World-One Guideline initiative to incorporate regional differences in the epidemiology and management of rare mould infections. Experts from 24 countries contributed their knowledge and analysed published evidence on the diagnosis and treatment of rare mould infections. This consensus document intends to provide practical guidance in clinical decision making by engaging physicians and scientists involved in various aspects of clinical management. Moreover, we identify areas of uncertainty and constraints in optimising this management.
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Affiliation(s)
- Martin Hoenigl
- Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA; Clinical and Translational Fungal Research Working Group, University of California San Diego, San Diego, CA, USA; European Confederation of Medical Mycology Council, Basel, Switzerland.
| | - Jon Salmanton-García
- Faculty of Medicine, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany
| | - Thomas J Walsh
- Department of Medicine, Department of Pediatrics, and Department of Microbiology and Immunology, Weill Cornell Medicine, New York, NY, USA; New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - Marcio Nucci
- Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Chin Fen Neoh
- Faculty of Pharmacy, and Collaborative Drug Discovery Research Group, Pharmaceutical and Life Sciences, Community of Research, Universiti Teknologi MARA, Selangor, Malaysia
| | - Jeffrey D Jenks
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA; Clinical and Translational Fungal Research Working Group, University of California San Diego, San Diego, CA, USA; Division of General Internal Medicine, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Michaela Lackner
- Institute of Hygiene and Medical Microbiology, Department of Hygiene, Medical Microbiology and Publics Health, Medical University Innsbruck, Innsbruck, Austria
| | - Rosanne Sprute
- Faculty of Medicine, University of Cologne, Cologne, Germany; German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany
| | - Abdullah M S Al-Hatmi
- Department of Microbiology, Natural & Medical Sciences Research Center, University of Nizwa, Nizwa, Oman
| | - Matteo Bassetti
- Division of Infections Diseases, Department of Health Sciences, IRCCS San Martino Polyclinic Hospital, University of Genoa, Genoa, Italy
| | - Fabianne Carlesse
- Department of Pediatrics, and Pediatric Oncology Institute IOP-GRAACC-UNIFESP, Federal Univeristy of São Paulo, São Paulo, Brazil
| | - Tomas Freiberger
- Centre for Cardiovascular Surgery and Transplantation, and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Philipp Koehler
- Faculty of Medicine, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany; German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cologne, Germany
| | - Thomas Lehrnbecher
- Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital, Frankfurt, Germany
| | - Anil Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Juergen Prattes
- Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria
| | - Malcolm Richardson
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK; Mycology Reference Centre Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| | - Sanjay Revankar
- Division of Infectious Diseases, Wayne State University, Detroit, MI, USA
| | - Monica A Slavin
- University of Melbourne, Melbourne, VIC, Australia; National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Jannik Stemler
- Faculty of Medicine, University of Cologne, Cologne, Germany; German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany
| | - Birgit Spiess
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Saad J Taj-Aldeen
- Department of Laboratory Medicne and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - Adilia Warris
- Medical Research Council Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Patrick C Y Woo
- Department of Microbiology, University of Hong Kong, Hong Kong, China
| | | | - Kerstin Albus
- Faculty of Medicine, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany
| | - Dorothee Arenz
- Faculty of Medicine, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany; Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Valentina Arsic-Arsenijevic
- National Reference Laboratory for Medical Mycology, Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; European Confederation of Medical Mycology Council, Basel, Switzerland
| | - Jean-Philippe Bouchara
- Host-Pathogen Interaction Study Group, and Laboratory of Parasitology and Mycology, Angers University Hospital, Angers University, Angers, France
| | | | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - G Sybren de Hoog
- Center of Expertise in Mycology, Radboud University Medical Center-Canisius Wilhelmina Hospital, Nijmegen, Netherlands
| | - George Dimopoulos
- Critical Care Department, Attikon University Hospital, National and Kapodistrian University of Athens, Greece
| | - Rafael F Duarte
- University Hospital Puerta de Hierro Majadahonda, Madrid, Spain
| | - Petr Hamal
- Department of Microbiology, Faculty of Medicine and Dentistry, University Hospital Olomouc, Palacky University Olomouc, Olomouc, Czech Republic; European Confederation of Medical Mycology Council, Basel, Switzerland
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Radboud University Medical Center-Canisius Wilhelmina Hospital, Nijmegen, Netherlands; Center of Expertise in Mycology, Radboud University Medical Center-Canisius Wilhelmina Hospital, Nijmegen, Netherlands; European Confederation of Medical Mycology Council, Basel, Switzerland
| | - Sayoki Mfinanga
- National Institute for Medical Research, Tanzania; Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Flavio Queiroz-Telles
- Department of Public Health, Clinics Hospital, Federal University of Parana, Curitiba, Brazil
| | - Thomas F Patterson
- UT Health San Antonio and South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Galia Rahav
- Sheba Medical Center, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Thomas R Rogers
- Department of Clinical Microbiology, Trinity College Dublin, St James's Hospital Campus, Dublin, Ireland
| | - Coleman Rotstein
- Division of Infectious Diseases, University of Toronto, Toronto, ON, Canada
| | - Retno Wahyuningsih
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Parasitology, Faculty of Medicine, Universitas Kristen Indonesia, Jakarta, Indonesia
| | - Danila Seidel
- Faculty of Medicine, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany; German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany
| | - Oliver A Cornely
- Faculty of Medicine, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany; Clinical Trials Center Cologne, University of Cologne, Cologne, Germany; German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany; European Confederation of Medical Mycology Council, Basel, Switzerland
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16
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Kalantri M, Khopkar U, Shah A, Bargir UA, Hule G, Madkaikar M. A case of disseminated subcutaneous phaeohyphomycosis caused by Exserohilum rostratum with CARD9 mutation. Indian J Dermatol Venereol Leprol 2021; 88:59-61. [PMID: 34245520 DOI: 10.25259/ijdvl_293_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 01/01/2020] [Indexed: 11/04/2022]
Abstract
Phaeohypomycosis is a rare cutaneous and subcutaneous fungal infection caused by dematiaceous fungi. They have a widespread global distribution occasionally affecting humans. A 26-year-old woman presented with multiple skin lesions over her face and extremities for last 7 years, unresponsive to systemic amphotericin B and itraconazole. Further investigations revealed CARD9 mutation and phaeohyphomycosis caused by the pigmented fungus Exserohilum rosatratum. Lesions subsequently improved with oral flucytosine and itraconazole.
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Affiliation(s)
- Mayuri Kalantri
- Department of Dermatology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - Uday Khopkar
- Department of Dermatology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - Avani Shah
- Dr. Miskeen's Central Clinical Microbiology Laboratory, Thane, India
| | - Umair Ahmed Bargir
- ICMR-National Institute of Immunohaematology, KEM Hospital, Mumbai, Maharashtra, India
| | - Gouri Hule
- ICMR-National Institute of Immunohaematology, KEM Hospital, Mumbai, Maharashtra, India
| | - Manisha Madkaikar
- ICMR-National Institute of Immunohaematology, KEM Hospital, Mumbai, Maharashtra, India
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17
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MYCOTIC PNEUMONIA AND ENCEPHALITIS IN SOUTHERN PUDU ( PUDU PUDA). J Zoo Wildl Med 2021; 52:379-388. [PMID: 33827202 DOI: 10.1638/2019-0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 11/21/2022] Open
Abstract
This case series describes six confirmed cases of mycotic encephalitis and/or mycotic pneumonia in southern pudu (Pudu puda). One case involved a 10.5-yr-old intact female that presented with an inability to stand, eventually progressing to grand mal seizures. Magnetic resonance imaging showed a lesion within the cerebellar vermis with edema causing cerebellar herniation. The animal was euthanized based on a grave prognosis. Gross and histologic examination revealed primary central nervous system phaeohyphomycosis. Curvularia spicifera was sequenced from the cerebellar tissue. This is the first time this fungus has been reported as a primary central nervous system infection in an artiodactyl species. The remaining five cases occurred in neonates between 17 and 67 days old. Clinical signs varied widely, including facial swelling, weakness, posterior paresis, and sudden death. Antifungal therapy was initiated in three neonatal animals but was unsuccessful in each case. All neonates had active mycotic pneumonia caused by Aspergillus fumigatus or Mucor spp. at time of death; four of these animals also had disseminated disease that caused mycotic encephalitis. This case series indicates that fungal disease should be included in the differential diagnosis list of any pudu presenting for neurologic or respiratory clinical signs.
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18
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Singh AK, Chandra A, Islahi S, Das A, Malhotra K, Rao N. Phialemonium obovatum Infection of the Renal Allograft: Case Report and Review of the Literature. EXP CLIN TRANSPLANT 2021; 19:871-876. [PMID: 33877040 DOI: 10.6002/ect.2020.0313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In this case report, we describe the first case of Phialemonium obovatum infection involving the renal allograft in a recipient beyond 1 year after living renal transplant. The patient presented with a locally invasive mycetoma caused by this melanized fungus in the anterior abdominal wall, which extended during the hospital stay to involve the allograft. The fungus was identified by its characteristic micromorphological features present on potato dextrose agar and Sabourad dextrose agar and on subsequent slide cultures. The patient did not survive despite repeated surgical procedures, including partial allograft nephrectomy and broad-spectrum antifungal medications. Other cases of Phialemonium infections involving renal and stem cell transplant recipients are reviewed.
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Affiliation(s)
- Amit Kumar Singh
- From the Department of Nephrology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India
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19
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Rai M, Ingle AP, Ingle P, Gupta I, Mobin M, Bonifaz A, Alves M. Recent advances on mycotic keratitis caused by dematiaceous hyphomycetes. J Appl Microbiol 2021; 131:1652-1667. [PMID: 33462841 DOI: 10.1111/jam.15008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/31/2020] [Accepted: 01/14/2021] [Indexed: 02/06/2023]
Abstract
Dematiaceous hyphomycetes (DH) are darkly pigmented fungi ubiquitously found all over the world as plant pathogens and saprophytes, and many of the members of this group have emerged as opportunistic pathogens. These fungi are responsible for a wide variety of infections including mycotic keratitis, which is considered as one of the major causes of corneal blindness, particularly in tropical and subtropical countries with an annual global burden of about 1 000 000 patients. The infection is more common in workers working in an outdoor environment. Moreover, trauma is found to be the most important predisposing cause of mycotic keratitis. Considerable delay in diagnosis and scarcity of effective pharmacological drugs are the major factors responsible for increased morbidity and visual impairment. Considering the crucial role of DH in mycotic keratitis, in the present review, we have focused on major DH with special emphasis on their pathogenicity, diagnosis and treatment strategies.
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Affiliation(s)
- M Rai
- Department of Biotechnology, Sant Gadge Baba Amravati University, Amravati, Maharashtra, India
| | - A P Ingle
- Department of Biotechnology, Engineering School of Lorena, University of Sao Paulo, Lorena, SP, Brazil
| | - P Ingle
- Department of Biotechnology, Sant Gadge Baba Amravati University, Amravati, Maharashtra, India
| | - I Gupta
- Department of Biotechnology, Sant Gadge Baba Amravati University, Amravati, Maharashtra, India
| | - M Mobin
- Research Laboratory, University Center UNINOVAFAPI, Teresina, Brazil
| | - A Bonifaz
- Department of Mycology & Dermatology Service, General Hospital of Mexico, Mexico City, Mexico
| | - M Alves
- Department of Ophthalmology, University of Campinas, Campinas, SP, Brazil
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20
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Malik A, Fatma T, Shamsi W, Khan HA, Gul A, Jamal A, Bhatti MF. Molecular Characterization of Medically Important Fungi: Current Research and Future Prospects. Fungal Biol 2021. [DOI: 10.1007/978-3-030-60659-6_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Park JB, Suh KS, Jang MS. Comments on "Unusual Presentation of Subcutaneous Phaeohyphomycosis by Alternaria alternate" by Lee et al. Ann Dermatol 2020; 32:536-537. [PMID: 33911803 PMCID: PMC7875233 DOI: 10.5021/ad.2020.32.6.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 11/19/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jong Bin Park
- Department of Dermatology, Kosin University College of Medicine, Busan, Korea
| | - Kee Suck Suh
- Department of Dermatology, Kosin University College of Medicine, Busan, Korea
| | - Min Soo Jang
- Department of Dermatology, Kosin University College of Medicine, Busan, Korea
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22
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Hesarur N, Seshagiri DV, Nagappa M, Rao S, Santosh V, Chandrashekar N, Reddy N, Sharma PP, Kumari P, Pruthi N, Shukla D, Saini J, Taly AB, Sinha S. Case Report: Chronic Fungal Meningitis Masquerading as Tubercular Meningitis. Am J Trop Med Hyg 2020; 103:1473-1479. [PMID: 32876006 DOI: 10.4269/ajtmh.19-0885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Phaeohyphomycosis causes a wide spectrum of systemic manifestations and can affect even the immunocompetent hosts. Involvement of the central nervous system is rare. A 48-year-old farmer presented with chronic headache, fever, and impaired vision and hearing. Serial MRIs of the brain showed enhancing exudates in the basal cisterns, and lesions in the sella and perichiasmatic and cerebellopontine angle regions along with enhancement of the cranial nerves and leptomeninges. Cerebrospinal fluid (CSF) showed lymphocytic pleocytosis with elevated protein and decreased glucose on multiple occasions. Clinical, imaging, and CSF abnormalities persisted despite treatment with antitubercular drugs and steroids for 2 years. Biopsy of the dura mater at the cervicomedullary junction revealed necrotizing granulomatous lesions, neutrophilic abscesses, and giant cells containing slender, pauci-septate, pigmented fungal hyphae. Fungal culture showed growth of Fonsecaea pedrosoi, which is classically known to cause brain abscesses. Here, we report the diagnostic odyssey in a patient with chronic meningitis from a region endemic for tuberculosis and describe the challenges in establishing the accurate diagnosis. Lack of therapeutic response to an adequate trial of empirical antitubercular therapy warrants search for alternative causes, including fungal meningitis. We highlight the uncommon manifestation of F. pedrosoi with chronic meningitis as well as the protracted clinical course despite not receiving antifungal therapy.
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Affiliation(s)
- Nagabushan Hesarur
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | | | - Madhu Nagappa
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Shilpa Rao
- Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Vani Santosh
- Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Nagarathna Chandrashekar
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Neeraja Reddy
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Praveen P Sharma
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Pratima Kumari
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Nupur Pruthi
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Dhaval Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Jitender Saini
- Neuroimaging and Interventional Radiology (NIIR), National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Arun B Taly
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sanjib Sinha
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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23
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Saito T, Hayashi M, Yaguchi Y, Okamura K, Araki Y, Yamaguchi S, Sano A, Ohe R, Suzuki T. Case of phaeohyphomycosis caused by
Cladophialophora boppii
successfully treated with local hyperthermia and systemic terbinafine. J Dermatol 2020; 47:e250-e251. [DOI: 10.1111/1346-8138.15357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Toru Saito
- Department of Dermatology Yamagata University Faculty of Medicine Yamagata Japan
| | - Masahiro Hayashi
- Department of Dermatology Yamagata University Faculty of Medicine Yamagata Japan
| | - Yoriko Yaguchi
- Department of Dermatology Yamagata University Faculty of Medicine Yamagata Japan
| | - Ken Okamura
- Department of Dermatology Yamagata University Faculty of Medicine Yamagata Japan
| | - Yuta Araki
- Department of Dermatology Yamagata University Faculty of Medicine Yamagata Japan
| | - Sayaka Yamaguchi
- Department of Dermatology Graduate School of Medicine University of the Ryukyus Okinawa Japan
| | - Ayako Sano
- Department of Animal Sciences Faculty of Agriculture University of the Ryukyus Okinawa Japan
| | - Rintaro Ohe
- Department of Pathological Diagnostics Yamagata University Faculty of Medicine Yamagata Japan
| | - Tamio Suzuki
- Department of Dermatology Yamagata University Faculty of Medicine Yamagata Japan
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24
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DERMATITIS AND RHINOSINUITIS CAUSED BY CURVULARIA SPECIES IN A CHINESE GORAL ( NAEMORHEDUS GRISEUS). J Zoo Wildl Med 2020; 50:1008-1011. [PMID: 31926538 DOI: 10.1638/2018-0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2019] [Indexed: 11/21/2022] Open
Abstract
Curvularia spp. are globally distributed saprophytic fungi, classified in the literature as dematiaceous, or darkly pigmented fungi. These fungi have been increasingly recognized as causing cutaneous, ocular, respiratory, and central nervous system infections in humans, but have been infrequently documented as pathogens in the veterinary literature. A 5-yr-old male Chinese goral (Naemorhedus griseus) presented with bilateral fungal dermatitis of the pinnae, and subsequent pyogranulomatous rhinosinusitis. Clinical signs included epistaxis, mucosanguineous nasal discharge, and dyspnea. Sequential histologic examinations of cutaneous and nasal lesions revealed pyogranulomatous inflammation with extracellular and phagocytized nonpigmented yeasts. Fungal culture and polymerase chain reaction identified Curvularia sp. The absence of pigmentation in tissue in this case suggests that pigmentation may not be a consistent histologic finding for this fungus, emphasizing the importance of molecular identification to prevent misidentification. Despite intensive interventions in this goral, the disease progressed, and was ultimately fatal.
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25
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Espanhol CM, Recuero JK, Pagani DM, Ribeiro AC, Vettorato G, Duquia RP, Luzzatto L, Scroferneker ML. Cutaneous phaeohyphomycosis caused by Exophiala xenobiotica: A case report. Med Mycol Case Rep 2020; 27:39-41. [PMID: 31908912 PMCID: PMC6940718 DOI: 10.1016/j.mmcr.2019.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/04/2019] [Accepted: 12/02/2019] [Indexed: 11/15/2022] Open
Abstract
We report a case of phaeohyphomycosis that affected the leg of a 45-year-old Brazilian man, car mechanic and renal transplanted. The direct mycological examination evidenced dematiaceous septated hyphae. The pathogenic fungal species was identified as Exophiala xenobiotica. Antifungal activity in vitro revealed terbinafine as the best antifungal. For treatment, it was chosen surgical excision of the entire lesion and used systemic itraconazole. Phaeohyphomycosis caused by Exophiala xenobiotica is extremely rare and is closely related to transplant patients.
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Affiliation(s)
- Clarissa Mitri Espanhol
- Department of Dermatology of the Hospital Santa Casa de Misericórdia de Porto Alegre, Rua Prof. Annes Dias, 285, Porto Alegre, CEP:90020-090, Brazil
| | - Júlia Kanaan Recuero
- Department of Dermatology of the Hospital Santa Casa de Misericórdia de Porto Alegre, Rua Prof. Annes Dias, 285, Porto Alegre, CEP:90020-090, Brazil
| | - Danielle Machado Pagani
- Postgraduate Program in Agricultural and Environmental Microbiology, Federal University of Rio Grande do Sul.Rua Sarmento Leite, 500, Sala 325, Porto Alegre, Rio Grande do Sul, CEP: 90050-170, Brazil
| | - Amanda Carvalho Ribeiro
- Faculty of Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Avenida Ipiranga, 2752, CEP: 90610-000, Brazil
| | - Gerson Vettorato
- Department of Dermatology of the Hospital Santa Casa de Misericórdia de Porto Alegre, Rua Prof. Annes Dias, 285, Porto Alegre, CEP:90020-090, Brazil
| | - Rodrigo Pereira Duquia
- Department of Dermatology of the Hospital Santa Casa de Misericórdia de Porto Alegre, Rua Prof. Annes Dias, 285, Porto Alegre, CEP:90020-090, Brazil
| | - Laura Luzzatto
- Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Sala 325, Porto Alegre, Rio Grande do Sul, CEP: 90050-170, Brazil
| | - Maria Lúcia Scroferneker
- Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Sala 325, Porto Alegre, Rio Grande do Sul, CEP: 90050-170, Brazil
- Corresponding author. Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Room, 325, Porto Alegre, CEP: 90050-170, Brazil.
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26
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Phaeohyphomycotic Rhinitis Caused by Bipolaris hawaiiensis in a Horse. J Equine Vet Sci 2019; 82:102798. [PMID: 31732112 DOI: 10.1016/j.jevs.2019.102798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/30/2019] [Accepted: 09/23/2019] [Indexed: 11/24/2022]
Abstract
This case represents the first reported case of Bipolaris hawaiiensis infection in an equid, and its aggressive clinical course. This case provides important descriptive and prognostic information for horses diagnosed with phaeohyphomycotic rhinitis. A 19-year-old American Quarter Horse mare was presented for second opinion of stertor and exercise intolerance of four-month duration. Endoscopy revealed generalized, proximal nasal edema, and computed tomography identified a soft tissue mass eroded through the rostral nasal bone. Biopsy of the mass was identified as a fungal granuloma caused by B. hawaiiensis resulting in chronic invasive fungal rhinitis. Treatment options were limited because of invasive infection, financial constraints, fungal sensitivity results, and published accounts of in vivo behavior of the organism. The infection progressed, resulting in euthanasia. In this case of equine phaeohyphomycosis, B. hawaiiensis was likely traumatically introduced into the patient's nasal cavity. Its aggressive nature in an apparently immunocompetent patient is noteworthy, in the face of surgical debridement and attempted medical therapy. Therapeutic decisions were challenging in this case based on limited in vivo efficacy data in equids, pharmacokinetic challenges with available antifungal agents, and client-driven limitations regarding management of airway restriction.
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27
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Mohammed A, Rahnama-Moghadam S. Following the Track to an Unexpected Diagnosis: Phaeohyphomycosis. Am J Med 2019; 132:1047-1049. [PMID: 30986396 DOI: 10.1016/j.amjmed.2019.03.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/10/2019] [Accepted: 03/18/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Arooj Mohammed
- Department of Dermatology, Indiana University School of Medicine, Indianapolis
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28
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Qiu Y, Zhang J, Tang Y, Zhong X, Deng J. Case report: Fever- pneumonia- lymphadenectasis- osteolytic- subcutaneous nodule: Disseminated chromoblastomycosis caused by phialophora. J Infect Chemother 2019; 25:1031-1036. [PMID: 31229375 DOI: 10.1016/j.jiac.2019.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/05/2019] [Accepted: 05/07/2019] [Indexed: 11/26/2022]
Abstract
Chromoblastomycosis (CBM) is a chronic cutaneous and subcutaneous fungal infection caused by certain dematiaceous fungi (usually Fonsecaea, Phialophora, or Cladophialophora). Histologically, CBM is characterized by the presence of medlar bodies. However, the diagnosis is difficult because of the rarity of these pathognomonic presentations and the wide variety of presentations. Treatment of these infections is challenging as it lacks standardization. Herein, we report a case of chromoblastomycosis caused by Phialophora, in a 42-year-old immunocompetent male agriculturist from the humid and subtropical region of southern China. He had a 3-month history of pneumonia with intermittent fever, coughing, and expectoration. The infection subsequently spread to the bone and lymph nodes forming deep lesions and eventually resulting in osteolysis and lymphadenectasis. These subcutaneous nodules were observed after 9 months. Antifungal treatment was administered for 20 months leading to clinical improvement before the patient was lost to follow-up. This case is unique because such deep lesions are rare in immunocompetent individuals and because the initial onset was associated with pneumonia.
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Affiliation(s)
- Ye Qiu
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jianquan Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
| | - Yanping Tang
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaoning Zhong
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jingmin Deng
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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29
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Disseminated melanized fungal infection due to Cladosporium halotolerans in a dog coinfected with canine adenovirus-1 and canine parvovirus-2. Braz J Microbiol 2019; 50:859-870. [PMID: 30997656 DOI: 10.1007/s42770-019-00082-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 02/25/2019] [Indexed: 12/18/2022] Open
Abstract
This report presents the pathologic findings associated with disseminated infection due to Cladosporium halotolerans in a dog that was simultaneously infected with canine adenovirus-1 (CAdV-1) and canine parvovirus-2 (CPV-2). A 12-year-old, mixed breed dog, with a clinical history of neurological manifestations was submitted for routine autopsy due to poor prognosis. The principal pathologic findings were mycotic necrotizing nephritis, hepatitis, and splenitis with embolic dissemination to the brain resulting in mycotic necrotizing meningoencephalitis, ventriculitis, choroid plexitis, and obstructive hydrocephalus associated with intralesional and intravascular septate pigmented fungi. PCR and sequencing of the ITS region of fungi revealed that the intralesional fungal organisms had 82% nucleotide identity with members of the Cladosporium sphaerospermum complex of organisms. However, a PCR assay and sequencing of the beta tubulin gene confirmed that the organism identified in this dog had 100% nucleotide sequence identity with C. halotolerans. Using immunohistochemistry, intralesional antigens of CAdV-1 were identified within the epithelial cells of the liver and lungs; there was positive immunolabeling for CPV-2 antigens in degenerated cardiomyocytes. These findings confirmed the active participation of C. halotolerans in the development of disseminated cladosporiosis in this dog and represent a rare occurrence of concomitant infection with CAdV-1 and CPV-2.
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Ferrándiz-Pulido C, Martin-Gomez MT, Repiso T, Juárez-Dobjanschi C, Ferrer B, López-Lerma I, Aparicio G, González-Cruz C, Moreso F, Roman A, García-Patos V. Cutaneous infections by dematiaceous opportunistic fungi: Diagnosis and management in 11 solid organ transplant recipients. Mycoses 2018; 62:121-127. [DOI: 10.1111/myc.12853] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Trinidad Repiso
- Department of Dermatology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | | | - Berta Ferrer
- Department of Pathology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - Ingrid López-Lerma
- Department of Dermatology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - Gloria Aparicio
- Department of Dermatology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | | | - Francesc Moreso
- Department of Nephology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - Antonio Roman
- Department of Neumology; Hospital Universitari Vall d'Hebron; Barcelona Spain
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Thomas E, Bertolotti A, Barreau A, Klisnick J, Tournebize P, Borgherini G, Zemali N, Jaubert J, Jouvion G, Bretagne S, Picot S. From phaeohyphomycosis to disseminated chromoblastomycosis: A retrospective study of infections caused by dematiaceous fungi. Med Mal Infect 2018; 48:278-285. [PMID: 29656841 DOI: 10.1016/j.medmal.2017.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/30/2016] [Accepted: 09/12/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Infections caused by dematiaceous fungi are more common in tropical and subtropical areas. We aimed to describe the clinical, microbiological and therapeutic aspects of case patients diagnosed at a University Hospital located on an Indian Ocean island. PATIENTS AND METHODS We performed an observational retrospective study of infections caused by dematiaceous fungi diagnosed at the University Hospital of Saint-Pierre, Reunion, from 2000 to 2015. Mycological identifications were performed at the National Reference Center for Invasive Mycosis and Antifungal Agents (Paris). RESULTS The review of clinical and microbiological data of 11 patients identified revealed that five were infected by dematiaceous fungi. Two had cutaneous phaeohyphomycosis, two had cerebral phaeohyphomycosis and one had cutaneous chromoblastomycosis with brain and potentially medullary dissemination. Skin lesions and cerebral abscesses were quite varied. CONCLUSION Infections caused by dematiaceous fungi are rare. Medullary and brain localizations are extremely rare, especially for chromoblastomycosis. Cutaneous manifestations of phaeohyphomycosis are varied; diagnosis is thus more difficult. It is therefore important, when confronted with a chronic tumor-like lesion in endemic areas, to perform a biopsy for pathology and fungal culture. While surgical excision is not always sufficient, medical treatment of these infections is not standardized, but relies on an azole, which can be associated with another antifungal agent.
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Affiliation(s)
- E Thomas
- Service de bactériologie, virologie, parasitologie, centre hospitalier universitaire de La Réunion, site Sud, BP 350, 97448 Saint-Pierre cedex, Reunion
| | - A Bertolotti
- Service de maladies infectieuses, centre hospitalier universitaire de La Réunion, site Sud, BP 350, 97448 Saint-Pierre cedex, Reunion
| | - A Barreau
- Service de bactériologie, virologie, parasitologie, centre hospitalier universitaire de La Réunion, site Sud, BP 350, 97448 Saint-Pierre cedex, Reunion
| | - J Klisnick
- Service de maladies infectieuses, centre hospitalier universitaire de La Réunion, site Sud, BP 350, 97448 Saint-Pierre cedex, Reunion
| | - P Tournebize
- Service de neurologie, centre hospitalier universitaire de La Réunion, site Sud, BP 350, 97448 Saint-Pierre cedex, Reunion
| | - G Borgherini
- Service de maladies infectieuses, centre hospitalier universitaire de La Réunion, site Sud, BP 350, 97448 Saint-Pierre cedex, Reunion
| | - N Zemali
- Service de bactériologie, virologie, parasitologie, centre hospitalier universitaire de La Réunion, site Sud, BP 350, 97448 Saint-Pierre cedex, Reunion
| | - J Jaubert
- Service de bactériologie, virologie, parasitologie, centre hospitalier universitaire de La Réunion, site Sud, BP 350, 97448 Saint-Pierre cedex, Reunion
| | - G Jouvion
- Institut Pasteur, histopathologie humaine et modèles animaux, 28, rue du Docteur-Roux, 75015 Paris, France
| | - S Bretagne
- Institut Pasteur, centre national de référence des mycoses invasives et des antifongiques, 28, rue du Docteur-Roux, 75015 Paris, France
| | - S Picot
- Service de bactériologie, virologie, parasitologie, centre hospitalier universitaire de La Réunion, site Sud, BP 350, 97448 Saint-Pierre cedex, Reunion.
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Spano M, Zuliani D, Peano A, Bertazzolo W. Cladosporium cladosporioides
-complex infection in a mixed-breed dog. Vet Clin Pathol 2018; 47:150-153. [DOI: 10.1111/vcp.12571] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Andrea Peano
- Department of Veterinary Sciences; University of Turin; Turin Italy
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Sunagawa K, Uchino Y, Ishimoto S, Nakamura S, Honma T, Nakanishi Y, Hatta Y, Miyazaki Y, Sakurai H, Hao H, Sugitani M. Mycotic pseudoaneurysm of a pulmonary artery branch caused by Cladosporium. Pathol Int 2017; 68:47-52. [PMID: 29193597 DOI: 10.1111/pin.12615] [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: 06/10/2017] [Accepted: 11/04/2017] [Indexed: 11/28/2022]
Abstract
We report the case of a 53-year-old male with a history of acute myelogenous leukemia, who suffered the rupturing of a right-sided pulmonary artery pseudoaneurysm combined with pneumonia. He underwent a right-sided lower lobectomy. The resected lung tissue demonstrated a mycotic pseudoaneurysm of a pulmonary artery branch together with a filamentous fungal infection. Pseudoaneurysms are caused by the breaching of all layers of a blood vessel wall. The extravasated blood is trapped by the surrounding extravascular tissue or clots. Cladosporium was detected during a polymerase chain reaction-based analysis followed by DNA sequencing of formalin-fixed paraffin-embedded lung tissue samples. Although previous cases of pulmonary artery pseudoaneurysms caused by fungal infections, e.g., Candida or Aspergillus sp., have been reported, to the best of our knowledge this is the first case to involve cladosporiosis.
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Affiliation(s)
- Keishin Sunagawa
- Department of Pathology, Showa University, Shinagawa-ku, Tokyo, Japan.,Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.,Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Yoshihito Uchino
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Shinichirou Ishimoto
- Department of Respiratory Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Shigeki Nakamura
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Taku Honma
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Yoko Nakanishi
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Yoshihiro Hatta
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Hiroyuki Sakurai
- Department of Respiratory Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Hiroyuki Hao
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masahiko Sugitani
- Department of Pathology, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
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Synergistic Effects of Tacrolimus and Azoles against Exophiala dermatitidis. Antimicrob Agents Chemother 2017; 61:AAC.00948-17. [PMID: 28923863 DOI: 10.1128/aac.00948-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/10/2017] [Indexed: 11/20/2022] Open
Abstract
In vitro interactions of tacrolimus, a calcineurin inhibitor, and azoles, including itraconazole, voriconazole, and posaconazole, against planktonic cells and biofilms of Exophiala dermatitidis were assessed via a broth microdilution checkerboard technique. A total of 16 clinical isolates were studied. The results revealed favorable synergistic inhibitory activity between tacrolimus and itraconazole, voriconazole, or posaconazole against 68.8%, 87.5%, and 100% of tested strains of planktonic E. dermatitidis, respectively.However, limited synergism was observed against biofilms of E. dermatitidis No antagonism was observed in all combinations.
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35
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Gonçalves CL, Mota FV, Ferreira GF, Mendes JF, Pereira EC, Freitas CH, Vieira JN, Villarreal JP, Nascente PS. Airborne fungi in an intensive care unit. BRAZ J BIOL 2017; 78:265-270. [PMID: 28793031 DOI: 10.1590/1519-6984.06016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 11/08/2016] [Indexed: 11/21/2022] Open
Abstract
The presence of airborne fungi in Intensive Care Unit (ICUs) is associated with increased nosocomial infections. The aim of this study was the isolation and identification of airborne fungi presented in an ICU from the University Hospital of Pelotas - RS, with the attempt to know the place's environmental microbiota. 40 Petri plates with Sabouraud Dextrose Agar were exposed to an environment of an ICU, where samples were collected in strategic places during morning and afternoon periods for ten days. Seven fungi genera were identified: Penicillium spp. (15.18%), genus with the higher frequency, followed by Aspergillus spp., Cladosporium spp., Fusarium spp., Paecelomyces spp., Curvularia spp., Alternaria spp., Zygomycetes and sterile mycelium. The most predominant fungi genus were Aspergillus spp. (13.92%) in the morning and Cladosporium spp. (13.92%) in the afternoon. Due to their involvement in different diseases, the identified fungi genera can be classified as potential pathogens of inpatients. These results reinforce the need of monitoring the environmental microorganisms with high frequency and efficiently in health institutions.
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Affiliation(s)
- C L Gonçalves
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - F V Mota
- Programa de Pós-graduação em Medicina Veterinária, Departamento de Veterinária Preventiva, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - G F Ferreira
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - J F Mendes
- Programa de Pós-graduação em Medicina Veterinária, Departamento de Veterinária Preventiva, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - C H Freitas
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - J N Vieira
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - J P Villarreal
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - P S Nascente
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
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36
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Andrade SLD, Leal AFG, Filho AML, Macêdo DPC, Abreu E Lima MDCCD, Neves RP. Oral phaeohyphomycosis in a patient with squamocellular carcinoma of the lip: second case report. Braz J Microbiol 2017; 48:208-210. [PMID: 28057425 PMCID: PMC5470452 DOI: 10.1016/j.bjm.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 02/25/2016] [Indexed: 11/20/2022] Open
Abstract
This communication reports the second known case of oral phaeohyphomycosis in a patient with squamocellular carcinoma of the lip. The patient, an 82-year-old black woman, a former smoker (for more than 30 years), suffering from an ulcerous vegetative lesion in the middle third of the lower lip for approximately 12 months. The result of the histopathological analysis indicated carcinoma, with well-differentiated keratinized squamous cells and the presence of septate mycelial filaments. In the direct mycological examination, thick and dematiaceous septate mycelial filaments were observed. After the resection surgery, the patient did not need to use an antifungal drug to treat the phaeohyphomycosis, and no follow-up radiotherapy was needed to treat the squamocellular carcinoma. We stress that the presence of the squamocellular lesion of the lip was a possible contributing factor to the infection.
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Affiliation(s)
| | | | | | | | | | - Rejane Pereira Neves
- Universidade Federal de Pernambuco, Departamento de Micologia, Recife, Pernambuco, Brasil
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37
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The Carbohydrate Lectin Receptor Dectin-1 Mediates the Immune Response to Exserohilum rostratum. Infect Immun 2017; 85:IAI.00903-16. [PMID: 28031265 DOI: 10.1128/iai.00903-16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/22/2016] [Indexed: 12/16/2022] Open
Abstract
Dematiaceous molds are found ubiquitously in the environment and cause a wide spectrum of human disease, including infections associated with high rates of mortality. Despite this, the mechanism of the innate immune response has been less well studied, although it is key in the clearance of fungal pathogens. Here, we focus on Exserohilum rostratum, a dematiaceous mold that caused 753 infections during a multistate outbreak due to injection of contaminated methylprednisolone. We show that macrophages are incapable of phagocytosing Exserohilum Despite a lack of phagocytosis, macrophage production of tumor necrosis factor alpha is triggered by hyphae but not spores and depends upon Dectin-1, a C-type lectin receptor. Dectin-1 is specifically recruited to the macrophage-hyphal interface but not the macrophage-spore interface due to differences in carbohydrate antigen expression between these two fungal forms. Corticosteroid and antifungal therapy perturb this response, resulting in decreased cytokine production. In vivo soft tissue infection in wild-type mice demonstrated that Exserohilum provokes robust neutrophilic and granulomatous inflammation capable of thwarting fungal growth. However, coadministration of methylprednisolone acetate results in robust hyphal tissue invasion and a significant reduction in immune cell recruitment. Our results suggest that Dectin-1 is crucial for macrophage recognition and the macrophage response to Exserohilum and that corticosteroids potently attenuate the immune response to this pathogen.
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Chhonkar A, Kataria D, Tambe S, Nayak CS. Three rare cases of cutaneous phaeohyphomycosis. Indian J Plast Surg 2016; 49:271-274. [PMID: 27833296 PMCID: PMC5053006 DOI: 10.4103/0970-0358.191321] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Phaeohyphomycosis is a chronic infectious condition caused by dematiaceous fungi which usually involve the skin and subcutaneous tissue. Subcutaneous phaeohyphomycosis is characterised by papulonodules, verrucous, hyperkeratotic or ulcerated plaques, cysts, abscesses, pyogranuloma, non-healing ulcers or sinuses. In India, commonly associated genera are Exophiala, Phialophora, Cladosporium, Curvularia, Fonsecaea and Alternaria. This condition involves the presence of brown-walled hyphal structures in the dermis and epidermis. Here, we are reporting a rare case series of three patients of phaeohyphomycosis with lesions on finger and dorsum of the hand.
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Affiliation(s)
- Aditi Chhonkar
- Department of Dermatology, Topiwala National Medical College and B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
| | - Deepti Kataria
- Department of Dermatology, Topiwala National Medical College and B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
| | - Swagata Tambe
- Department of Dermatology, Topiwala National Medical College and B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
| | - Chitra S Nayak
- Department of Dermatology, Topiwala National Medical College and B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
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Impairment of Immune Response against Dematiaceous Fungi in Card9 Knockout Mice. Mycopathologia 2016; 181:631-42. [PMID: 27421992 DOI: 10.1007/s11046-016-0029-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/12/2016] [Indexed: 10/21/2022]
Abstract
Dematiaceous fungi are a large group of pathogens that can cause a wide range of diseases in both immunocompetent and immunocompromised hosts. Based on our previous finding of caspase recruitment domain-containing protein 9 (CARD9) mutations in patients with subcutaneous phaeohyphomycosis caused by Phialophora verrucosa (P. verrucosa), we further investigated the exact role of CARD9 in the pathogenesis of phaeohyphomycosis using Card9 knockout (Card9 KO) mice. We showed that Card9 KO mice are profoundly susceptible to P. verrucosa infection compared with wild-type mice, reflected by significantly more severe footpad swelling, higher fungal burden, lower survival, and systemic dissemination. The inability of Card9 KO mice to control P. verrucosa infection was associated with lack of Th17 differentiation and reduction of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-17A levels in footpad homogenates. In vitro experiments showed a defect of fungal conidia killing and pro-inflammatory cytokine production in Card9 KO bone marrow-derived macrophages and dendritic cells. Furthermore, ex vivo coculture and in vitro T cell differentiation assay demonstrated that Card9 signaling pathway acts indispensably on differentiation of Th17 cells. In conclusion, our findings suggest that CARD9 mediate the innate immune and Th17-mediated adaptive immune responses against dematiaceous fungal infections at the early stage of infection.
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Concurrent Phaeohyphomycosis and Ranavirus Infection in an Eastern Box Turtle ( Terrapene carolina ) in Athens, Georgia, USA. J Wildl Dis 2016; 52:742-5. [PMID: 27310167 DOI: 10.7589/2014-08-195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An eastern box turtle (Terrapene carolina) was found in a stream in the southeastern US, with a mass affecting the distal right forelimb. The turtle developed complications during hospitalization, including lethargy and oral caseous plaques and eventually died. Postmortem analyses diagnosed a mixed infection of phaeohyphomycosis and Ranavirus.
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Abstract
ABSTRACT
Filamentous mycoses are often associated with significant morbidity and mortality. Prompt diagnosis and aggressive treatment are essential for good clinical outcomes in immunocompromised patients. The host immune response plays an essential role in determining the course of exposure to potential fungal pathogens. Depending on the effectiveness of immune response and the burden of organism exposure, fungi can either be cleared or infection can occur and progress to a potentially fatal invasive disease. Nonspecific cellular immunity (i.e., neutrophils, natural killer [NK] cells, and macrophages) combined with T-cell responses are the main immunologic mechanisms of protection. The most common potential mold pathogens include certain hyaline hyphomycetes, endemic fungi, the
Mucorales
, and some dematiaceous fungi. Laboratory diagnostics aimed at detecting and differentiating these organisms are crucial to helping clinicians make informed decisions about treatment. The purpose of this chapter is to provide an overview of the medically important fungal pathogens, as well as to discuss the patient characteristics, antifungal-therapy considerations, and laboratory tests used in current clinical practice for the immunocompromised host.
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Vijayakumar R, Saleh Al-Aboody M, Sandle T. A review of melanized (black) fungal contamination in pharmaceutical products-incidence, drug recall and control measures. J Appl Microbiol 2016; 120:831-41. [DOI: 10.1111/jam.12888] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 06/22/2015] [Accepted: 06/22/2015] [Indexed: 12/17/2022]
Affiliation(s)
- R. Vijayakumar
- Department of Medical Laboratory; College of Science AlZulfi; Majmaah University; AlZulfi Saudi Arabia
| | - M. Saleh Al-Aboody
- Department of Medical Laboratory; College of Science AlZulfi; Majmaah University; AlZulfi Saudi Arabia
| | - T. Sandle
- Microbiology; Bio Products Laboratory; Elstree Hertfordshire UK
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Abstract
The nasal cavity and paranasal sinuses occupy the top of the upper respiratory tract and form pneumatic spaces connected with the atmosphere. They are located immediately beneath the base of the cranium, where crucial vital structures are harbored. From this region, very much exposed to airborne agents, arise some of the more complex and rare benign and malignant lesions seen in humans, whose difficulties in interpretation make this remarkable territory one of the most challenging in the practice of surgical pathology. Contents of this chapter cover inflammations and infections, polyps and pseudotumors, fungal and midfacial destructive granulomatous lesions, as well as benign, borderline, and malignant neoplasms. Among the neoplasms, emphasis is made on those entities characteristic or even unique for the sinonasal region, such as Schneiderian papillomas, glomangiopericytoma, intestinal- and non-intestinal-type adenocarcinomas, olfactory neuroblastoma, nasal-type NK-/T-cell lymphoma, and teratocarcinosarcoma. Moreover, recently recognized entities involving this territory, i.e., HPV-related non-keratinizing carcinoma, NUT carcinoma, and SMARCB1-deficient basaloid carcinoma, are also discussed in the light of their specific molecular findings. Furthermore, the text is accompanied by numerous classical and recent references, several tables, and 100 illustrations.
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Affiliation(s)
- Antonio Cardesa
- University of Barcelona, Anatomic Pathology Hospital Clínic University of Barcelona, Barcelona, Spain
| | - Pieter J. Slootweg
- Radboud Univ Nijmegen Medical Center, Pathology Radboud Univ Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Nina Gale
- University of Ljubljana,, Institute of Pathology, Faculty of Medic University of Ljubljana,, Ljublijana, Slovenia
| | - Alessandro Franchi
- University of Florence, Dept of Surg & Translational Medicine University of Florence, Florence, Italy
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Phaeohyphomycosis in Transplant Patients. J Fungi (Basel) 2015; 2:jof2010002. [PMID: 29376919 PMCID: PMC5753083 DOI: 10.3390/jof2010002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 12/15/2015] [Accepted: 12/17/2015] [Indexed: 11/17/2022] Open
Abstract
Phaeohyphomycosis is caused by a large, heterogenous group of darkly pigmented fungi. The presence of melanin in their cell walls is characteristic, and is likely an important virulence factor. These infections are being increasingly seen in a variety of clinical syndromes in both immunocompromised and normal individuals. Transplant patients are especially at risk due their prolonged immunosuppression. There are no specific diagnostic tests for these fungi, though the Fontana-Masson stain is relatively specific in tissue. They are generally seen in a worldwide distribution, though a few species are only found in specific geographic regions. Management of these infections is not standardized due to lack of clinical trials, though recommendations are available based on clinical experience from case reports and series and animal models. Superficial infections may be treated without systemic therapy. Central nervous system infections are unique in that they often affect otherwise normal individuals, and are difficult to treat. Disseminated infections carry a high mortality despite aggressive therapy, usually with multiple antifungal drugs. Considerable work is needed to determine optimal diagnostic and treatment strategies for these infections.
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45
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Kumar GN, Nair SP. Phaeohyphomycosis presenting as a solitary nodulocystic lesion in a renal transplant patient. Indian Dermatol Online J 2015; 6:359-61. [PMID: 26500874 PMCID: PMC4594403 DOI: 10.4103/2229-5178.164468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
| | - Sukumaran Pradeep Nair
- Department of Dermatology and Venereology, Government Medical College, Trivandrum, Kerala, India
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46
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Cochliobolus hawaiiensis Sinusitis, a Tropical Disease? A Case Report and Review of the Literature. Mycopathologia 2015; 180:117-21. [PMID: 25805318 DOI: 10.1007/s11046-015-9886-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 03/16/2015] [Indexed: 01/16/2023]
Abstract
A sinusitis caused by Cochliobolus hawaiiensis (anamorph: Bipolaris hawaiiensis) was diagnosed in metropolitan France in a patient originating from New Caledonia. The patient completely recovered after surgical treatment consisting in marsupialization of the mucoceles and removal of the fungus balls located in the left nasal cavity and the left maxilla and ethmoid sinuses. One year after, both endoscopic examination and CT scan of the sinuses were normal. Various clinical presentations of diseases associated with C. hawaiiensis have been reported. A review of the literature indicates that although C. hawaiiensis is very rarely reported in Europe, it is one of the major rhinosinusitis agents in areas with a relatively warmer climate, such as India or Southwestern USA. This is the first report of a sinusitis caused by C. hawaiiensis diagnosed in France, with a total recovery outcome.
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Allton DR, Parvez N, Ranganath S, Jinadatha C. Surgical management of subcutaneous Colletotrichum gloeosporioides. BMJ Case Rep 2015; 2015:bcr-2014-207540. [PMID: 25737220 DOI: 10.1136/bcr-2014-207540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 52-year-old male patient with a history of sarcoidosis and over 10 years of chronic low-dose glucocorticoid use, cirrhosis and type 2 diabetes mellitus presented with two painful, enlarging subcutaneous nodules ultimately identified as Colletotrichum gloeosporioides. Two attempts at needle aspiration of the larger nodule resulted in rapid reaccumulation. Complete surgical excision of both nodules resulted in complete resolution without the use of any concomitant antifungals. Patient had no recurrence at 2 years of follow-up.
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Affiliation(s)
- David R Allton
- Infectious Diseases Division, Department of Medicine, Central Texas Veterans Health Care System, Temple, Texas, USA Department of Medicine, Texas A & M Health Science Center, Bryan, Texas, USA
| | - Najma Parvez
- Infectious Diseases Division, Department of Medicine, Central Texas Veterans Health Care System, Temple, Texas, USA Department of Medicine, Texas A & M Health Science Center, Bryan, Texas, USA
| | - Sangeetha Ranganath
- Infectious Diseases Division, Department of Medicine, Baylor Scott & White Memorial Hospital, Temple, Texas, USA
| | - Chetan Jinadatha
- Infectious Diseases Division, Department of Medicine, Central Texas Veterans Health Care System, Temple, Texas, USA Department of Medicine, Texas A & M Health Science Center, Bryan, Texas, USA
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Azevedo CMPS, Marques SG, Santos DWCL, Silva RR, Silva NF, Santos DA, Resende-Stoianoff MA. Squamous cell carcinoma derived from chronic chromoblastomycosis in Brazil. Clin Infect Dis 2015; 60:1500-4. [PMID: 25681378 DOI: 10.1093/cid/civ104] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 02/04/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Chromoblastomycosis (CBM) is a chronic fungal infection caused mainly by the melanized fungi Fonsecaea species. The chronic lesions may be predisposed to develop into cancer, the most serious complication of the disease. METHODS In this report, 7 cases of squamous cell carcinoma (SCC) resulting from chronic CBM in patients from Maranhão in the Brazilian Amazon are described. RESULTS The 7 patients presented with SCC that resulted from chronic CBM, caused by Fonsecaea species >10 years' duration. The malignant lesions occurred independent of the antifungal therapy and all patients underwent curative amputation, except for 1 patient who developed metastases in the inguinal and intra-abdominal lymph nodes and thigh muscles. A majority of previous reports have focused on the malignant transformation of CBM described in only 1 patient each. This is a first report describing a group of patients from a single Brazilian state. CONCLUSIONS Here, we provide new epidemiologic data on malignant CBM lesions, an endemic disease that is seemingly neglected worldwide. We reinforce the idea that typically chronic lesions may be predisposed to turn malignant.
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Affiliation(s)
| | - Sirlei G Marques
- Departamento de Patologia, Universidade Federal do Maranhão, São Luiz
| | | | - Raimunda R Silva
- Departamento de Patologia, Universidade Federal do Maranhão, São Luiz
| | - Nayara F Silva
- Departamento de Patologia, Universidade Federal do Maranhão, São Luiz
| | - Daniel Assis Santos
- Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Jung NY, Kim E. Cerebral phaeohyphomycosis: a rare cause of brain abscess. J Korean Neurosurg Soc 2014; 56:444-7. [PMID: 25535526 PMCID: PMC4273007 DOI: 10.3340/jkns.2014.56.5.444] [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: 08/07/2014] [Revised: 10/01/2014] [Accepted: 10/22/2014] [Indexed: 11/27/2022] Open
Abstract
Cerebral phaeohyphomycosis (CP) is a very rare but serious form of central nervous system fungal infection that is caused by dematiaceous fungi. It is commonly associated with poor prognosis irrespective of the immune status of the patient. In this study, the authors describe the first case of CP in Korea that occurred in a 75-year-old man without immunodeficiency and showed favorable outcome after surgical excision and antifungal therapy. In addition, the authors herein review the literature regarding characteristics of this rare clinical entity with previously reported cases.
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Affiliation(s)
- Na-Young Jung
- Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Ealmaan Kim
- Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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Yew SM, Chan CL, Lee KW, Na SL, Tan R, Hoh CC, Yee WY, Ngeow YF, Ng KP. A five-year survey of dematiaceous fungi in a tropical hospital reveals potential opportunistic species. PLoS One 2014; 9:e104352. [PMID: 25098697 PMCID: PMC4123927 DOI: 10.1371/journal.pone.0104352] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 07/11/2014] [Indexed: 01/06/2023] Open
Abstract
Dematiaceous fungi (black fungi) are a heterogeneous group of fungi present in diverse environments worldwide. Many species in this group are known to cause allergic reactions and potentially fatal diseases in humans and animals, especially in tropical and subtropical climates. This study represents the first survey of dematiaceous fungi in Malaysia and provides observations on their diversity as well as in vitro response to antifungal drugs. Seventy-five strains isolated from various clinical specimens were identified by morphology as well as an internal transcribed spacer (ITS)-based phylogenetic analysis. The combined molecular and conventional approach enabled the identification of three classes of the Ascomycota phylum and 16 genera, the most common being Cladosporium, Cochliobolus and Neoscytalidium. Several of the species identified have not been associated before with human infections. Among 8 antifungal agents tested, the azoles posaconazole (96%), voriconazole (90.7%), ketoconazole (86.7%) and itraconazole (85.3%) showed in vitro activity (MIC ≤1 µg/mL) to the largest number of strains, followed by anidulafungin (89.3%), caspofungin (74.7%) and amphotericin B (70.7%). Fluconazole appeared to be the least effective with only 10.7% of isolates showing in vitro susceptibility. Overall, almost half (45.3%) of the isolates showed reduced susceptibility (MIC >1 µg/mL) to at least one antifungal agent, and three strains (one Pyrenochaeta unguis-hominis and two Nigrospora oryzae) showed potential multidrug resistance.
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Affiliation(s)
- Su Mei Yew
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chai Ling Chan
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kok Wei Lee
- Codon Genomics SB, Jalan Bandar Lapan Belas, Pusat Bandar Puchong, Selangor Darul Ehsan, Malaysia
| | - Shiang Ling Na
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ruixin Tan
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chee-Choong Hoh
- Codon Genomics SB, Jalan Bandar Lapan Belas, Pusat Bandar Puchong, Selangor Darul Ehsan, Malaysia
| | - Wai-Yan Yee
- Codon Genomics SB, Jalan Bandar Lapan Belas, Pusat Bandar Puchong, Selangor Darul Ehsan, Malaysia
| | - Yun Fong Ngeow
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kee Peng Ng
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
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