1
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Tsui YW, Tsai CY, Chen HC. Microsurgical Debridement for Persistent Ulcers Due to Rare Fungus Infection: Case Report and Literature Review. Arch Plast Surg 2024; 51:135-138. [PMID: 38425853 PMCID: PMC10901585 DOI: 10.1055/a-2166-8413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 09/01/2023] [Indexed: 03/02/2024] Open
Abstract
A patient suffered from chronic ulcer due to recalcitrant fungal infection for 3.5 years. Five antifungal agents and 40 times of debridement-all failed. Finally, radical microscopic debridement was performed for eradication of fungal conidiospores. Since then, there was no recurrence at 2 years of follow-up. Scopulariopsis brevicaulis is one of the rarest pathogens of cutaneous fungal infections, for which multidrug resistance increased the complexity and difficulty of treatment. Radical excision, especially microscopic debridement, was the key for eradication of fungal conidiospores in this case.
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Affiliation(s)
- Yu-Wen Tsui
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Yu Tsai
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Chi Chen
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
- Department of Plastic Surgery, China Medical University Hospital, Taichung, Taiwan
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2
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Non- Aspergillus Hyaline Molds: A Host-Based Perspective of Emerging Pathogenic Fungi Causing Sinopulmonary Diseases. J Fungi (Basel) 2023; 9:jof9020212. [PMID: 36836326 PMCID: PMC9964096 DOI: 10.3390/jof9020212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
The incidence of invasive sino-pulmonary diseases due to non-Aspergillus hyaline molds is increasing due to an enlarging and evolving population of immunosuppressed hosts as well as improvements in the capabilities of molecular-based diagnostics. Herein, we review the following opportunistic pathogens known to cause sinopulmonary disease, the most common manifestation of hyalohyphomycosis: Fusarium spp., Scedosporium spp., Lomentospora prolificans, Scopulariopsis spp., Trichoderma spp., Acremonium spp., Paecilomyces variotii, Purpureocillium lilacinum, Rasamsonia argillacea species complex, Arthrographis kalrae, and Penicillium species. To facilitate an understanding of the epidemiology and clinical features of sino-pulmonary hyalohyphomycoses in the context of host immune impairment, we utilized a host-based approach encompassing the following underlying conditions: neutropenia, hematologic malignancy, hematopoietic and solid organ transplantation, chronic granulomatous disease, acquired immunodeficiency syndrome, cystic fibrosis, and healthy individuals who sustain burns, trauma, or iatrogenic exposures. We further summarize the pre-clinical and clinical data informing antifungal management for each pathogen and consider the role of adjunctive surgery and/or immunomodulatory treatments to optimize patient outcome.
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3
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Bupha-Intr O, Butters C, Reynolds G, Kennedy K, Meyer W, Patil S, Bryant P, Morrissey CO. Consensus guidelines for the diagnosis and management of invasive fungal disease due to moulds other than Aspergillus in the haematology/oncology setting, 2021. Intern Med J 2021; 51 Suppl 7:177-219. [PMID: 34937139 DOI: 10.1111/imj.15592] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Invasive fungal disease (IFD) due to moulds other than Aspergillus is a significant cause of mortality in patients with malignancies or post haemopoietic stem cell transplantation. The current guidelines focus on the diagnosis and management of the common non-Aspergillus moulds (NAM), such as Mucorales, Scedosporium species (spp.), Lomentospora prolificans and Fusarium spp. Rare but emerging NAM including Paecilomyces variotii, Purpureocillium lilacinum and Scopulariopsis spp. are also reviewed. Culture and histological examination of tissue biopsy specimens remain the mainstay of diagnosis, but molecular methods are increasingly being used. As NAM frequently disseminate, blood cultures and skin examination with biopsy of any suspicious lesions are critically important. Treatment requires a multidisciplinary approach with surgical debridement as a central component. Other management strategies include control of the underlying disease/predisposing factors, augmentation of the host response and the reduction of immunosuppression. Carefully selected antifungal therapy, guided by susceptibility testing, is critical to cure. We also outline novel antifungal agents still in clinical trial which offer substantial potential for improved outcomes in the future. Paediatric recommendations follow those of adults. Ongoing epidemiological research, improvement in diagnostics and the development of new antifungal agents will continue to improve the poor outcomes that have been traditionally associated with IFD due to NAM.
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Affiliation(s)
- Olivia Bupha-Intr
- Department of Infection Services, Wellington Regional Hospital, Wellington, New Zealand
| | - Coen Butters
- Department of General Paediatric and Adolescent Medicine, John Hunter Children's Hospital, Newcastle, New South Wales, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Gemma Reynolds
- Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia
| | - Karina Kennedy
- Department of Infectious Diseases and Microbiology, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia.,ANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Research and Education Network, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Sushrut Patil
- Malignant Haematology and Stem Cell Transplantation Service, Department of Clinical Haematology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Penelope Bryant
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Infectious Diseases, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Catherine O Morrissey
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.,Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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4
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Pérez-Cantero A, Guarro J. Current knowledge on the etiology and epidemiology of Scopulariopsis infections. Med Mycol 2020; 58:145-155. [PMID: 31329937 DOI: 10.1093/mmy/myz036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/06/2019] [Accepted: 04/01/2019] [Indexed: 11/13/2022] Open
Abstract
Scopulariopsis is a common fungus in the environment, characterized by its intrinsic resistance to the available antifungal drugs. Around 70 cases of infection by this fungus have been described in the literature. Pulmonary and disseminated infections are the most common and their treatment is difficult; therefore, very diverse approaches have been taken, with varied results. A successful outcome has been reported in only a few cases, generally attributed to a multitreatment strategy combining medical and surgical procedures that ultimately led to the resection of the infected tissue if possible, identification of the mould, and an aggressive long-term antifungal therapy. Although most of the infections are caused by Scopulariopsis brevicaulis, a few other species have also been linked to these cases, although molecular evidence has not been proven for all of them. On this basis, more knowledge on the epidemiology, presentation, diagnosis, treatment, and prognosis of these unusual infections would improve their management. This review aims to compile the current data on Scopulariopsis infections.
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Affiliation(s)
| | - Josep Guarro
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili (IISPV). Reus, Tarragona, Spain
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5
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Huang L, Chen W, Guo L, Zhao L, Cao B, Liu Y, Lu B, Li B, Chen J, Wang C. Scopulariopsis/Microascus isolation in lung transplant recipients: A report of three cases and a review of the literature. Mycoses 2019; 62:883-892. [PMID: 31166635 DOI: 10.1111/myc.12952] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/10/2019] [Accepted: 05/31/2019] [Indexed: 02/01/2023]
Abstract
The current knowledge of invasive Scopulariopsis/Microascus infection in lung transplantation has been derived from only four case reports. Although these fungi are uncommon compared with Aspergillus, they are highly resistant to the current antifungal agents, and the mortality is extremely high. To explore the risk factors, clinical manifestations, notable diagnostic characteristics and outcomes of positive Scopulariopsis/Microascus isolation in lung transplantation patients. We included all cases with positive Scopulariopsis/Microascus isolation from lower respiratory tracts or bronchial mucosa biopsies in our lung transplantation centre. Proven cases from the literature were added. Positive isolation occurred in 2% (3/157) in our centre. Four cases from the literature were added. The mortality could be considered as high as 80%, once the two cases of colonisation were excluded. The average interval between transplantation and positive isolation was 106 (19-131) days. A total of 57.1% of patients had experienced a combination of infection with Aspergillus or other fungi as well as long-term azole antifungal agent treatment before the positive isolation, which may be possible risk factors. The combination of micafungin, posaconazole and terbinafine may be an effective treatment. The peak time of positive isolation was consistent with that of some opportunistic pathogens, and the possible risk factors were the infection of other fungi as well as prior long-term azole antifungal administration. In addition to its high mortality, Scopulariopsis/Microascus was also highly resistant to common antifungal agents and the combination of two or three drugs for therapy was recommended.
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Affiliation(s)
- Linna Huang
- Department of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Wenhui Chen
- Department of Lung Transplantation, Centre for Lung Transplantation, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Lijuan Guo
- Department of Lung Transplantation, Centre for Lung Transplantation, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Li Zhao
- Department of Lung Transplantation, Centre for Lung Transplantation, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.,Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yingmei Liu
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Binghuai Lu
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Binbin Li
- Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Jingyu Chen
- Department of Lung Transplantation, Centre for Lung Transplantation, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.,Department of Lung Transplantation, Centre for Lung Transplantation, Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
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6
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Kurata K, Nishimura S, Ichikawa H, Sakai R, Mizutani Y, Takenaka K, Kakiuchi S, Miyata Y, Kitao A, Yakushijin K, Kawamoto S, Yamamoto K, Ito M, Matsuoka H, Tokimatsu I, Kamei K, Minami H. Invasive Scopulariopsis alboflavescens infection in patient with acute myeloid leukemia. Int J Hematol 2018; 108:658-664. [PMID: 29987744 DOI: 10.1007/s12185-018-2496-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/29/2018] [Accepted: 06/29/2018] [Indexed: 11/28/2022]
Abstract
Scopulariopsis alboflavescens is a soil saprophyte that is widely distributed in nature. Recently, there have been increasing number of reports of invasive infections with Scopulariopsis species in immunocompromised patients. In this report, we described an adult woman with acute myeloid leukemia and who developed S. alboflavescens pneumonia. Liposomal amphotericin B and voriconazole combination therapy was unsuccessful and the patient died because of pneumonia. Scopulariopsis is highly resistant to available antifungal agents and almost invariably fatal. This case report should alert clinicians to the importance of listing Scopulariopsis as a pathogenic fungus in immunocompromised patients.
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Affiliation(s)
- Keiji Kurata
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Sho Nishimura
- Division of Infectious Diseases, Kobe University Hospital, Kobe, Japan
| | - Hiroya Ichikawa
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Rina Sakai
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yu Mizutani
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kei Takenaka
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Seiji Kakiuchi
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yoshiharu Miyata
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Akihito Kitao
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shinichiro Kawamoto
- Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Kobe, Japan
| | - Katsuya Yamamoto
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Mitsuhiro Ito
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroshi Matsuoka
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Issei Tokimatsu
- Department of Infection Control and Prevention, Kobe University Hospital, Kobe, Japan
| | - Katsuhiko Kamei
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Hironobu Minami
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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7
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Interface Scopulariopsis gracilis fungal keratitis following Descemet’s stripping automated endothelial keratoplasty (DSAEK) with a contaminated graft. Int Ophthalmol 2017; 38:2211-2217. [DOI: 10.1007/s10792-017-0706-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
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8
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de Miguel-Martinez I, Hernandez-Cabrera PM, Armesto-Fernández MA, Martín-Sánchez AM. Necrotising otitis externa due to Scopulariopsis brevicaulis in a patient without predisposing factors. Enferm Infecc Microbiol Clin 2017; 36:62-64. [PMID: 28473174 DOI: 10.1016/j.eimc.2017.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/25/2017] [Accepted: 03/24/2017] [Indexed: 11/20/2022]
Affiliation(s)
- Isabel de Miguel-Martinez
- Servicio de Microbiología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España.
| | | | - María Aser Armesto-Fernández
- Servicio de Otorrinolaringología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, España
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9
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Rapid Assays for Specific Detection of Fungi of Scopulariopsis and Microascus Genera and Scopulariopsis brevicaulis Species. Mycopathologia 2016; 181:465-74. [PMID: 27255522 PMCID: PMC4937093 DOI: 10.1007/s11046-016-0008-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 04/06/2016] [Indexed: 11/30/2022]
Abstract
Purpose Fungi of Scopulariopsis and Microascus genera cause a wide range of infections, with S. brevicaulis being the most prevalent aetiological agent of mould onychomycosis. Proper identification of these pathogens requires sporulating culture, which considerably delays the diagnosis. So far, sequencing of rDNA regions of clinical isolates has produced ambiguous results due to the lack of reference sequences in publicly available databases. Thus, there is a clear need for the development of new molecular methods that would provide simple, rapid and highly specific identification of Scopulariopsis and Microascus species. The objective of this study was to develop simple and fast assays based on PCR and real-time PCR for specific detection of fungi from Scopulariopsis and Microascus genera, and separately, S. brevicaulis species. Methods On the basis of alignment of β-tubulin gene sequences, Microascus/Scopulariopsis-specific primers were designed and S. brevicaulis-specific primers were reevaluated. DNA from cultured fungal isolates, extracted in a two-step procedure, was used in Microascus/Scopulariopsis-specific and S. brevicaulis-specific PCR and real-time PCR followed by electrophoresis or melting temperature analysis, respectively. Results The specificity of the assays was confirmed, as positive results were obtained only for Scopulariopsis spp. and Microascus spp. isolates tested in Microascus/Scopulariopsis-specific assay, and only for S. brevicaulis and S. koningii (syn. S. brevicaulis) isolates in a S. brevicaulis-specific assay, respectively, and no positive results were obtained neither for other moulds, dermatophytes, yeast-like fungi, nor for human DNA. Conclusions The developed assays enable fast and unambiguous identification of Microascus spp. and Scopulariopsis spp. pathogens.
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10
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Abstract
The history of cheese manufacture is a "natural history" in which animals, microorganisms, and the environment interact to yield human food. Part of the fascination with cheese, both scientifically and culturally, stems from its ability to assume amazingly diverse flavors as a result of seemingly small details in preparation. In this review, we trace the roots of cheesemaking and its development by a variety of human cultures over centuries. Traditional cheesemakers observed empirically that certain environments and processes produced the best cheeses, unwittingly selecting for microorganisms with the best biochemical properties for developing desirable aromas and textures. The focus of this review is on the role of fungi in cheese ripening, with a particular emphasis on the yeast-like fungus Geotrichum candidum. Conditions that encourage the growth of problematic fungi such as Mucor and Scopulariopsis as well as Arachnida (cheese mites), and how such contaminants might be avoided, are discussed. Bethlehem cheese, a pressed, uncooked, semihard, Saint-Nectaire-type cheese manufactured in the United Sates without commercial strains of bacteria or fungi, was used as a model for the study of stable microbial succession during ripening in a natural environment. The appearance of fungi during a 60-day ripening period was documented using light and scanning electron microscopy, and it was shown to be remarkably reproducible and parallel to the course of ripening of authentic Saint-Nectaire cheese in the Auvergne region of France. Geotrichum candidum, Mucor, and Trichothecium roseum predominate the microbiotas of both cheese types. Geotrichum in particular was shown to have high diversity in different traditional cheese ripening environments, suggesting that traditional manufacturing techniques selected for particular fungi. This and other studies suggest that strain diversity arises in relation to the lore and history of the regions from which these types of cheeses arose.
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11
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Invasive Microascus trigonosporus Species Complex Pulmonary Infection in a Lung Transplant Recipient. Case Rep Transplant 2015; 2015:745638. [PMID: 26075134 PMCID: PMC4446491 DOI: 10.1155/2015/745638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/30/2015] [Indexed: 11/17/2022] Open
Abstract
Because of the high incidence of morbidity and mortality associated with invasive fungal infections, antifungal prophylaxis is often used in solid organ transplant recipients. However, this prophylaxis is not universally effective and may contribute to the selection of emerging, resistant pathogens. Here we present a rare case of invasive infection caused by Microascus trigonosporus species complex in a human, which developed during voriconazole prophylaxis in a lung transplant recipient. Nebulized liposomal amphotericin B was used in addition to systemic therapy in order to optimize antifungal drug exposure; this regimen appeared to reduce the patient's fungal burden. Despite this apparent improvement, the patient's pulmonary status progressively declined in the setting of multiple comorbidities, ultimately leading to respiratory failure and death.
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12
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A Case of Scopulariopsis brevicaulis Endocarditis with Mycotic Aneurysm in an Immunocompetent Host. Case Rep Med 2015; 2015:872871. [PMID: 25866512 PMCID: PMC4381573 DOI: 10.1155/2015/872871] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 11/30/2022] Open
Abstract
Scopulariopsis is a genus of mold that is usually associated with onychomycosis and rarely causes complicated infection in immunocompetent persons. We describe a case of an immunocompetent 65-year-old male with a history of mitral valve repair with prosthetic ring placement who developed acute left posterior knee pain. Imaging showed a left popliteal artery aneurysm and thrombus, and further evaluation with transesophageal echocardiogram demonstrated two large, mobile mitral valve vegetations. He underwent debridement and replacement of the mitral valve, followed by debridement of the left popliteal artery with peroneal artery bypass. The intraoperative cultures grew Scopulariopsis brevicaulis. Due to the resistant nature of the organism, he was initially treated with combination antifungals including liposomal amphotericin B, caspofungin, and voriconazole and was continued on chronic suppression with posaconazole with no evidence of recurrence. Scopulariopsis is a rare cause of fungal endocarditis. Treatment of Scopulariopsis endocarditis is challenging and is not well understood due to its rarity.
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13
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Skóra M, Macura AB, Bulanda M. In vitro antifungal susceptibility of Scopulariopsis brevicaulis isolates. Med Mycol 2014; 52:723-7. [DOI: 10.1093/mmy/myu039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Sattler L, Sabou M, Ganeval-Stoll A, Dissaux C, Candolfi E, Letscher-Bru V. Sinusitis caused by Scopulariopsis brevicaulis: Case report and review of the literature. Med Mycol Case Rep 2014; 5:24-7. [PMID: 25003024 PMCID: PMC4081977 DOI: 10.1016/j.mmcr.2014.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/28/2014] [Accepted: 05/28/2014] [Indexed: 11/01/2022] Open
Abstract
We report a case of non-invasive sinusitis caused by Scopulariopsis brevicaulis in a 70-year-old immunocompetent patient who had an antibiotic-resistant suppurative tooth infection evolving for seven months. The sinus endoscopy highlighted a foreign body at the bottom of the sinus, which led to the hypothesis of fungal ball sinusitis. Culture of excised tissue was positive for S. brevicaulis.
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Affiliation(s)
- Laurent Sattler
- Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France
| | - Marcela Sabou
- Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France ; Institut de Parasitologie et de Pathologie Tropicale, 3 Rue Koeberlé, 67000 Strasbourg, France
| | - Amina Ganeval-Stoll
- Service de Chirurgie Maxillo-Faciale et Réparatrice, Pavillon Chirurgie B, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France
| | - Caroline Dissaux
- Service de Chirurgie Maxillo-Faciale et Réparatrice, Pavillon Chirurgie B, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France
| | - Ermanno Candolfi
- Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France ; Institut de Parasitologie et de Pathologie Tropicale, 3 Rue Koeberlé, 67000 Strasbourg, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 1 Place de l׳Hôpital, BP 426, 67091 Strasbourg Cedex, France ; Institut de Parasitologie et de Pathologie Tropicale, 3 Rue Koeberlé, 67000 Strasbourg, France
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15
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Perusquía-Ortiz AM, Vázquez-González D, Bonifaz A. Opportunistic filamentous mycoses: aspergillosis, mucormycosis, phaeohyphomycosis and hyalohyphomycosis. J Dtsch Dermatol Ges 2013; 10:611-21; quiz 621-2. [PMID: 22925358 DOI: 10.1111/j.1610-0387.2012.07994.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Opportunistic filamentous mycoses are widely distributed all over the world. They are rarely observed in Europe but are common in developing countries. The most common are the aspergilloses (due to Aspergillus spp.) mostly in neutropenia and immunosuppression; the mucormycoses characterized by rapid progression in patients with diabetic ketoacidosis; the phaeohyphomycoses due to pigmented fungi causing either a mild superficial or a very serious deep disease and the hyalohyphomycoses due to hyaline filamentous fungi (Fusarium spp., Pseudallescheria spp., Scopulariopsis spp.). Cutaneous manifestations are usually secondary to dissemination from pulmonary or visceral disease; primary cases are less frequent and due to direct inoculation into the skin. We review epidemiological, clinical, diagnostic, and therapeutic data on the four most important opportunistic filamentous mycoses: aspergillosis, mucormycosis, phaeohyphomycosis and hyalohyphomycosis.
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Affiliation(s)
- Ana María Perusquía-Ortiz
- Department of Dermatology, University of Münster, Germany Departamento de Micología, Servicio de Dermatología, Hospital General de México, Ciudad de México, México
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Yang Q, Wei J, Chen Z. Fatal bronchial invasion of Scopulariopsis brevicaulis in an acute monocytic leukemia patient. Diagn Microbiol Infect Dis 2012; 73:369-71. [DOI: 10.1016/j.diagmicrobio.2012.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 04/21/2012] [Accepted: 04/25/2012] [Indexed: 10/28/2022]
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Iwen PC, Schutte SD, Florescu DF, Noel-Hurst RK, Sigler L. InvasiveScopulariopsis brevicaulisinfection in an immunocompromised patient and review of prior cases caused byScopulariopsisandMicroascusspecies. Med Mycol 2012; 50:561-9. [DOI: 10.3109/13693786.2012.675629] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Miossec C, Morio F, Lepoivre T, Le Pape P, Garcia-Hermoso D, Gay-Andrieu F, Haloun A, Treilhaud M, Leclair F, Miegeville M. Fatal invasive infection with fungemia due to Microascus cirrosus after heart and lung transplantation in a patient with cystic fibrosis. J Clin Microbiol 2011; 49:2743-7. [PMID: 21543579 PMCID: PMC3147864 DOI: 10.1128/jcm.00127-11] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 04/20/2011] [Indexed: 11/20/2022] Open
Abstract
Scopulariopsis species are rarely but increasingly recognized as opportunistic pathogens in immunocompromised patients. We report on a patient suffering from cystic fibrosis who developed disseminated fungal infection due to a rare Scopulariopsis species, Microascus cirrosus, after heart and lung transplantation. Despite antifungal combination therapy with voriconazole and caspofungin, the patient died 4 weeks after transplantation. Diagnostic difficulties and optimal management of disseminated Scopulariopsis/Microascus infections are discussed.
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Affiliation(s)
- Charline Miossec
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
| | - Florent Morio
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
- Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155–IICiMed, Faculté de Pharmacie, Nantes, France
| | - Thierry Lepoivre
- Unité de Transplantation Thoracique, CHU de Nantes, Nantes, France
| | - Patrice Le Pape
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
- Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155–IICiMed, Faculté de Pharmacie, Nantes, France
| | - Dea Garcia-Hermoso
- Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France
- CNRS URA3012, Paris, France
| | - Françoise Gay-Andrieu
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
- Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155–IICiMed, Faculté de Pharmacie, Nantes, France
| | - Alain Haloun
- Unité de Transplantation Thoracique, CHU de Nantes, Nantes, France
| | | | | | - Michel Miegeville
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
- Département de Parasitologie et Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155–IICiMed, Faculté de Pharmacie, Nantes, France
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Rivier A, Perny J, Debourgogne A, Thivillier C, Lévy B, Gérard A, Machouart M. Fatal disseminated infection due toScedosporium prolificansin a patient with acute myeloid leukemia and posaconazole prophylaxis. Leuk Lymphoma 2011; 52:1607-10. [DOI: 10.3109/10428194.2011.573034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vignon M, Michonneau D, Baixench MT, Al-Nawakil C, Bouscary D, Buzyn A, Salmon D, Paugam A. Disseminated Scopulariopsis brevicaulis infection in an allogeneic stem cell recipient. Bone Marrow Transplant 2010; 46:1276-7. [PMID: 21113187 DOI: 10.1038/bmt.2010.292] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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