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TROIANO GIANMARCO, NANTE NICOLA. Emerging fungal infections: focus on Saksenaea Erythrospora. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E382-E385. [PMID: 34604577 PMCID: PMC8451331 DOI: 10.15167/2421-4248/jpmh2021.62.2.1953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/02/2021] [Indexed: 11/20/2022]
Abstract
Introduction In recent times, improved diagnostic techniques have revealed an alarming number of cases of mucormycosis in immunocompetent individuals. The Saksenaea species, is a rare cause of mucormycosis, and is often associated with skin and subcutaneous infection due to trauma in both immunocompromised and immunocompetent subjects. The purpose of this study was therefore, through a review of the literature, to investigate the problem of infections caused by Saksenaea Erythrospora, evaluating the clinical manifestations of the infection, the triggering factors, the therapies and patients’ outcomes, implementing and updating what already reported in literature. Methods A research of peer-reviewed literature in the electronic databases MEDLINE (PubMed) and Scopus was conducted in the period June 2020-January 2021 using the key word “Saksenaea erythrospora”. Studies in Italian, English, French, Spanish focused on cases of Saksenaea erythrospora were included, without time restrictions. Studies that provided ambiguous or insufficient data were excluded. Results Bibliographic research yielded 23 publications; 7 were included in the review. The studies were published between 2011 and 2015 and involved a total of 11 patients of average age 37.9 years (SD 17.23) hospitalized in several hospitals in: USA, India, Argentina, Colombia, Thailand. 6 patients were women, 5 men. All patients had an almost normal immune status. The causes of the infection were: injections, traumas, surgery. Two patients, despite surgical and medical therapy, died. Conclusions Our review partially updated what already published, because only one new study was found. Serious necrotizing infections from Saksenaea erythrospora have been observed in recent years and a early identification and timely management are essential to reduce morbidity and mortality. A greater awareness and education about the risks deriving from carrying out surgical procedures abroad, especially in precarious hygiene situations, could be additional effective weapons to reduce the incidence of these infections.
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Affiliation(s)
- GIANMARCO TROIANO
- ASST Melegnano e della Martesana, Vizzolo Predabissi (MI), Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Correspondence: Gianmarco Troiano, ASST Melegnano e della Martesana, via Pandina 1, 20070 Vizzolo Predabissi (MI), Italy - Department of Molecular and Developmental Medicine, University of Siena, via A. Moro 2, 53100 Siena, Italy - Tel.: +39 347-9512771 - E-mail: /
| | - NICOLA NANTE
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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Lai SHY, Duque JSR, Chung BHY, Chung TWH, Leung D, Ho RSL, Lee R, Poon RWS, Chua GT, Cheong KN, Chui MMC, Lee M, Tam S, Him AHC, Cheng KF, Ho WWS, Yuen KY, Lee P, Lau YL. Invasive cerebral phaeohyphomycosis in a Chinese boy with CARD9 deficiency and showing unique radiological features, managed with surgical excision and antifungal treatment. Int J Infect Dis 2021; 107:59-61. [PMID: 33872781 DOI: 10.1016/j.ijid.2021.04.052] [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: 03/09/2021] [Revised: 04/14/2021] [Accepted: 04/14/2021] [Indexed: 11/29/2022] Open
Abstract
We report this rare case of cerebral phaeohyphomycosis in a previously healthy Chinese boy, who was found to have caspase recruitment domain family member 9 (CARD9) deficiency. Initial radiological features suggested a neoplastic cerebral lesion, while histopathological examination supplemented by internal transcribed sequencing (ITS) of cerebral tissue confirmed the diagnosis of phaeohyphomycosis. He was treated with intravenous (IV) liposomal amphotericin B and voriconazole, guided by plasma and cerebrospinal fluid (CSF) level monitoring at drug initiation. At the 1 year follow-up, the patient demonstrated near complete neurological and radiological recovery.
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Affiliation(s)
- Sophie H Y Lai
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong
| | - Jaime S Rosa Duque
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | | | - Tom Wai-Hin Chung
- Department of Microbiology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Daniel Leung
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Ronnie Siu-Lun Ho
- Department of Pathology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Raymand Lee
- Department of Radiology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Rosana W S Poon
- Department of Microbiology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Gilbert T Chua
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kai-Ning Cheong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong; Hong Kong Children's Hospital, Hong Kong
| | | | - Mianne Lee
- Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Sidney Tam
- Department of Pathology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Andrew Ho Cheuk Him
- Department of Neurosurgery, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - King-Fai Cheng
- Department of Neurosurgery, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Wilson Wai-Shing Ho
- Department of Neurosurgery, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kwok-Yung Yuen
- Department of Microbiology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Pamela Lee
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Hong Kong Children's Hospital, Hong Kong
| | - Yu-Lung Lau
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong; Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Hong Kong Children's Hospital, Hong Kong.
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Chandra S, Sharma S, Vats R, Pandey S. Isolated cerebral mucormycosis masquerading as a tumor in an immunocompetent patient. AUTOPSY AND CASE REPORTS 2021; 11:e2020233. [PMID: 33968820 PMCID: PMC8020582 DOI: 10.4322/acr.2020.233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Mucormycosis is an opportunistic fungal disease that commonly presents as cutaneous or rhinocerebral infections associated with immunocompromised states. It may exceptionally present as isolated involvement of the brain with a varied clinical presentation, which may be difficult to diagnose early, leading to increased mortality. Herein, we report the case of a 42-year-old immunocompetent female with left-sided limb weakness and a history of recurrent vomiting and headache for the last two years. Clinically, glioma was suspected, but histopathological examination revealed a few broad aseptate fungal hyphae. As no other organ was involved, the diagnosis of isolated cerebral mucormycosis was rendered. Reporting this case, we show an unusual presentation of a central nervous system mucormycosis masquerading a tumor in an immunocompetent patient. The case also highlights the importance of a careful histopathological examination to avoid missing the presence of occasional fungal hyphae. Ideally, recognition of fungal hyphae in the brain, during intraoperative consultation, can prompt brain tissue culture for definitive diagnosis and early empirical antifungal therapy, which may prove life-saving.
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Affiliation(s)
- Smita Chandra
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Pathology, Dehradun, Uttarakhand, India
| | - Shubhi Sharma
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Pathology, Dehradun, Uttarakhand, India
| | - Ruchir Vats
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Neurosurgery, Dehradun, Uttarakhand, India
| | - Sanjeev Pandey
- Swami Rama Himalayan University, Himalayan Institute of Medical Sciences, Department of Neurosurgery, Dehradun, Uttarakhand, India
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