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Faure E, Brugière O, de Verdiere SC, Vuotto F, Limousin L, Cardot E, Cordier C, Coulon P, Garcia-Hermoso D, Lortholary O, Lanternier F. Refractory Microascus Bronchopulmonary Infection Treated with Olorofim, France. Emerg Infect Dis 2023; 29:2401-2403. [PMID: 37877687 PMCID: PMC10617333 DOI: 10.3201/eid2911.230984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
We report 3 cases of successful treatment of Microascus spp. bronchopulmonary infection in a multiple-traumatized patient and 2 lung transplant recipients in France. We emphasize the promising use of olorofim antifungal therapy in a rising context of intrinsically less-susceptible respiratory infections caused by mold.
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Kaplan NM, Al-Dwairi RA, AlRabadi NN. Fungal keratitis due to Scopulariopsis brevicaulis and a potential promising therapeutic effect of antibacterial agents: A case report. Medicine (Baltimore) 2021; 100:e28203. [PMID: 34889303 PMCID: PMC8663826 DOI: 10.1097/md.0000000000028203] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Microbial keratitis is a serious potentially blinding corneal infection. Contact lens wear remains the most common predisposing factor. Fungal keratitis represent only a small fraction of the overall number of cases of contact lens-associated microbial keratitis, however they are proportionally more severe. PATIENT CONCERNS An 18-year-old female, who occasionally used eye cosmetic soft contact lenses, presented with pain, redness, and blurring of vision in her left eye. DIAGNOSIS The left eye showed decreased visual acuity, central corneal ulcer and abscess, and severe ciliary injection. A provisional diagnosis of infectious keratitis was considered. INTERVENTION Corneal scrapings were aseptically collected and directly inoculated onto sterile bacterial and fungal agar plates that were immediately incubated. The patient was admitted and started on topical and systemic antibacterial agents. OUTCOMES The infection showed signs of satisfactory clinical resolution. However, the mold Scopulariopsis brevicaulis was isolated in pure colonies 5 days after presentation. CONCLUSION We report the first case from Jordan of fungal keratitis caused by the mold S brevicaulis. A high index of suspicion is required for fungal keratitis caused by S brevicaulis in immunocompetent patients who wear contact lenses despite its rarity. This fungal infection was successfully treated using antibacterial agents. However, larger studies are recommended to investigate the clinical effectiveness of antimicrobial agents that have both antibacterial and antifungal effects and to assess their role as empirical therapeutic modalities for infectious keratitis.
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Affiliation(s)
- Nasser M. Kaplan
- Department of Pathology and Microbiology, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan
| | - Rami A. Al-Dwairi
- Department of Special Surgery (Ophthalmology), King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan
| | - Nasr N. AlRabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Liu Q, Kong L, Hua L, Xu S. Pulmonary Microascus cirrosus infection in an immunocompetent patient with bronchiectasis: A case report. Respir Med Case Rep 2021; 34:101484. [PMID: 34386343 PMCID: PMC8346684 DOI: 10.1016/j.rmcr.2021.101484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/23/2021] [Accepted: 07/23/2021] [Indexed: 11/17/2022] Open
Abstract
Microascus species are widely distributed and rarely cause invasive infection in humans. Here we report a case of lung Microascus cirrosus infection in an immunocompetent patient with bronchiectasis. While on systemic voriconazole and aerosolized amphotericin B for three months, the patient's overall condition improved. This case report highlights the possibility of rare pathogen infection occurred in a bronchiectasis patient, as well as the importance of accurate diagnosis and individualized therapy of pulmonary Microascus infection.
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Affiliation(s)
- Qian Liu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Luxia Kong
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lijuan Hua
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuyun Xu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Nebulized Micafungin Treatment for Scopulariopsis/ Microascus Tracheobronchitis in Lung Transplant Recipients. Antimicrob Agents Chemother 2021; 65:AAC.02174-20. [PMID: 33722884 DOI: 10.1128/aac.02174-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/06/2021] [Indexed: 02/02/2023] Open
Abstract
Scopulariopsis/Microascus isolates cause infections with high mortality in lung transplant recipients. Treatment is challenging due to antimicrobial resistance. We describe two cases of Scopulariopsis/Microascus tracheobronchitis in lung transplant recipients successfully treated with nebulized micafungin. This antifungal was well tolerated and achieved high concentrations in epithelial lining fluid up to 14 h after nebulization without significant plasma concentrations. Nebulized micafungin may be a safe and effective option for the treatment of fungal tracheobronchitis.
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Foote BC, Smith JS, Bowden AC, Allbaugh RA, Sebbag L. Case Report: Successful Management of Refractory Keratomycosis in an Alpaca Using Penetrating Keratoplasty and Combination Antifungal Therapy (Caspofungin 0.5% and Terbinafine 1%). Front Vet Sci 2021; 8:644074. [PMID: 33791355 PMCID: PMC8006453 DOI: 10.3389/fvets.2021.644074] [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: 12/19/2020] [Accepted: 01/28/2021] [Indexed: 12/02/2022] Open
Abstract
Fungal keratitis is a common disease in certain parts of the world and affects several species, including equids, camelids, and homo sapiens, leading to blindness or loss of the eye if the infection is not adequately controlled. Reports of clinical use of antifungals caspofungin and terbinafine are limited across both veterinary and human medical literature. The alpaca presented in this case demonstrates that deep keratomycosis can be caused by Scopulariopsis brevicaulis and Fusarium verticillioides, two previously unreported fungi to cause keratomycosis in camelids. This report demonstrates successful management with a combination of surgery and topical ophthalmic treatment with caspofungin 0.5% solution and terbinafine 1% dermatologic cream, after initially failing treatment with topical voriconazole 1% solution. Combination therapy appears more effective than monotherapy with some fungal organisms, and synergy between antifungal agents is thought to play a role in the success of combination therapy. Surgery to remove the bulk of the fungal infection is especially helpful in cases that fail initial medical therapy.
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Affiliation(s)
- Braidee C Foote
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Joe S Smith
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Anna Catherine Bowden
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Rachel A Allbaugh
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Lionel Sebbag
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.,Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Nematollahi S, Shoham S. Updates on the Treatment of Non-Aspergillus Hyaline Mold Infections. CURRENT FUNGAL INFECTION REPORTS 2019. [DOI: 10.1007/s12281-019-00364-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kordalewska M, Kalita J, Bakuła Z, Brillowska-Dąbrowska A, Jagielski T. PCR-RFLP assays for species-specific identification of fungi belonging to Scopulariopsis and related genera. Med Mycol 2019; 57:643-648. [PMID: 30329089 DOI: 10.1093/mmy/myy106] [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: 05/28/2018] [Revised: 08/31/2018] [Accepted: 09/14/2018] [Indexed: 11/13/2022] Open
Abstract
Fungi of the Scopulariopsis genus, commonly found in the environment, are opportunistic pathogens that can cause various types of human infections. So far, no efficient molecular method has been developed for species differentiation among Scopulariopsis and related genera. In order to advance this field, we have evaluated performance of polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assays, based on cytochrome c oxidase subunit 1 and β-tubulin genes. The assays resulted in 2-10 restriction patterns, depending on the gene amplified and restriction enzyme applied. Pooled analysis of the patterns allowed to propose an algorithm, that can be successfully used for an accurate species-specific identification of 21 species of the Scopulariopsis-like fungi.
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Affiliation(s)
- Milena Kordalewska
- Department of Molecular Biotechnology and Microbiology, Faculty of Chemistry, Gdansk University of Technology, Gdansk, Poland
| | - Joanna Kalita
- Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Zofia Bakuła
- Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Anna Brillowska-Dąbrowska
- Department of Molecular Biotechnology and Microbiology, Faculty of Chemistry, Gdansk University of Technology, Gdansk, Poland
| | - Tomasz Jagielski
- Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland
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Taton O, Bernier B, Etienne I, Bondue B, Lecomte S, Knoop C, Jacob F, Montesinos I. NecrotizingMicroascustracheobronchitis in a bilateral lung transplant recipient. Transpl Infect Dis 2017; 20. [DOI: 10.1111/tid.12806] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/07/2017] [Accepted: 07/17/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Olivier Taton
- Department of Pneumology; CUB-Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - Benjamin Bernier
- Department of Pneumology; CUB-Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - Isabelle Etienne
- Department of Pneumology; CUB-Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - Benjamin Bondue
- Department of Pneumology; CUB-Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - Sophie Lecomte
- Department of Pathology; CUB-Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - Christiane Knoop
- Department of Pneumology; CUB-Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - Frederique Jacob
- Department of Infectious Diseases; CUB-Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - Isabel Montesinos
- Department of Microbiology; CUB-Erasme; Université Libre de Bruxelles; Brussels Belgium
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Gavril D, Woerther PL, Ben Lakhdar A, Mahjoubi L, Routier E, Chachaty E, Gachot B, De Botton S, Micol JB, Willekens C. Invasive cutaneous infection due to Scopulariopsis brevicaulis unsuccessfully treated with high-dose micafungin in a neutropenic patient. Infection 2016; 45:361-363. [PMID: 27909895 DOI: 10.1007/s15010-016-0971-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/28/2016] [Indexed: 11/28/2022]
Abstract
Scopulariopsis brevicaulis onychomycosis with local cutaneous invasion was diagnosed in an acute leukemia patient and unsuccessfully treated with high-dose micafungin, based on antifungal susceptibility testing. This case should alert clinicians to the possible severe evolution of onychomycosis in neutropenic patients and suggests that surgery should be preferred in such a situation.
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Affiliation(s)
- Daniela Gavril
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, 114 Avenue Edouard Vaillant, 94805, Villejuif, France
| | - Paul-Louis Woerther
- Département de Biologie-Pathologie, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Aicha Ben Lakhdar
- Département de Biologie-Pathologie, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Linda Mahjoubi
- Département de Médecine Oncologique, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Emilie Routier
- Département de Médecine Oncologique, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Elisabeth Chachaty
- Département de Biologie-Pathologie, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Bertrand Gachot
- Département de Soins Aigus, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Stephane De Botton
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, 114 Avenue Edouard Vaillant, 94805, Villejuif, France.,Faculty of Medicine, University Paris-Sud, Le Kremlin-Bicêtre, France
| | - Jean-Baptiste Micol
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, 114 Avenue Edouard Vaillant, 94805, Villejuif, France
| | - Christophe Willekens
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, 114 Avenue Edouard Vaillant, 94805, Villejuif, France. .,Faculty of Medicine, University Paris-Sud, Le Kremlin-Bicêtre, France.
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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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Virulence and Resistance to Antifungal Therapies of Scopulariopsis Species. Antimicrob Agents Chemother 2016; 60:2063-8. [PMID: 26787688 DOI: 10.1128/aac.02275-15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 01/07/2016] [Indexed: 11/20/2022] Open
Abstract
Scopulariopsisis an emerging opportunistic fungus characterized by its high resistance to antifungal therapies. We have developed a murine model of disseminated infection in immunosuppressed animals by intravenous inoculation ofScopulariopsis brevicaulisandScopulariopsis brumptii, the most clinically relevant species, in order to evaluate their virulence and their responses to conventional antifungal treatments. Survival and tissue burden studies showed thatS. brumptiiwas more virulent thanS. brevicaulis The three drugs tested, liposomal amphotericin B, posaconazole, and voriconazole, prolonged the survival of mice infected withS. brumptii, but none showed efficacy againstS. brevicaulis The different therapies were only able to modestly reduce the fungal burden of infected tissue; however, in general, despite the high serum levels reached, they showed poor efficacy in the treatment of the infection. Unfortunately, the most effective therapy forScopulariopsisinfections remains unresolved.
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