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Ye J, Li Y, Hao J, Song M, Guo Y, Gao W, Zheng C, Huang Y, Feng Z, Zhang L. Rare occurrence of pulmonary coinfection involving Aspergillus fumigatus and Nocardia cyriacigeorgica in immunocompetent patients based on NGS: A case report and literature review. Medicine (Baltimore) 2023; 102:e36692. [PMID: 38134116 PMCID: PMC10735146 DOI: 10.1097/md.0000000000036692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
RATIONALE In our search on PubMed, we found that reports of co-infections involving Aspergillus fumigatus and Nocardia cyriacigeorgica in the literature are notably scarce. Most cases have been documented in patients with compromised immune systems or underlying pulmonary conditions. In contrast, our patient did not present with any of these risk factors. Furthermore, there have been no recent incidents such as near-drowning or other accidents in the patient history. To the best of our knowledge, this case represents a hitherto unreported clinical scenario. To enhance comprehension, we conducted a comprehensive literature review by compiling a total of 20 case reports (spanning from 1984 to 2023) on co-infections involving Aspergillus and Nocardia species, retrieved from PubMed. PATIENT CONCERNS AND DIAGNOSIS Chest CT revealed the presence of multiple nodules and clustered high-density shadows in both lungs. Bronchoscopy revealed mucosal congestion and edema in the apical segment of the right upper lobe of the lung, along with the presence of 2 spherical polypoid new organisms. The pathological analysis reported severe chronic inflammation with evidence of Aspergillus within the tissue. Next-Generation Sequencing of bronchoalveolar lavage fluid revealed the presence of reads corresponding to A fumigatus and N cyriacigeorgica. Positive cultures for A fumigatus and the Nocardia genus were yielded by prolonging the incubation of samples in the microbiology laboratory. INTERVENTIONS Treatment with voriconazole for A fumigatus and sulfamethoxazole-trimethoprim for N cyriacigeorgica infection was given. OUTCOMES The patient improved and was discharged. After 6 months of telephone follow-up, the patient reported no clinical symptoms, discontinued the medication on his own. LESSONS A fumigatus and N cyriacigeorgica can manifest as a co-infection in immunocompetent patients. Clinicians should prioritize the significant advantages and value of NGS in detecting rare and mixed pathogens associated with pulmonary infections.
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Affiliation(s)
- Jiaqing Ye
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Yahua Li
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Jiahao Hao
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Minghui Song
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Yumei Guo
- Hebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, Hebei, PR China
| | - Weili Gao
- Hebei Key Laboratory of Intractable Pathogens, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, Hebei, PR China
| | - Cuiying Zheng
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Yinqi Huang
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Zhongjun Feng
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Lijie Zhang
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
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Liu X, Xiang L, Yin Y, Li H, Ma D, Qu Y. Pneumonia caused by Pseudomonas fluorescens: a case report. BMC Pulm Med 2021; 21:212. [PMID: 34225696 PMCID: PMC8259381 DOI: 10.1186/s12890-021-01573-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pseudomonas fluorescens (P. fluorescens) has been detected in respiratory samples from patients. However, no previous reports have been published about these P. fluorescens cultures from lung tissues. CASE PRESENTATION Here, we report a case of pneumonia caused by P. fluorescens. P. fluorescens was identified from lung biopsy specimens for the first time in this case. According to the antibiotic susceptibility testing (AST) of P. fluorescens, the patient was given ciprofloxacin treatment. The temperature of the patient then returned to normal. Chest CT examination revealed improvements in pulmonary inflammation. CONCLUSIONS These findings suggest that the patients with pneumonia caused by P. fluorescens should be treated in a timely manner according to the AST results.
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Affiliation(s)
- Xiao Liu
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Lei Xiang
- Department of Pathology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Yunhong Yin
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, China
| | - Hao Li
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, China
| | - Dedong Ma
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, China
| | - Yiqing Qu
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Wenhuaxi Road 107#, Jinan, 250012, China.
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Lavrin T, Konte T, Kostanjšek R, Sitar S, Sepčič K, Prpar Mihevc S, Žagar E, Župunski V, Lenassi M, Rogelj B, Gunde Cimerman N. The Neurotropic Black Yeast Exophiala dermatitidis Induces Neurocytotoxicity in Neuroblastoma Cells and Progressive Cell Death. Cells 2020; 9:cells9040963. [PMID: 32295162 PMCID: PMC7226985 DOI: 10.3390/cells9040963] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/10/2020] [Accepted: 04/11/2020] [Indexed: 12/13/2022] Open
Abstract
The neurotropic and extremophilic black yeast Exophiala dermatitidis (Herpotrichellaceae) inhabits diverse indoor environments, in particular bathrooms, steam baths, and dishwashers. Here, we show that the selected strain, EXF-10123, is polymorphic, can grow at 37 °C, is able to assimilate aromatic hydrocarbons (toluene, mineral oil, n-hexadecane), and shows abundant growth with selected neurotransmitters (acetylcholine, gamma-aminobutyric acid, glycine, glutamate, and dopamine) as sole carbon sources. We have for the first time demonstrated the effect of E. dermatitidis on neuroblastoma cell model SH-SY5Y. Aqueous and organic extracts of E. dermatitidis biomass reduced SH-SY5Y viability by 51% and 37%, respectively. Melanized extracellular vesicles (EVs) prepared from this strain reduced viability of the SH-SY5Y to 21%, while non-melanized EVs were considerably less neurotoxic (79% viability). We also demonstrated direct interactions of E. dermatitidis with SH-SY5Y by scanning electron and confocal fluorescence microscopy. The observed invasion and penetration of neuroblastoma cells by E. dermatitidis hyphae presumably causes the degradation of most neuroblastoma cells in only three days. This may represent a so far unknown indirect or direct cause for the development of some neurodegenerative diseases such as Alzheimer’s.
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Affiliation(s)
- Teja Lavrin
- Biotechnical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (R.K.); (K.S.)
- Correspondence: (T.L.); (N.G.C.); Tel.: +386-(0)1-543-7652 (T.L.); +386-(0)1-320-3400 (N.G.C.)
| | - Tilen Konte
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (T.K.); (M.L.)
| | - Rok Kostanjšek
- Biotechnical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (R.K.); (K.S.)
| | - Simona Sitar
- Laboratory for Polymer Chemistry and Technology, National Institute of Chemistry, 1000 Ljubljana, Slovenia; (S.S.); (E.Ž.)
| | - Kristina Sepčič
- Biotechnical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (R.K.); (K.S.)
| | | | - Ema Žagar
- Laboratory for Polymer Chemistry and Technology, National Institute of Chemistry, 1000 Ljubljana, Slovenia; (S.S.); (E.Ž.)
| | - Vera Župunski
- Faculty of Chemistry and Chemical Technology, University of Ljubljana, 1000 Ljubljana, Slovenia; (V.Ž.); (B.R.)
| | - Metka Lenassi
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (T.K.); (M.L.)
| | - Boris Rogelj
- Faculty of Chemistry and Chemical Technology, University of Ljubljana, 1000 Ljubljana, Slovenia; (V.Ž.); (B.R.)
- Department of Biotechnology, Jožef Stefan Institute, 1000 Ljubljana, Slovenia
- Biomedical Research Institute, 1000 Ljubljana, Slovenia
| | - Nina Gunde Cimerman
- Biotechnical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia; (R.K.); (K.S.)
- Correspondence: (T.L.); (N.G.C.); Tel.: +386-(0)1-543-7652 (T.L.); +386-(0)1-320-3400 (N.G.C.)
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Belliere J, Rolland M, Tournier E, Cassaing S, Iriart X, Paul C, Kamar N. Early necrotic skin lesions after a ABO-incompatible kidney transplantation: The threat of Cunninghamella Spp. Transpl Infect Dis 2019; 21:e13173. [PMID: 31529558 DOI: 10.1111/tid.13173] [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: 04/07/2019] [Revised: 08/14/2019] [Accepted: 09/01/2019] [Indexed: 12/28/2022]
Abstract
A 49-year-old man underwent ABO-incompatible kidney transplantation with a living donor. At day 33 post-transplantation, he presented with undiagnosed epilepsy with generalized tonic-clonic seizures. At day 44 post-transplantation, he developed left-sided pneumonia attributed to Aspergillus fumigatus and treatment with liposomal amphotericin B was initiated. At day 51 post-transplantation, necrotic skin lesions appeared. DNA sequencing in a fresh cutaneous biopsy finally identified Cunninghamella Spp., a member of the order Mucorales. Unfortunately, the necrotic lesions spread, and the patient died at day 60 post-transplantation. This case report highlights the infectious risk related to ABO-incompatible kidney transplantation and suggests a requirement for rapid identification of every skin lesion, even in the early phases of immunosuppression.
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Affiliation(s)
- Julie Belliere
- Department of Nephrology, Dialysis and Organ Transplantation, Toulouse University Hospital, Toulouse, France.,INSERM U1048, I2MC, University Paul Sabatier, Toulouse, France
| | - Marion Rolland
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - Emilie Tournier
- Department of Anatomopathology, Toulouse University Hospital, Toulouse, France
| | - Sophie Cassaing
- Department of Parasitology and Mycology, Toulouse University Hospital, Toulouse, France
| | - Xavier Iriart
- Department of Parasitology and Mycology, Toulouse University Hospital, Toulouse, France
| | - Carle Paul
- Department of Dermatology and Allergology, Toulouse University Hospital, Toulouse, France
| | - Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, Toulouse University Hospital, Toulouse, France.,INSERM U1043, IFR -BMT, University Paul Sabatier, Toulouse, France
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