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Gupta S, Srivastava A, Vyas N, Kaur H, Sharma BS, Rudramurthy SM. Fungal thalamic abscess caused by Rhinocladiella mackenziei in an immunocompetent patient. Indian J Med Microbiol 2024; 49:100605. [PMID: 38734140 DOI: 10.1016/j.ijmmb.2024.100605] [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: 03/20/2024] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
Cerebral phaeohyphomycosis (CP) stands as an exceedingly uncommon yet severe type of fungal infection affecting the central nervous system, attributable to dematiaceous fungi. Despite the patient's immune status, CP is associated with grave prognosis. In the present study, authors describe the first case of left thalamic fungal abscess due to Rhinocladiella mackenziei in an immunocompetent 39-year-old male patient in Jaipur, Rajasthan. Early diagnosis by direct microscopy of aspirated pus and extensive management with surgical excision and prolonged antifungal coverage showed favourable outcome. The present case is one of the few cases documented globally who has survived.
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Affiliation(s)
- Shilpi Gupta
- Microbiology, Mahatma Gandhi Medical College and Hospital, Jaipur, India.
| | - Anurag Srivastava
- Neurosurgery, Mahatma Gandhi Medical College and Hospital, Jaipur, India.
| | - Nitya Vyas
- Microbiology, Mahatma Gandhi Medical College and Hospital, Jaipur, India.
| | - Harsimran Kaur
- Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - B S Sharma
- Neurosurgery, Mahatma Gandhi Medical College and Hospital, Jaipur, India.
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2
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Kucukkaya IC, Gulsever CI, Dolas I, Genc GE, Kuskucu MA, Sabanci PA, Erturan Z. First case of Rhinocladiella mackenziei brain abscess in Turkey: Case report and review of the literature. Mycoses 2023; 66:755-766. [PMID: 37165906 DOI: 10.1111/myc.13601] [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: 03/08/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 05/12/2023]
Abstract
Rhinocladiella mackenziei is a highly neurotropic fungus, mainly reported from the Middle East. However, in recent years, there have been some cases from outside this region. We described an additional fatal case of R. mackenziei cerebral infection for the first time from Turkey and made a literature review of all previously reported cases. During 34 years (1988-2022), there have been 42 R. mackenziei brain abscess cases. Most patients have been reported from Saudi Arabia (n = 14, 33.3%). It is noteworthy that 40.5% of patients, including our case, were immunocompetent at initial diagnosis and mostly presented with a single lesion (n = 10, 23.8%). The most frequent comorbidities were solid organ transplant (n = 9, 21.4%), diabetes mellitus (n = 6, 14.3%), malignancy (n = 6, 14.3%) and prior surgery (n = 3, 7.1%). The most commonly used initial antifungal regimen were amphotericin B together with itraconazole (n = 9, 21.4%), combinations of lipid preparations of amphotericin B, voriconazole and/or posaconazole (n = 9, 21.4%) and amphotericin B alone (n = 8, 19%). Although both surgical procedures and antifungal medication in the majority of patients were performed, mortality rates remained high (90.4%). The area at risk of R. mackenziei cerebral abscess cases extends to other countries. Clinicians should be aware of this emerging disease and take a detailed travel history in patients with atypical and undocumented brain abscesses. Our case confirms the hypothesis that this fungus might spread more widely than previously predicted regions.
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Affiliation(s)
| | - Cafer Ikbal Gulsever
- Department of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilyas Dolas
- Department of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gonca Erkose Genc
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mert Ahmet Kuskucu
- Department of Medical Microbiology, School of Medicine, Koç University, Istanbul, Turkey
- İş-Bank Center for Infectious Diseases, Department of Medical Microbiology, School of Medicine, Koç University, Istanbul, Turkey
| | - Pulat Akin Sabanci
- Department of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zayre Erturan
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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3
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Li JF, Jiang HB, Jeewon R, Hongsanan S, Bhat DJ, Tang SM, Lumyong S, Mortimer PE, Xu JC, Camporesi E, Bulgakov TS, Zhao GJ, Suwannarach N, Phookamsak R. <i>Alternaria</i>: update on species limits, evolution, multi-locus phylogeny, and classification. STUDIES IN FUNGI 2023. [DOI: 10.48130/sif-2023-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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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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Li JF, Jiang HB, Jeewon R, Hongsanan S, Bhat DJ, Tang SM, Mortimer PE, Xu JC, Camporesi E, Bulgakov TS, Zhao GJ, Suwannarach N, Phookamsak R. <i>Alternaria</i>: update on species limits, evolution, multi-locus phylogeny, and classification. STUDIES IN FUNGI 2022. [DOI: 10.48130/sif-2022-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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6
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Zain Mushtaq M, Zafar Mahmood SB, Nasir N, Saad Rashid M, Irshad M, Habib K, Khanum I. Cerebral phaeohyphomycosis due to Rhinocladiella mackenziei in an immunocompetent patient: A case report and review of literature. Curr Med Mycol 2021; 6:65-68. [PMID: 33834146 PMCID: PMC8018822 DOI: 10.18502/cmm.6.3.4497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background and Purpose Rhinocladiella mackenziei is a neurotropic fungus, which can cause devastating intracerebral infections with up to 100% fatality rate. It is difficult to isolate this fungus in laboratory as it grows slowly and requires diagnostic skills. Case report A 42-year-old Pakistani man presented with headache, facial numbness, progressive upper limb weakness, and dysarthria. Magnetic resonance imaging of the brain showed a space-occupying lesion in the basal ganglia region. The patient underwent supratentorial craniotomy for biopsy and excision. Histopathology of the specimen revealed granulomatous inflammation with abscess formation. Periodic acid- Schiff special stains highlighted the presence of numerous septate fungal hyphae. The results revealed the growth of dematiaceous fungi, which were morphologically classified as R. mackenziei. The patient is currently stable and is being on amphotericin and posaconazole, along with neurorehabilitation therapy. Conclusion Rhinocladiella mackenziei brain abscess is a devastating infection with significant mortality. This condition should be suspected in patients with brain abscess from high endemic areas.
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Affiliation(s)
- Muhammad Zain Mushtaq
- Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
| | | | - Nosheen Nasir
- Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
| | - Malik Saad Rashid
- Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
| | - Memoona Irshad
- Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
| | - Kiren Habib
- Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
| | - Iffat Khanum
- Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
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7
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Mohammadi A, Bahramikia S. Molecular identification and genetic variation of Alternaria species isolated from tomatoes using ITS1 sequencing and inter simple sequence repeat methods. Curr Med Mycol 2019; 5:1-8. [PMID: 31321331 PMCID: PMC6626712 DOI: 10.18502/cmm.5.2.1154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background and Purpose: Alternaria is one of the most abundant fungi that exists in numerous places around the world. This saprophytic fungus causes diseases in plants and accounts for the spoilage of cereals in warehouses. The aim of this study was to identify Alternaria isolates based on their morphological characteristics and internal transcribed spacer ribosomal RNA (ITS rRNA) sequencing method. To this end, genetic diversity in the isolates was also examined using inter simple sequence repeat (ISSR) markers. Materials and Methods: To conduct this research, a total of 60 tomato samples with black spots were collected from supermarkets in Khorramabad City, Iran, in the winter of 2017. The specimens were cultured on a potato dextrose agar medium. After the purification of the fungus by the single-spore method, the identification of the species was carried out using morphological characteristics and ITS rRNA sequencing by polymerase chain reaction. The genetic diversity of the identified species with four primers was evaluated using the ISSR marker. Results: Based on the sequencing of the ITS1 region, all the isolates were identified as A. alternata. Cluster diagrams for the ISSR marker were classified into six distinct groups. The mean polymorphism information content was obtained as 0.35, indicating the effectiveness of the primers in the separation of the isolates. Conclusion: The sequencing of ITS1 led to the identification of Alternaria species that are morphologically similar. The production of various mycotoxins by A. Alternata species leads to the contamination of livestock and human food. Regarding this, the investigation of the genetic diversity of A. alternata species using the ISSR marker would facilitate the identification of suitable and effective strategies for controlling the fungal and mycotoxin contamination of human nutrition.
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Affiliation(s)
| | - Seifollah Bahramikia
- Department of Biology, Faculty of Science, Lorestan University, Khorramabad, Iran
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Paul S, Singh P, Sharma S, Prasad GS, Rudramurthy SM, Chakrabarti A, Ghosh AK. MALDI-TOF MS-Based Identification of Melanized Fungi is Faster and Reliable After the Expansion of In-House Database. Proteomics Clin Appl 2018; 13:e1800070. [PMID: 30141266 DOI: 10.1002/prca.201800070] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 07/28/2018] [Indexed: 01/27/2023]
Abstract
PURPOSE Invasive fungal infections caused by melanized fungi are a growing concern. Rapid and reliable identification plays an important role in optimizing therapy. Matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS)-based identification has emerged as a faster and more accurate diagnostic technique. However, lack of a protein extraction protocol and limited database restricts the identification of melanized fungi by MALDI-TOF MS. The study is designed to standardize protein extraction protocol, to enrich the existing, and to create an in-house database for the rapid identification of melanized fungi. EXPERIMENTAL DESIGN In this study, 59 sequence-confirmed, melanized fungi were used to expand and to create an in-house database using a modified protein extraction protocol. A total of 117 clinical isolates are further used to validate the created database. RESULT Using existing Bruker database, only 29(24.8%) out of 117 moulds could be identified. However, all the isolates are identified accurately by supplementing the Bruker database with the created in-house database. MALDI-TOF MS takes significantly lesser time for identification compared to DNA sequencing. CONCLUSION AND CLINICAL RELEVANCE An expanded database with modified protein extraction protocol can reduce significant time to identify melanized fungi by MALDI-TOF MS.
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Affiliation(s)
- Saikat Paul
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Singh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Savitri Sharma
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | | | | | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anup K Ghosh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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9
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Satta R, Dore MP, Pes GM, Biondi G. Iatrogenic immunosuppression may favour Alternaria skin lesion flares. BMJ Case Rep 2018; 2018:bcr-2017-223857. [PMID: 29739763 DOI: 10.1136/bcr-2017-223857] [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] [Indexed: 11/04/2022] Open
Abstract
Alternaria spp may cause opportunistic mycoses in the skin after cutaneous inoculation or through blood dissemination in immune-suppressed patients. Here, we describe a case of cutaneous infection with Alternaria spp in a 62-year-old man, presenting with multifocal papules and erythematous nodules involving distal limbs bilaterally. The absence of inflammatory bowel disease was confirmed by a gastroenterologist. The patient was under treatment for uveitis of unknown origin with immunosuppressive doses of cyclosporin and prednisolone for approximately 3 months. The diagnosis was based on clinical signs, demonstration of fungal elements in skin biopsies and deep fungal culture. Complete clinical remission was achieved by oral and systemic treatment with antifungal drugs. However, because cessation of the immunosuppressive medication was not possible, his clinical history was characterised by multiple flares requiring each time oral and intravenous antifungal treatment.
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Affiliation(s)
- Rosanna Satta
- Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Maria Pina Dore
- Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Giovanni Mario Pes
- Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Gabriele Biondi
- Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
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Revankar SG, Baddley JW, Chen SCA, Kauffman CA, Slavin M, Vazquez JA, Seas C, Morris MI, Nguyen MH, Shoham S, Thompson GR, Alexander BD, Simkins J, Ostrosky-Zeichner L, Mullane K, Alangaden G, Andes DR, Cornely OA, Wahlers K, Lockhart SR, Pappas PG. A Mycoses Study Group International Prospective Study of Phaeohyphomycosis: An Analysis of 99 Proven/Probable Cases. Open Forum Infect Dis 2017; 4:ofx200. [PMID: 29766015 PMCID: PMC5946886 DOI: 10.1093/ofid/ofx200] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 09/14/2017] [Indexed: 12/28/2022] Open
Abstract
Background Phaeohyphomycosis is infection caused by dematiaceous, or darkly pigmented, fungi. The spectrum of disease is broad, and optimal therapy remains poorly defined. The Mycoses Study Group established an international case registry of patients with proven/probable phaeohyphomycosis with the goal of improving the recognition and management of these infections. Methods Patients from 18 sites in 3 countries were enrolled from 2009-2015. Cases were categorized as local superficial, local deep (pulmonary, sinus, osteoarticular infections), and disseminated infections. End points were clinical response (partial and complete) and all-cause mortality at 30 days and end of follow-up. Results Of 99 patients, 32 had local superficial infection, 41 had local deep infection, and 26 had disseminated infection. The most common risk factors were corticosteroids, solid organ transplantation, malignancy, and diabetes. Cultures were positive in 98% of cases. All-cause mortality was 16% at 30 days and 33% at end of follow-up, and 18 of 26 (69%) with dissemination died. Itraconazole was most commonly used for local infections, and voriconazole was used for more severe infections, often in combination with terbinafine or amphotericin B. Conclusions Phaeohyphomycosis is an increasingly recognized infection. Culture remains the most frequently used diagnostic method. Triazoles are currently the drugs of choice, often combined with other agents. Further studies are needed to develop optimal therapies for disseminated infections.
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Affiliation(s)
- Sanjay G Revankar
- Division of Infectious Diseases, Wayne State University, Detroit, Michigan
| | - John W Baddley
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama.,Birmingham VA Medical Center, Birmingham, Alabama
| | - Sharon C-A Chen
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, and the University of Sydney, Westmead, Australia
| | - Carol A Kauffman
- Division of Infectious Diseases, University of Michigan Medical School and VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Monica Slavin
- Victorian Infectious Diseases Service, Melbourne Health, Parkville, Australia
| | - Jose A Vazquez
- Division of Infectious Diseases, Georgia Regents University, Augusta, Georgia
| | - Carlos Seas
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Michele I Morris
- Division of Infectious Diseases, University of Miami, Miami, Florida
| | - M Hong Nguyen
- Division of Infectious Diseases, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Shmuel Shoham
- Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland
| | - George R Thompson
- Division of Infectious Diseases, University of California at Davis, Davis, California
| | - Barbara D Alexander
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Jacques Simkins
- Division of Infectious Diseases, University of Miami, Miami, Florida
| | - Luis Ostrosky-Zeichner
- Division of Infectious Diseases, University of Texas Health Science Center, Houston, Texas
| | - Kathleen Mullane
- Division of Infectious Diseases, University of Chicago, Chicago, Illinois
| | - George Alangaden
- Division of Infectious Diseases, Henry Ford Health System, Detroit, Michigan
| | - David R Andes
- Division of Infectious Diseases, University of Wisconsin, Madison, Wisconsin
| | - Oliver A Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), and Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - Kerstin Wahlers
- Division of Infectious Diseases, Klinikum Oldenburg, Oldenburg, Germany
| | - Shawn R Lockhart
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Peter G Pappas
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama
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Liu AW, Bateman AC, Greenbaum A, Garvin K, Clarridge J, Grim J. Cutaneous phaeohyphomycosis in a hematopoietic stem cell transplant patient caused by Alternaria rosae: First case report. Transpl Infect Dis 2017; 19. [PMID: 28295973 DOI: 10.1111/tid.12698] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 09/29/2016] [Accepted: 12/30/2016] [Indexed: 11/29/2022]
Abstract
Alternaria species have been reported as a rare cause of fungal infection in organ and stem cell transplant recipients, but to date, no reports have been published of infection in humans caused by Alternaria rosae. Here, we report cutaneous A. rosae infection in a 66-year-old farmer with a history of primary myelofibrosis who had undergone allogeneic unrelated donor hematopoietic stem cell transplantation. Forty-nine days post transplant, he presented with a nodule on the thumb with no findings suggestive of disseminated infection. Pathology, culture, and molecular speciation showed the nodule was caused by cutaneous A. rosae. He had been on voriconazole as antifungal prophylaxis, but was found to have a subtherapeutic voriconazole level. He was switched to posaconazole based on published in vitro data showing its superior efficacy in Alternaria treatment. Susceptibility testing showed that the A. rosae isolate was indeed susceptible to posaconazole. His cutaneous lesion remained stable, but he died from respiratory failure secondary to lobar pneumonia. At lung autopsy, A. rosae was not identified in the lungs. We believe this to be the first published report, to our knowledge, of A. rosae infection in humans.
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Affiliation(s)
- Amy W Liu
- Division of General Internal Medicine, University of Washington, Seattle, WA, USA
| | - Allen C Bateman
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Adam Greenbaum
- Division of Hematology, University of Washington, Seattle, WA, USA.,Division of Medical Oncology, University of Washington, Seattle, WA, USA
| | - Kanishka Garvin
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Jill Clarridge
- Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.,Pathology and Laboratory Medicine Service, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Jonathan Grim
- Division of Medical Oncology, University of Washington, Seattle, WA, USA.,Hospital and Specialty Medicine, Medical Oncology Section, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Disseminated Nocardiosis in an Immunocompetent Individual Infected with Nocardia brasiliensis, an Opportunistic Agent. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2016. [DOI: 10.5812/archcid.37738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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13
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Lyskova P, Kubanek M, Hubka V, Sticova E, Voska L, Kautznerova D, Kolarik M, Hamal P, Vasakova M. Successful Posaconazole Therapy of Disseminated Alternariosis due to Alternaria infectoria in a Heart Transplant Recipient. Mycopathologia 2016; 182:297-303. [DOI: 10.1007/s11046-016-0094-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
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14
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Refractory Cutaneous Alternariosis Successfully Treated With Mohs Surgery and Full-Thickness Skin Grafting. Dermatol Surg 2016; 42:426-9. [PMID: 26945322 DOI: 10.1097/dss.0000000000000625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Thorn-Induced Alternaria Septic Arthritis and Osteomyelitis of the Hand. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2016. [DOI: 10.1097/ipc.0000000000000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Didehdar M, Gokanian A, Sofian M, Mohammadi S, Mohammadi R, Aslani N, Haghani I, Badali H. First fatal cerebral phaeohyphomycosis due to Rhinocladiella mackenziei in Iran, based on ITS rDNA. J Mycol Med 2015; 25:81-6. [PMID: 25637429 DOI: 10.1016/j.mycmed.2014.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 11/05/2014] [Accepted: 11/19/2014] [Indexed: 11/30/2022]
Abstract
Black yeast-like fungi and relatives as agents of cerebral phaeohyphomycosis are often encountered in human fatal brain abscesses and lead to almost 100% mortality despite the application of antifungal and surgical therapy. We report to our knowledge the first case of brain infection due to Rhinocladiella mackenziei in a 54-year-old immunocompetent male in Iran where R. mackenziei has not been reported previously. The initial diagnosis was brain fungal infection because of pigmented, irregular, branched, septated hyphae based on histopathological staining. The patient was treated with intravenous amphotericin B deoxycholate (0.5mg/kg/day) combined with oral itraconazole (200mg twice daily), nevertheless, his neurological function deteriorated rapidly and ultimately the patient died due to respiratory failure later two weeks. R. mackenziei was identified based on the sequencing of internal transcribed spacer (ITS rDNA region) (KJ140287). Therefore, considerable attention for this life-threatening infection is highly recommended.
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Affiliation(s)
- M Didehdar
- Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran; Department of Medical Mycology and Parasitology, Arak University of Medical Sciences, Arak, Iran
| | - A Gokanian
- Department of Surgery and cerebral, Arak University of Medical Sciences, Arak, Iran
| | - M Sofian
- Tuberculosis and pediatric infectious Research Center, Arak University of Medical Sciences, Arak, Iran
| | - S Mohammadi
- Laboratory of Valiaasr Hospital, Arak University of Medical Sciences, Arak, Iran
| | - R Mohammadi
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - N Aslani
- Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran
| | - I Haghani
- Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran
| | - H Badali
- Department of Medical Mycology and Parasitology/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran.
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Chowdhary A, Meis J, Guarro J, de Hoog G, Kathuria S, Arendrup M, Arikan-Akdagli S, Akova M, Boekhout T, Caira M, Guinea J, Chakrabarti A, Dannaoui E, van Diepeningen A, Freiberger T, Groll A, Hope W, Johnson E, Lackner M, Lagrou K, Lanternier F, Lass-Flörl C, Lortholary O, Meletiadis J, Muñoz P, Pagano L, Petrikkos G, Richardson M, Roilides E, Skiada A, Tortorano A, Ullmann A, Verweij P, Cornely O, Cuenca-Estrella M. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of systemic phaeohyphomycosis: diseases caused by black fungi. Clin Microbiol Infect 2014; 20 Suppl 3:47-75. [DOI: 10.1111/1469-0691.12515] [Citation(s) in RCA: 216] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 12/13/2013] [Accepted: 12/16/2013] [Indexed: 11/28/2022]
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18
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Severe Disseminated Phaeohyphomycosis in an Immunocompetent Patient Caused by Veronaea botryosa. Mycopathologia 2013; 175:497-503. [DOI: 10.1007/s11046-013-9632-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 01/21/2013] [Indexed: 10/27/2022]
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