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Ranjbar Golafshani FZ, Ghaffari Lashkenari E, Kermani F, Abbaszadeh Godarzi S, Mahdavi Omran S. A Unique Case of Fungal Endometritis Caused by Aspergillus quadrilineatus in an Immunocompetent Woman and Literature Review. Clin Case Rep 2025; 13:e70146. [PMID: 39949584 PMCID: PMC11821450 DOI: 10.1002/ccr3.70146] [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: 12/11/2024] [Revised: 01/10/2025] [Accepted: 01/13/2025] [Indexed: 02/16/2025] Open
Abstract
Abnormal uterine bleeding (AUB) is a common gynecological concern often attributed to hormonal disorders, malignancies, or infections. While bacterial and viral infections are frequently investigated, fungal infections, such as aspergillosis, are often overlooked. This case report highlights a rare instance of endometrial aspergillosis caused by Aspergillus quadrilineatus in an immunocompetent woman. A 64-year-old woman presented with persistent vaginal bleeding. Histopathological examination of endometrial tissue revealed septate hyphae consistent with fungal infection. Molecular analysis identified the causative agent as A. quadrilineatus. The A. quadrilineatus isolate demonstrated susceptibility to various antifungal agents, including azoles and amphotericin B. This report emphasizes the need for increased awareness of fungal infections, including aspergillosis, as a potential cause of AUB. Further research is needed to enhance understanding of the epidemiology, risk factors, and clinical manifestations of endometrial aspergillosis.
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Affiliation(s)
- Fatemeh Zahra Ranjbar Golafshani
- Parasitology and medical mycology Department, Faculty of MedicineBabol University of Medical SciencesBabolIran
- Infectious Diseases and Tropical Medicine Research CenterHealth Research Institute, Babol University of Medical SciencesBabolIran
- Student Research CommitteeBabol University of Medical SciencesBabolIran
| | | | - Firoozeh Kermani
- Parasitology and medical mycology Department, Faculty of MedicineBabol University of Medical SciencesBabolIran
- Infectious Diseases and Tropical Medicine Research CenterHealth Research Institute, Babol University of Medical SciencesBabolIran
| | - Soheila Abbaszadeh Godarzi
- Obstetrics and Gynecology Department, Faculty of MedicineBabol University of Medical SciencesBabolIran
- Infertility and Reproductive Health Research CenterHealth Research Institute, Rouhani Hospital, Babol University of Medical SciencesBabolIran
| | - Saeid Mahdavi Omran
- Parasitology and medical mycology Department, Faculty of MedicineBabol University of Medical SciencesBabolIran
- Infectious Diseases and Tropical Medicine Research CenterHealth Research Institute, Babol University of Medical SciencesBabolIran
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Lu Z, Zhang R, Wu P, Zhao D, Chen J, Pan X, Wang J, Zhang H, Qi X, Weng Q, Ye S, Zhou B. Occurrence and Exposure Assessment of Zearalenone in the Zhejiang Province, China. Toxins (Basel) 2024; 17:9. [PMID: 39852962 PMCID: PMC11769038 DOI: 10.3390/toxins17010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Revised: 12/20/2024] [Accepted: 12/26/2024] [Indexed: 01/26/2025] Open
Abstract
This study aims to examine the hazards of zearalenone (ZEN) to humans and assess the risk of dietary exposure to ZEN, particularly in relation to precocious puberty in children from the Zhejiang Province. The test results from five types of food from the Zhejiang Province show that corn oil has the highest detection rate of 87.82%. The levels of ZEN do not exceed the existing safety standards in any sample investigated in this study. According to the data from the Food Consumption Survey of Zhejiang Province residents, rice is the primary source of ZEN exposure, accounting for 55.85% of total exposure among all age groups. Based on the 50th exposure percentile, it would take 6.25 years of rice consumption to reach 1 year of safe ZEN exposure. Overall, the majority of the residents in the Zhejiang Province have a low risk of exposure to ZEN. In an extreme case (based on the 95th exposure percentile), the total ZEN exposure from the studied foods with respect to children aged ≤6 years and 7-12 years is 0.38 μg/kg b.w. and 0.26 μg/kg b.w., respectively-both exceeding the safety limit of 0.25 μg/kg b.w. set by the European Food Safety Authority, indicating a potential risk of exposure. Precocious puberty assessments show that ZEN exposure levels in children in the Zhejiang Province are significantly lower than those associated with precocious puberty; thus, precocious puberty is unlikely to occur in this area. Given ZEN's estrogenic effect, it is necessary to monitor the level of ZEN in different food items, revise the relevant standards as needed, and focus on exposure to ZEN in younger age groups.
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Affiliation(s)
- Zijie Lu
- School of Public Health, Hangzhou Medical College, Hangzhou 310013, China; (Z.L.); (Q.W.)
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Ronghua Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Pinggu Wu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Dong Zhao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Jiang Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Xiaodong Pan
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Jikai Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Hexiang Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Xiaojuan Qi
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Qin Weng
- School of Public Health, Hangzhou Medical College, Hangzhou 310013, China; (Z.L.); (Q.W.)
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
| | - Shufeng Ye
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
- School of Public Health, Ningbo University, Ningbo 315211, China
| | - Biao Zhou
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (R.Z.); (P.W.); (D.Z.); (J.C.); (X.P.); (J.W.); (H.Z.); (X.Q.); (S.Y.)
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Szentirmay A, Molnár Z, Plank P, Mézes M, Sajgó A, Martonos A, Buzder T, Sipos M, Hruby L, Szőke Z, Sára L. The Potential Influence of the Presence of Mycotoxins in Human Follicular Fluid on Reproductive Outcomes. Toxins (Basel) 2024; 16:509. [PMID: 39728767 PMCID: PMC11728479 DOI: 10.3390/toxins16120509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2024] [Revised: 11/20/2024] [Accepted: 11/22/2024] [Indexed: 12/28/2024] Open
Abstract
The effect of mycotoxin exposure on follicular fluid composition and reproductive outcomes in women undergoing in vitro fertilisation (IVF) was investigated in this study. Twenty-five patients were included, and follicular fluid and serum samples were analysed for various mycotoxins. Principal observations:1. Mycotoxin presence: All examined mycotoxins were detected in follicular fluid. Follicular fluid (ff) levels: Deoxynivalenol (DON), alfa-Zearalenol (α-ZOL), Zearalenone (ZEN), and total aflatoxin (AFs) were significantly higher in follicular fluid than in serum. 2. Follicular fluid and reproductive outcomes: A positive correlation was observed between the ratio of oocytes to total follicles and the follicular Fumonisin B1 (FB1) levels. Multiple linear regression analysis revealed a significant relationship between DON and T-2/HT-2 toxins (T2/HT2) levels in the follicular fluid. 3. Hormone levels: Follicular 17-beta estradiol (E2) and progesterone (P4) levels were higher than the serum levels. Follicular P4 correlated with serum P4 and Anti-Müllerian hormone (AMH) levels. In contrast, follicular E2 did not correlate with plasma E2 levels. 4. Mycotoxin-hormone interactions: A positive correlation was observed between follicular P4 and T2/HT2 toxin levels, whereas a negative correlation was found between ffE2 and ffT2/HT2, and a positive correlation was found between ZEN and E2. Conclusion: This study elucidated the presence of various mycotoxins in the follicular fluid and their potential influence on reproductive outcomes. Further research is warranted to clarify the specific mechanisms underlying these effects and develop strategies for detecting mycotoxin exposure in women undergoing IVF.
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Affiliation(s)
- Apolka Szentirmay
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary;
| | - Zsófia Molnár
- Department of Animal Biotechnology, Agribiotechnology and Precision Breeding for Food Security National Laboratory, Institute of Genetics and Biotechnology, Hungarian University of Agriculture and Life Sciences, 2100 Gödöllő, Hungary; (Z.M.); (P.P.)
| | - Patrik Plank
- Department of Animal Biotechnology, Agribiotechnology and Precision Breeding for Food Security National Laboratory, Institute of Genetics and Biotechnology, Hungarian University of Agriculture and Life Sciences, 2100 Gödöllő, Hungary; (Z.M.); (P.P.)
| | - Miklós Mézes
- Department of Feed Safety, Institute of Physiology and Nutrition, Hungarian University of Agriculture and Life Sciences, 2100 Gödöllő, Hungary;
| | - Attila Sajgó
- Central of Assisted Reproduction, Semmelweis University, 1097 Budapest, Hungary; (A.S.); (T.B.); (M.S.)
| | - Attila Martonos
- Central of Assisted Reproduction, Semmelweis University, 1097 Budapest, Hungary; (A.S.); (T.B.); (M.S.)
| | - Tímea Buzder
- Central of Assisted Reproduction, Semmelweis University, 1097 Budapest, Hungary; (A.S.); (T.B.); (M.S.)
| | - Miklós Sipos
- Central of Assisted Reproduction, Semmelweis University, 1097 Budapest, Hungary; (A.S.); (T.B.); (M.S.)
| | - Lili Hruby
- Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany;
| | - Zsuzsanna Szőke
- Department of Animal Biotechnology, Agribiotechnology and Precision Breeding for Food Security National Laboratory, Institute of Genetics and Biotechnology, Hungarian University of Agriculture and Life Sciences, 2100 Gödöllő, Hungary; (Z.M.); (P.P.)
| | - Levente Sára
- Department of Obstetrics and Gynecology, Semmelweis University, 1088 Budapest, Hungary;
- Department of Animal Biotechnology, Agribiotechnology and Precision Breeding for Food Security National Laboratory, Institute of Genetics and Biotechnology, Hungarian University of Agriculture and Life Sciences, 2100 Gödöllő, Hungary; (Z.M.); (P.P.)
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