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Tang M, Li J, Xia F, Min C, Liu Z, Hu Y, Wang H, Xu H, Zou M. Acute Post-Cataract Endophthalmitis Due to Phialemoniopsis curvata: A Rare Case Report. Infect Drug Resist 2022; 15:1651-1657. [PMID: 35422644 PMCID: PMC9004724 DOI: 10.2147/idr.s359481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/26/2022] [Indexed: 11/23/2022] Open
Abstract
Phialemonium species are a class of opportunistic pathogenic fungi widely present in the environment that cause invasive diseases in hosts with normal or weak immune functions. Common infections include peritonitis, endocarditis, osteomyelitis, and skin infections of wounds after burns, whereas endophthalmitis is rarely reported. Here, we report acute post-cataract endophthalmitis caused by Phialemoniopsis curvata in China. The isolated pathogen was identified using microscopy, culture, and sequencing. After vitrectomy, intraocular lens removal surgery, voriconazole injection, and topical voriconazole treatment, the patient’s symptoms were alleviated.
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Affiliation(s)
- Mengli Tang
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Jun Li
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Fengjun Xia
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Changhang Min
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Zhaojun Liu
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Yongmei Hu
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Haichen Wang
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Heping Xu
- Department of Clinical Laboratory, the First Affiliated Hospital of Xiamen University, Xiamen, Fujian, People’s Republic of China
| | - Mingxiang Zou
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- Correspondence: Mingxiang Zou, Department of Clinical Laboratory, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha, 410008, Hunan, People’s Republic of China, Tel +86 13907496278, Email
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Miyazawa H, Matsuda Y, Sakai S, Kamei K, Wada T. Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous disease. IDCases 2022; 27:e01375. [PMID: 35028293 PMCID: PMC8739448 DOI: 10.1016/j.idcr.2022.e01375] [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: 10/05/2021] [Accepted: 01/02/2022] [Indexed: 11/23/2022] Open
Abstract
Opportunistic infections are life-threatening conditions in immunocompromised patients including those with primary immunodeficiency. We describe a case of X-linked chronic granulomatous disease presenting with mesenteric abscess caused by a coinfection with Bacillus Calmette-Guérin (BCG) and Phialemonium sp. The patient received BCG vaccination at 5 months old. He developed left axillary BCG lymphadenitis at 17 months of age, and 3 months later mesenteric abscess occurred. Concomitant use of rifampicin and itraconazole at 17 months of age might have reduced serum itraconazole concentrations and led to superinfection with Phialemonium sp. in our patient, which was susceptible to itraconazole and voriconazole in vitro. The patient was successfully treated with a combination of isoniazid, rifampicin, streptomycin, ciprofloxacin, prednisolone, interferon-γ, and an increased dose of itraconazole, followed by hematopoietic stem cell transplantation. Our results suggest that clinician need to be aware of rifampicin drug interactions, and that precise detection and identification of pathogens are essential to appropriate treatment.
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