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Loubet D, Sarton B, Lelièvre L, Grouteau G, Iriart X, Chauvin P, Fillaux J, Valentin A, Berry A, Silva S, Bonneville F, Cassaing S, Guemas E. Fatal mucormycosis and aspergillosis coinfection associated with haemophagocytic lymphohistiocytosis: A case report and literature review. J Mycol Med 2023; 33:101325. [PMID: 36270214 DOI: 10.1016/j.mycmed.2022.101325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/08/2022] [Accepted: 08/05/2022] [Indexed: 11/15/2022]
Abstract
Invasive mould infections are life-threatening and mainly occur in immunocompromised patients. Whereas aspergillosis is described during haemophagocytic lymphohistiocytosis (HLH), only a few cases of concomitant mucormycosis with HLH have been reported. Here, we present an uncommon coinfection of mucormycosis and aspergillosis associated with HLH probably due to a varicella zoster virus (VZV) viraemia which was unresponsive to triple antifungal therapy (liposomal amphotericin B combined with isavuconazole and caspofungin). A review of the cases of mucormycosis with HLH showed that this uncommon association was always lethal and underscored the relevance of screening for mould infections in patients with HLH.
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Affiliation(s)
- Dorian Loubet
- Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France
| | - Benjamine Sarton
- Critical Care Unit, University Hospital of Purpan, Toulouse, France; Toulouse NeuroImaging Center, Unité Mixte de Recherche 1214, Institut National de la Santé et de la Recherche Médicale, Université Paul Sabatier, Toulouse, France
| | - Lucie Lelièvre
- Department of Infectious and Tropical Diseases, CHU Toulouse, Toulouse, France
| | - Gaspard Grouteau
- Department of Infectious and Tropical Diseases, CHU Toulouse, Toulouse, France
| | - Xavier Iriart
- Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse, CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
| | - Pamela Chauvin
- Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France
| | - Judith Fillaux
- Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France
| | - Alexis Valentin
- Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France; PHARMA-Dev, UMR 152 IRD-UPS, Université Toulouse, France
| | - Antoine Berry
- Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse, CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France
| | - Stein Silva
- Critical Care Unit, University Hospital of Purpan, Toulouse, France; Toulouse NeuroImaging Center, Unité Mixte de Recherche 1214, Institut National de la Santé et de la Recherche Médicale, Université Paul Sabatier, Toulouse, France
| | - Fabrice Bonneville
- Neuroradiology Department, Pierre-Paul-Riquet/Purpan University Hospital, Toulouse, France
| | - Sophie Cassaing
- Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France; RESTORE Institute, UMR 1301-Inserm 5070-CNRS EFS Univ. P. Sabatier, Toulouse, France
| | - Emilie Guemas
- Department of Parasitology and Mycology, CHU Toulouse, Toulouse, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse, CNRS UMR5051, INSERM UMR1291, UPS, Toulouse, France.
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Bossuet N, Guyonnet C, Chagneau CV, Tang-Fichaux M, Penary M, Loubet D, Branchu P, Oswald E, Nougayrede JP. Oxygen concentration modulates colibactin production. Gut Microbes 2023; 15:2222437. [PMID: 37312436 DOI: 10.1080/19490976.2023.2222437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Up to 25% of the E. coli strains isolated from the feces of healthy humans harbor the pks genomic island encoding the synthesis of colibactin, a genotoxic metabolite. Evidence is accumulating for an etiologic role of colibactin in colorectal cancer. Little is known about the conditions of expression of colibactin in the gut. The intestine is characterized by a unique oxygenation profile, with a steep gradient between the physiological hypoxic epithelial surface and the anaerobic lumen, which favors the dominance of obligate anaerobes. Here, we report that colibactin production is maximal under anoxic conditions and decreases with increased oxygen concentration. We show that the aerobic respiration control (ArcA) positively regulates colibactin production and genotoxicity of pks+ E. coli in response to oxygen availability. Thus, colibactin synthesis is inhibited by oxygen, indicating that the pks biosynthetic pathway is adapted to the anoxic intestinal lumen and to the hypoxic infected or tumor tissue.
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Affiliation(s)
- Nadège Bossuet
- IRSD, Université de Toulouse, INSERM, INRAE, ENVT, Univ Toulouse III Paul Sabatier (UPS), Toulouse, France
| | - Cécile Guyonnet
- IRSD, Université de Toulouse, INSERM, INRAE, ENVT, Univ Toulouse III Paul Sabatier (UPS), Toulouse, France
| | - Camille V Chagneau
- IRSD, Université de Toulouse, INSERM, INRAE, ENVT, Univ Toulouse III Paul Sabatier (UPS), Toulouse, France
- CHU Toulouse, Hôpital Purpan, Service de Bactériologie-Hygiène, Toulouse, France
| | - Min Tang-Fichaux
- IRSD, Université de Toulouse, INSERM, INRAE, ENVT, Univ Toulouse III Paul Sabatier (UPS), Toulouse, France
| | - Marie Penary
- IRSD, Université de Toulouse, INSERM, INRAE, ENVT, Univ Toulouse III Paul Sabatier (UPS), Toulouse, France
| | - Dorian Loubet
- IRSD, Université de Toulouse, INSERM, INRAE, ENVT, Univ Toulouse III Paul Sabatier (UPS), Toulouse, France
| | - Priscilla Branchu
- IRSD, Université de Toulouse, INSERM, INRAE, ENVT, Univ Toulouse III Paul Sabatier (UPS), Toulouse, France
| | - Eric Oswald
- IRSD, Université de Toulouse, INSERM, INRAE, ENVT, Univ Toulouse III Paul Sabatier (UPS), Toulouse, France
- CHU Toulouse, Hôpital Purpan, Service de Bactériologie-Hygiène, Toulouse, France
| | - Jean-Philippe Nougayrede
- IRSD, Université de Toulouse, INSERM, INRAE, ENVT, Univ Toulouse III Paul Sabatier (UPS), Toulouse, France
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