1
|
Zhu X, Ma J, Zheng B, Cai W, Li J, Lin L, Xi L, Li X, Lu S. Combination therapy with itraconazole and terbinafine for phaeohyphomycosis caused by Exophiala spinifera: A case report and literature review. Mycoses 2023; 66:1012-1017. [PMID: 37553547 DOI: 10.1111/myc.13642] [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: 05/15/2023] [Revised: 07/21/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023]
Abstract
Exophiala spinifera is a rare dematiaceous fungus causing cutaneous, subcutaneous and disseminated phaeohyphomycosis (PHM). Standard antifungal therapy for PHM is still uncertain. Here, we report a case of a Chinese male with PHM caused by E. spinifera, who received significant clinical improvement after the treatment with oral itraconazole and terbinafine. With the aim of evaluating the antifungal therapy for PHM caused by E. spinifera, a detailed review was performed.
Collapse
Affiliation(s)
- Xianzhong Zhu
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Dermatology and Venereology, The Second Affiliated Hospital of Guangzhou Medical University
| | - Jianchi Ma
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bowen Zheng
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wenying Cai
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiahao Li
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Li Lin
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liyan Xi
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Xiqing Li
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sha Lu
- Department of Dermatology and Venereology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
2
|
Heidrich D, Koehler A, Ramírez-Castrillón M, Pagani DM, Ferrão MF, Scroferneker ML, Corbellini VA. Rapid classification of chromoblastomycosis agents genera by infrared spectroscopy and chemometrics supervised by sequencing of rDNA regions. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2021; 254:119647. [PMID: 33744705 DOI: 10.1016/j.saa.2021.119647] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 06/12/2023]
Abstract
Chromoblastomycosis (CBM) is a skin and subcutaneous infection caused by species of seven fungal genera. Identification of CBM species is performed by DNA sequencing of one or more genes, which becomes a time-consuming work. Fourier Transform Infrared Spectroscopy (FTIR) has been used for the identification of other microorganisms, however, only one CBM genus was evaluated by FTIR analysis to date. Therefore, the study is aimed to differentiate the CBM agents for identification at genera level using FTIR supervised by Internal Transcribed Spacer (ITS) rDNA region. Seventy-seven isolates of the main five CBM genera were prepared for Attenuated Total Reflection FTIR (ATR-FTIR) with a new methodology using slices of dry fungus in glass fixing-modeling proposed in this study. The algorithm Hierarchical Cluster Analysis (HCA) was used to analyze the differences and similarities between species through the spectra. Orthogonal Partial Least Square Discriminant Analysis (OPLS-DA) allowed to correctly classify all samples of five CBM genera. The ATR-FTIR/OPLS-DA models highlighted important contributions of regions attributed to NH and OH stretching, amide I of proteins, polysaccharides bands and fingerprint region for the complete differentiation of the genera investigated. Thus, FTIR can be a fast and inexpensive alternative for identification of CBM agents.
Collapse
Affiliation(s)
- Daiane Heidrich
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, CEP: 90035-003 Porto Alegre, RS, Brazil
| | - Alessandra Koehler
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, CEP: 90035-003 Porto Alegre, RS, Brazil
| | - Mauricio Ramírez-Castrillón
- Postgraduate Program in Molecular and Cellular Biology, Biotechnology Center, Universidade Federal do Rio Grande do Sul, Avenida Bento Gonçalves, 9500, CEP: 91501-970 Porto Alegre, RS, Brazil.
| | - Danielle Machado Pagani
- Postgraduate Program in Agricultural and Environmental Microbiology, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, CEP: 90050-170 Porto Alegre, RS, Brazil
| | - Marco Flores Ferrão
- Department of Inorganic Chemistry, Chemistry Institute, Universidade Federal do Rio Grande do Sul, Avenida Bento Gonçalves 9500, CEP: 91501-970 Porto Alegre, RS, Brazil.
| | - Maria Lúcia Scroferneker
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, CEP: 90035-003 Porto Alegre, RS, Brazil; Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, CEP: 90050-170 Porto Alegre, RS, Brazil.
| | - Valeriano Antonio Corbellini
- Department of Sciences, Humanities and Education, Postgraduate Program in Health Promotion, Postgraduate Program in Environmental Technology, Universidade de Santa Cruz do Sul, Avenida Independência, 2293, CEP: 96815-900 Santa Cruz do Sul, RS, Brazil.
| |
Collapse
|
3
|
Espanhol CM, Recuero JK, Pagani DM, Ribeiro AC, Vettorato G, Duquia RP, Luzzatto L, Scroferneker ML. Cutaneous phaeohyphomycosis caused by Exophiala xenobiotica: A case report. Med Mycol Case Rep 2020; 27:39-41. [PMID: 31908912 PMCID: PMC6940718 DOI: 10.1016/j.mmcr.2019.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/04/2019] [Accepted: 12/02/2019] [Indexed: 11/15/2022] Open
Abstract
We report a case of phaeohyphomycosis that affected the leg of a 45-year-old Brazilian man, car mechanic and renal transplanted. The direct mycological examination evidenced dematiaceous septated hyphae. The pathogenic fungal species was identified as Exophiala xenobiotica. Antifungal activity in vitro revealed terbinafine as the best antifungal. For treatment, it was chosen surgical excision of the entire lesion and used systemic itraconazole. Phaeohyphomycosis caused by Exophiala xenobiotica is extremely rare and is closely related to transplant patients.
Collapse
Affiliation(s)
- Clarissa Mitri Espanhol
- Department of Dermatology of the Hospital Santa Casa de Misericórdia de Porto Alegre, Rua Prof. Annes Dias, 285, Porto Alegre, CEP:90020-090, Brazil
| | - Júlia Kanaan Recuero
- Department of Dermatology of the Hospital Santa Casa de Misericórdia de Porto Alegre, Rua Prof. Annes Dias, 285, Porto Alegre, CEP:90020-090, Brazil
| | - Danielle Machado Pagani
- Postgraduate Program in Agricultural and Environmental Microbiology, Federal University of Rio Grande do Sul.Rua Sarmento Leite, 500, Sala 325, Porto Alegre, Rio Grande do Sul, CEP: 90050-170, Brazil
| | - Amanda Carvalho Ribeiro
- Faculty of Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Avenida Ipiranga, 2752, CEP: 90610-000, Brazil
| | - Gerson Vettorato
- Department of Dermatology of the Hospital Santa Casa de Misericórdia de Porto Alegre, Rua Prof. Annes Dias, 285, Porto Alegre, CEP:90020-090, Brazil
| | - Rodrigo Pereira Duquia
- Department of Dermatology of the Hospital Santa Casa de Misericórdia de Porto Alegre, Rua Prof. Annes Dias, 285, Porto Alegre, CEP:90020-090, Brazil
| | - Laura Luzzatto
- Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Sala 325, Porto Alegre, Rio Grande do Sul, CEP: 90050-170, Brazil
| | - Maria Lúcia Scroferneker
- Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Sala 325, Porto Alegre, Rio Grande do Sul, CEP: 90050-170, Brazil
- Corresponding author. Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Room, 325, Porto Alegre, CEP: 90050-170, Brazil.
| |
Collapse
|
4
|
Zhang J, Wu X, Li M, Huang J, Yin S, Huang H, Lu C, Xi L. Synergistic effect of terbinafine and amphotericin B in killing Fonsecaea nubica in vitro and in vivo. Rev Inst Med Trop Sao Paulo 2019; 61:e31. [PMID: 31241660 PMCID: PMC6592013 DOI: 10.1590/s1678-9946201961031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/02/2019] [Indexed: 12/26/2022] Open
Abstract
Chromoblastomycosis is a chronic fungal infection. Itraconazole and terbinafine are the most recommended antifungal drugs for chromoblastomycosis, while amphotericin B is not usually recommended. A patient with chromoblastomycosis in our hospital showed poor clinical responses to itraconazole and terbinafine. The fungus isolated from the lesions of this patient was identified as Fonsecaea nubica and numbered zssy0803. In vitro antifungal susceptibilities of F. nubica zssy0803 to terbinafine, amphotericin B, itraconazole, voriconazole and caspofungin were evaluated, as well as the combinations of terbinafine with the other four antifungals. The combined effect of terbinafine and amphotericin B on other 20 clinical F. nubica strains was also evaluated. The minimal inhibitory concentrations of terbinafine, amphotericin B, itraconazole, voriconazole and caspofungin on F. nubica zssy0803 were 0.25 μg/mL, 2 μg/mL, 1 μg/mL, 4 μg/mL and 8 μg/mL, respectively. The combination of terbinafine and amphotericin B showed the lowest fractional inhibitory concentration index of 0.28 to F. nubica zssy0803 in comparison with combinations of terbinafine and the other four antifungal drugs. The combination of terbinafine and amphotericin B was also synergistic for all the other 20 F. nubica strains. Then, the combination of oral terbinafine (500 mg/day) and intralesional injections of amphotericin B (1 mg/mL) was used to treat this patient. After this combined therapy for 25 weeks and terbinafine monotherapy for additional 12 weeks, the patient was cured. These findings indicate for the first time that terbinafine and amphotericin B are synergistic in killing F. nubica both in vitro and in vivo.
Collapse
Affiliation(s)
- Jing Zhang
- Yat-sen University, Third Affiliated Hospital of Sun, Department of Dermatology and Venereology, Guangzhou, China.,Yat-sen University, Sun Yat-sen Memorial Hospital, Department of Dermatology and Venereology, Guangzhou, China.,Sun Yat-sen University, Sun Yat-sen Memorial Hospital, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangzhou, China
| | - Xiaoyan Wu
- Yat-sen University, Third Affiliated Hospital of Sun, Department of Dermatology and Venereology, Guangzhou, China
| | - Meirong Li
- Yat-sen University, Third Affiliated Hospital of Sun, Department of Dermatology and Venereology, Guangzhou, China
| | - Jiamin Huang
- Yat-sen University, Third Affiliated Hospital of Sun, Department of Dermatology and Venereology, Guangzhou, China
| | - Songchao Yin
- Yat-sen University, Third Affiliated Hospital of Sun, Department of Dermatology and Venereology, Guangzhou, China
| | - Huaiqiu Huang
- Yat-sen University, Third Affiliated Hospital of Sun, Department of Dermatology and Venereology, Guangzhou, China
| | - Chun Lu
- Yat-sen University, Third Affiliated Hospital of Sun, Department of Dermatology and Venereology, Guangzhou, China
| | - Liyan Xi
- Yat-sen University, Sun Yat-sen Memorial Hospital, Department of Dermatology and Venereology, Guangzhou, China
| |
Collapse
|
5
|
Combination of Amphotericin B and Terbinafine against Melanized Fungi Associated with Chromoblastomycosis. Antimicrob Agents Chemother 2018; 62:AAC.00270-18. [PMID: 29581111 DOI: 10.1128/aac.00270-18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/15/2018] [Indexed: 11/20/2022] Open
Abstract
Our in vitro studies showed that a combination of amphotericin B and terbinafine had synergistic effects against the majority of melanized fungi associated with chromoblastomycosis (CBM) and similar infections, including those with Cladophialophora carrionii, Cladophialophora arxii, Exophialadermatitidis, Exophialaspinifera, Fonsecaea monophora, Fonsecaea nubica, Fonsecaea pedrosoi, and Phialophora verrucosa. This drug combination could provide an option for the treatment of severe or unresponsive cases of CBM, particularly in cases due to species of Fonsecaea and Cladophialophora.
Collapse
|
6
|
Heidrich D, Corbellini VA, Mendes SDC, Fernandes EK, Lazzarotto L, Ribeiro AC, Zanette RA, Scroferneker ML. Melanin: Quantification and protection against oxidative stress in chromoblastomycosis agents. Med Mycol 2018; 57:260-263. [DOI: 10.1093/mmy/myy013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Daiane Heidrich
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Sandra Denise Camargo Mendes
- Santa Catarina State Agricultural Research and Rural Extension Agency (Epagri), Laboratory of Analysis of Wines and Derivatives, Experimental Station of Videira, Videira, SC, Brazil
| | - Elissa Kerli Fernandes
- Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Letícia Lazzarotto
- Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Amanda Carvalho Ribeiro
- Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Régis Adriel Zanette
- Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Maria Lúcia Scroferneker
- Postgraduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Department of Microbiology, Immunology and Parasitology, ICBS, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| |
Collapse
|
7
|
Song Y, Laureijssen-van de Sande WWJ, Moreno LF, Gerrits van den Ende B, Li R, de Hoog S. Comparative Ecology of Capsular Exophiala Species Causing Disseminated Infection in Humans. Front Microbiol 2017; 8:2514. [PMID: 29312215 PMCID: PMC5742258 DOI: 10.3389/fmicb.2017.02514] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/04/2017] [Indexed: 12/15/2022] Open
Abstract
Exophiala spinifera and Exophiala dermatitidis (Fungi: Chaetothyriales) are black yeast agents potentially causing disseminated infection in apparently healthy humans. They are the only Exophiala species producing extracellular polysaccharides around yeast cells. In order to gain understanding of eventual differences in intrinsic virulence of the species, their clinical profiles were compared and found to be different, suggesting pathogenic strategies rather than coincidental opportunism. Ecologically relevant factors were compared in a model set of strains of both species, and significant differences were found in clinical and environmental preferences, but virulence, tested in Galleria mellonella larvae, yielded nearly identical results. Virulence factors, i.e., melanin, capsule and muriform cells responded in opposite direction under hydrogen peroxide and temperature stress and thus were inconsistent with their hypothesized role in survival of phagocytosis. On the basis of physiological profiles, possible natural habitats of both species were extrapolated, which proved to be environmental rather than animal-associated. Using comparative genomic analyses we found differences in gene content related to lipid metabolism, cell wall modification and polysaccharide capsule production. Despite the fact that both species cause disseminated infections in apparently healthy humans, it is concluded that they are opportunists rather than pathogens.
Collapse
Affiliation(s)
- Yinggai Song
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing, China.,Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
| | | | | | | | - Ruoyu Li
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Research Center for Medical Mycology, Peking University, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Peking University First Hospital, Beijing, China
| | - Sybren de Hoog
- Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands.,Center of Expertise in Mycology Radboudumc/CWZ, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
| |
Collapse
|
8
|
Heidrich D, González GM, Pagani DM, Ramírez-Castrillón M, Scroferneker ML. Chromoblastomycosis caused by Rhinocladiella similis: Case report. Med Mycol Case Rep 2017; 16:25-27. [PMID: 28458993 PMCID: PMC5397130 DOI: 10.1016/j.mmcr.2017.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 03/31/2017] [Accepted: 04/05/2017] [Indexed: 02/07/2023] Open
Abstract
We report a case of chromoblastomycosis in lesions on the chest and foot. Itraconazole was chosen as the initial treatment for this patient, who was followed up for 8 months before becoming noncompliant. The pathogenic fungal species was identified as Rhinocladiella similis by ITS region sequencing. In vitro analyses indicate that the fungus was sensitive to posaconazole and itraconazole. This report presents R. similis as a new agent of chromoblastomycosis and raises the hypothesis that this species could be more resistant to some antifungals than R. aquaspersa.
Collapse
Affiliation(s)
- Daiane Heidrich
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 − 2nd floor, Porto Alegre CEP: 90035-003, Brazil
| | - Gloria M. González
- Department of Microbiology, Facultad de Medicina, Universidad Autónoma de Nuevo León, Madero y Aguirre Pequeño, Col. Mitras Centro, Monterrey, N.L. C.P. 64460, Mexico
| | - Danielle M. Pagani
- Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500, Sala 210, Porto Alegre CEP: 90050-170, Brazil
| | - Mauricio Ramírez-Castrillón
- Department of Microbiology, ICBS, Universidade Federal do Rio Grande do Sul. Rua Sarmento Leite, 500, Sala 210, Porto Alegre CEP: 90050-170, Brazil
| | - Maria Lucia Scroferneker
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2400 − 2nd floor, Porto Alegre CEP: 90035-003, Brazil
- Department of Microbiology, Facultad de Medicina, Universidad Autónoma de Nuevo León, Madero y Aguirre Pequeño, Col. Mitras Centro, Monterrey, N.L. C.P. 64460, Mexico
| |
Collapse
|
9
|
Diversity of opportunistic black fungi on babassu coconut shells, a rich source of esters and hydrocarbons. Fungal Biol 2017; 121:488-500. [DOI: 10.1016/j.funbio.2017.01.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 01/31/2017] [Accepted: 01/31/2017] [Indexed: 11/18/2022]
|
10
|
Bohelay G, Robert S, Bouges-Michel C, Gerin M, Levy A, Fain O, Caux F. Subcutaneous phaeohyphomycosis caused byExophiala spiniferain a European patient with lymphoma: a rare occurrence case report and literature review. Mycoses 2016; 59:691-696. [DOI: 10.1111/myc.12515] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 03/27/2016] [Accepted: 04/19/2016] [Indexed: 11/28/2022]
Affiliation(s)
- G. Bohelay
- Department of Dermatology; Avicenne Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bobigny France
| | - S. Robert
- Department of General Practice; University Paris Diderot; Sorbonne Paris Cité; Paris France
| | - C. Bouges-Michel
- Laboratory of Mycology; Avicenne Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bobigny France
| | - M. Gerin
- Department of Internal Medicine; Jean Verdier Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bondy France
| | - A. Levy
- Department of Pathology; Avicenne Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bobigny France
| | - O. Fain
- Department of Internal Medicine; Saint-Antoine Hospital; AP-HP; DHU i2B; University Paris 6; Paris France
| | - F. Caux
- Department of Dermatology; Avicenne Hospital; Assistance Publique des Hôpitaux de Paris (AP-HP); Bobigny France
| |
Collapse
|
11
|
Ch K, Thejaswids P, Kini H, Shenoy S, Prabhu S. Phaeohyphomycotic cyst in the Foot by Exophiala. J Clin Diagn Res 2015; 8:ND10-1. [PMID: 25584264 DOI: 10.7860/jcdr/2014/9495.5184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 09/10/2014] [Indexed: 11/24/2022]
Abstract
A 52-year-old male, presented to us with a swelling over plantar aspect of right foot following trauma. Clinically it was a cystic swelling diagnosed as an abscess; ultrasound showed thick walled multilocular collection with thick echogenic debris, following which complete excision of the swelling was done. A part of the swelling was sent for histopathological examination and cut section showed thick purulent material. Other part sent for culture sensitivity grew, Exophiala, which belongs to Dematiaceous group of fungi. Surgical excision with antifungal treatment is the management in general for fungal cyst, whereas in our case complete excision was done without antifungal treatment.
Collapse
Affiliation(s)
- Karunakarreddy Ch
- Post Graduate, Department of General surgery, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
| | - Poornachandra Thejaswids
- Post Graduate, Department of General surgery, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
| | - Hema Kini
- Post Graduate, Department of General surgery, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
| | - Suchitra Shenoy
- Post Graduate, Department of General surgery, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
| | - Shivananda Prabhu
- Post Graduate, Department of General surgery, Kasturba Medical College, Manipal University , Mangalore, Karnataka, India
| |
Collapse
|
12
|
Lanternier F, Barbati E, Meinzer U, Liu L, Pedergnana V, Migaud M, Héritier S, Chomton M, Frémond ML, Gonzales E, Galeotti C, Romana S, Jacquemin E, Angoulvant A, Bidault V, Canioni D, Lachenaud J, Mansouri D, Mahdaviani SA, Adimi P, Mansouri N, Jamshidi M, Bougnoux ME, Abel L, Lortholary O, Blanche S, Casanova JL, Picard C, Puel A. Inherited CARD9 deficiency in 2 unrelated patients with invasive Exophiala infection. J Infect Dis 2014; 211:1241-50. [PMID: 25057046 DOI: 10.1093/infdis/jiu412] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Exophiala species are mostly responsible for skin infections. Invasive Exophiala dermatitidis disease is a rare and frequently fatal infection, with 42 cases reported. About half of these cases had no known risk factors. Similarly, invasive Exophiala spinifera disease is extremely rare, with only 3 cases reported, all in patients with no known immunodeficiency. Autosomal recessive CARD9 deficiency has recently been reported in otherwise healthy patients with severe fungal diseases caused by Candida species, dermatophytes, or Phialophora verrucosa. METHODS We investigated an 8-year-old girl from a nonconsanguineous Angolan kindred, who was born in France and developed disseminated E. dermatitidis disease and a 26 year-old woman from an Iranian consaguineous kindred, who was living in Iran and developed disseminated E. spinifera disease. Both patients were otherwise healthy. RESULTS We sequenced CARD9 and found both patients to be homozygous for loss-of-function mutations (R18W and E323del). The first patient had segmental uniparental disomy of chromosome 9, carrying 2 copies of the maternal CARD9 mutated allele. CONCLUSIONS These are the first 2 patients with inherited CARD9 deficiency and invasive Exophiala disease to be described. CARD9 deficiency should thus be considered in patients with unexplained invasive Exophiala species disease, even in the absence of other infections.
Collapse
Affiliation(s)
- Fanny Lanternier
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163 Paris Descartes University-Sorbonne Paris Cité, Imagine Institute Department of Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre d'Infectiologie Necker Pasteur
| | - Elisa Barbati
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163 Paris Descartes University-Sorbonne Paris Cité, Imagine Institute
| | - Ulrich Meinzer
- Department of General Pediatrics and Internal Medicine, Robert Debré Hospital, AP-HP University Paris 7 Denis Diderot, Paris Sorbonne Cité
| | - Luyan Liu
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163 Paris Descartes University-Sorbonne Paris Cité, Imagine Institute
| | - Vincent Pedergnana
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163 Paris Descartes University-Sorbonne Paris Cité, Imagine Institute
| | - Mélanie Migaud
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163 Paris Descartes University-Sorbonne Paris Cité, Imagine Institute
| | - Sébastien Héritier
- Paris Descartes University-Sorbonne Paris Cité, Imagine Institute Pediatric Hematology-Immunology Unit
| | - Maryline Chomton
- Paris Descartes University-Sorbonne Paris Cité, Imagine Institute Pediatric Hematology-Immunology Unit
| | - Marie-Louise Frémond
- Paris Descartes University-Sorbonne Paris Cité, Imagine Institute Pediatric Hematology-Immunology Unit
| | - Emmanuel Gonzales
- Pediatric Hepatology Unit, DHU Hépatinov, INSERM U757, Paris-Sud 11 University, Bicêtre Hospital, AP-HP
| | - Caroline Galeotti
- Pediatric Rheumatology Unit, Bicêtre Hospital, AP-HP, Paris Sud University, CeReMAI
| | | | - Emmanuel Jacquemin
- Pediatric Hepatology Unit, DHU Hépatinov, INSERM U757, Paris-Sud 11 University, Bicêtre Hospital, AP-HP
| | | | - Valeska Bidault
- Pediatric Surgery Unit, Bicêtre Hospital, AP-HP, Kremlin Bicêtre
| | | | - Julie Lachenaud
- Department of Pediatrics, Pontoise Hospital, Cergy Pontoise, France, EU
| | - Davood Mansouri
- Department of Clinical Immunology and Allergy, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital
| | - Seyed Alireza Mahdaviani
- Pediatric Respiratory Disease Research Centre, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences
| | - Parvaneh Adimi
- Department of Medical Mycology and Parasitology, Islamic Azad University Tehran Medical Branch
| | - Nahal Mansouri
- Department of Clinical Immunology and Allergy, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital
| | - Mahin Jamshidi
- Department of Infectious Disease, Iran University of Medical Sciences, Tehran, Iran
| | - Marie-Elisabeth Bougnoux
- Paris Descartes University-Sorbonne Paris Cité, Imagine Institute Microbiology Laboratory Fungal Biology and Pathogenicity, INRA USC 2019, Institut Pasteur
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163 Paris Descartes University-Sorbonne Paris Cité, Imagine Institute St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York
| | - Olivier Lortholary
- Paris Descartes University-Sorbonne Paris Cité, Imagine Institute Department of Infectious Diseases, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre d'Infectiologie Necker Pasteur Molecular Mycology Unit, National Reference Center for Invasive Mycoses and Antifungals, Institut Pasteur, Paris
| | - Stéphane Blanche
- Paris Descartes University-Sorbonne Paris Cité, Imagine Institute Pediatric Hematology-Immunology Unit
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163 Paris Descartes University-Sorbonne Paris Cité, Imagine Institute Pediatric Hematology-Immunology Unit St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York
| | - Capucine Picard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163 Paris Descartes University-Sorbonne Paris Cité, Imagine Institute Pediatric Hematology-Immunology Unit Study Center for Primary Immunodeficiencies, Necker-Enfants malades Hospital, AP-HP
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM UMR1163 Paris Descartes University-Sorbonne Paris Cité, Imagine Institute
| |
Collapse
|
13
|
Daboit TC, Massotti Magagnin C, Heidrich D, Czekster Antochevis L, Vigolo S, Collares Meirelles L, Alves K, Scroferneker ML. In vitrosusceptibility of chromoblastomycosis agents to five antifungal drugs and to the combination of terbinafine and amphotericin B. Mycoses 2013; 57:116-20. [DOI: 10.1111/myc.12111] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 06/24/2013] [Accepted: 06/26/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Tatiane C. Daboit
- Postgraduate Program in Medicine: Medical Sciences; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
- Department of Microbiology, Immunology and Parasitology; ICBS; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
| | - Cibele Massotti Magagnin
- Postgraduate Program in Medicine: Medical Sciences; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
- Department of Microbiology, Immunology and Parasitology; ICBS; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
| | - Daiane Heidrich
- Postgraduate Program in Medicine: Medical Sciences; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
- Department of Microbiology, Immunology and Parasitology; ICBS; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
| | - Laura Czekster Antochevis
- Department of Microbiology, Immunology and Parasitology; ICBS; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
| | - Suelen Vigolo
- Department of Microbiology, Immunology and Parasitology; ICBS; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
| | - Lúcia Collares Meirelles
- Department of Microbiology, Immunology and Parasitology; ICBS; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
| | - Karine Alves
- Department of Microbiology, Immunology and Parasitology; ICBS; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
| | - Maria L. Scroferneker
- Postgraduate Program in Medicine: Medical Sciences; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
- Department of Microbiology, Immunology and Parasitology; ICBS; Universidade Federal do Rio Grande do Sul; Porto Alegre Brazil
| |
Collapse
|
14
|
Daboit TC, Magagnin CM, Heidrich D, Castrillón MR, Mendes SDC, Vettorato G, Valente P, Scroferneker ML. A case of relapsed chromoblastomycosis due to Fonsecaea monophora: antifungal susceptibility and phylogenetic analysis. Mycopathologia 2013; 176:139-44. [PMID: 23645135 DOI: 10.1007/s11046-013-9660-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 04/19/2013] [Indexed: 11/25/2022]
Abstract
Chromoblastomycosis is a chronic cutaneous and subcutaneous mycosis. The management of this infection continues to be challenging because there is no consensus on the therapeutic regimen. We report here a case of a 69-year-old male patient with cauliflower-like lesions on his left leg and foot. He had already been treated with itraconazole at a dose of 200 mg/day for 5 months, with mycological cure for all the affected areas. However, the lesions relapsed at both sites, and treatment with itraconazole was resumed at the dose previously used. Initially, direct mycological examination, cultural, and microculture slide observation were performed. Afterward, sequencing of the ITS1-5.8S rDNA-ITS2 region of the fungal DNA and evaluation of its susceptibility to antifungal agents alone and in combination were performed. In direct mycological examination, the presence of sclerotic cells was verified, and the fungus was identified as Fonsecaea based on cultural and microscopic examinations. Identification as Fonsecaea monophora was confirmed after sequencing of the ITS region and phylogenetic analysis. The isolate was susceptible to itraconazole and terbinafine. The combinations of amphotericin B and terbinafine and terbinafine and voriconazole were synergistic. The use of drugs for which the causative agent is susceptible to singly or in combination may be an alternative for the treatment of mycosis. Furthermore, the identification of the agent by molecular techniques is important for epidemiological purposes. To the best of our knowledge, this is the first case of relapsed chromoblastomycosis caused by F. monophora in Brazil.
Collapse
Affiliation(s)
- Tatiane Caroline Daboit
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400-2º andar, Porto Alegre, Rio Grande do Sul, CEP 90035-003, Brazil,
| | | | | | | | | | | | | | | |
Collapse
|