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Yang J, Ouyang L, Chen S, Zhang C, Zheng J, He S. Amendments affect the community assembly and co-occurrence network of microorganisms in Cd and Pb tailings of the Eucalyptus camaldulensis rhizosphere. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 930:172365. [PMID: 38641118 DOI: 10.1016/j.scitotenv.2024.172365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 04/21/2024]
Abstract
Mining tailings containing large amounts of Pb and Cd cause severe regional ecosystem pollution. Soil microorganisms play a regulatory role in the restoration of degraded ecosystems. The remediation of heavy metal-contaminated tailings with amendments and economically valuable Eucalyptus camaldulensis is a research hotspot due to its cost-effectiveness and sustainability. However, the succession and co-occurrence patterns of these microbial communities in this context remain unclear. Tailing samples of five kinds of Cd and Pb were collected in E. camaldulensis restoration models. Physicochemical properties, the proportions of different Cd and Pb forms, microbial community structure, and the co-occurrence network of rhizosphere tailings during different restoration process (organic bacterial manure, organic manure, inorganic fertilizer, bacterial agent) were considered. Organic and organic bacterial manures significantly increased pH, cation exchange capacity, and the proportion of residual Pb. Still, there was a significant decrease in the proportion of reducible Pb. The changes in microbial communities were related to physicochemical properties and the types of amendments. Organic and organic bacterium manures decreased the relative abundance of oligotrophic groups and increased the relative abundance of syntrophic groups. Inorganic fertilizers and bacterial agents decreased the relative abundance of saprophytic fungi. B. subtilis would play a better role in the environment improved by organic manure, increasing the relative abundance of beneficial microorganism and reducing the relative abundance of pathogenic microorganism. pH, cation exchange capacity, and the proportion of different forms of Pb were the main factors affecting the bacterial and fungi variation. All four amendments transformed the main critical groups of the microbial network structure from acidophilus and pathogenic microorganisms to beneficial microorganisms. Heavy metal-resistant microorganisms, stress-resistant microorganisms, beneficial microorganisms that promote nutrient cycling, and copiotrophic groups have become critical to building stable rhizosphere microbial communities. The topological properties and stability of the rhizosphere co-occurrence network were also enhanced. Adding organic and organic bacterium manures combined with E. camaldulensis to repair Cd and Pb tailings improved (1) pH and cation exchange capacity, (2) reduced the biological toxicity of Pb, (3) enhanced the stability of microbial networks, and (4) improved ecological network relationships. These positive changes are conducive to the restoration of the ecological functions of tailings.
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Affiliation(s)
- Jiaqi Yang
- Research Institute of Fast-growing Trees, Chinese Academy of Forestry, State Key Laboratory of Efficient Production of Forest Resources, Zhanjiang 524022, China
| | - Linnan Ouyang
- Research Institute of Fast-growing Trees, Chinese Academy of Forestry, State Key Laboratory of Efficient Production of Forest Resources, Zhanjiang 524022, China.
| | - Shaoxiong Chen
- Research Institute of Fast-growing Trees, Chinese Academy of Forestry, State Key Laboratory of Efficient Production of Forest Resources, Zhanjiang 524022, China
| | - Cheng Zhang
- Experimental Forest Farm of Qingyuan County,Qingyuan 323800, China
| | - Jiaqi Zheng
- Research Institute of Fast-growing Trees, Chinese Academy of Forestry, State Key Laboratory of Efficient Production of Forest Resources, Zhanjiang 524022, China
| | - Shae He
- Research Institute of Fast-growing Trees, Chinese Academy of Forestry, State Key Laboratory of Efficient Production of Forest Resources, Zhanjiang 524022, China
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Gamaletsou MN, Rammaert B, Brause B, Bueno MA, Dadwal SS, Henry MW, Katragkou A, Kontoyiannis DP, McCarthy MW, Miller AO, Moriyama B, Pana ZD, Petraitiene R, Petraitis V, Roilides E, Sarkis JP, Simitsopoulou M, Sipsas NV, Taj-Aldeen SJ, Zeller V, Lortholary O, Walsh TJ. Osteoarticular Mycoses. Clin Microbiol Rev 2022; 35:e0008619. [PMID: 36448782 PMCID: PMC9769674 DOI: 10.1128/cmr.00086-19] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Osteoarticular mycoses are chronic debilitating infections that require extended courses of antifungal therapy and may warrant expert surgical intervention. As there has been no comprehensive review of these diseases, the International Consortium for Osteoarticular Mycoses prepared a definitive treatise for this important class of infections. Among the etiologies of osteoarticular mycoses are Candida spp., Aspergillus spp., Mucorales, dematiaceous fungi, non-Aspergillus hyaline molds, and endemic mycoses, including those caused by Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides species. This review analyzes the history, epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, inflammatory biomarkers, diagnostic imaging modalities, treatments, and outcomes of osteomyelitis and septic arthritis caused by these organisms. Candida osteomyelitis and Candida arthritis are associated with greater events of hematogenous dissemination than those of most other osteoarticular mycoses. Traumatic inoculation is more commonly associated with osteoarticular mycoses caused by Aspergillus and non-Aspergillus molds. Synovial fluid cultures are highly sensitive in the detection of Candida and Aspergillus arthritis. Relapsed infection, particularly in Candida arthritis, may develop in relation to an inadequate duration of therapy. Overall mortality reflects survival from disseminated infection and underlying host factors.
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Affiliation(s)
- Maria N. Gamaletsou
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Blandine Rammaert
- Université de Poitiers, Faculté de médecine, CHU de Poitiers, INSERM U1070, Poitiers, France
| | - Barry Brause
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Marimelle A. Bueno
- Far Eastern University-Dr. Nicanor Reyes Medical Foundation, Manilla, Philippines
| | | | - Michael W. Henry
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Aspasia Katragkou
- Nationwide Children’s Hospital, Columbus, Ohio, USA
- The Ohio State University School of Medicine, Columbus, Ohio, USA
| | | | - Matthew W. McCarthy
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Andy O. Miller
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Zoi Dorothea Pana
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Ruta Petraitiene
- Weill Cornell Medicine of Cornell University, New York, New York, USA
| | | | - Emmanuel Roilides
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | | | - Maria Simitsopoulou
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Nikolaos V. Sipsas
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Valérie Zeller
- Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Olivier Lortholary
- Université de Paris, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR 2000, Paris, France
| | - Thomas J. Walsh
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
- Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA
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Lee SH, Kim JT, Lee MK, Jeong JH, Kim KW. Pseudallescheria boydii Necrotizing Scleritis Treated with Several Antifungal Agents. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.1.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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4
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Hoh DZ, Lin YF, Liu WA, Sidique SNM, Tsai IJ. Nest microbiota and pathogen abundance in sea turtle hatcheries. FUNGAL ECOL 2020. [DOI: 10.1016/j.funeco.2020.100964] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Terris DJ, Steiniger JR. Scedosporium Apiospermum: Fungal Sinusitis in an Immunocompetent Patient. ACTA ACUST UNITED AC 2018. [DOI: 10.2500/105065892781874775] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Scedosporium apiospermum (also known as Pseudallescheria boydii) is a well-recognized cause of mycetoma and, more recently, pulmonary fungomas. We describe the sixth occurrence of S. apiospermum sinusitis in an otherwise healthy adult. This patient is unique in her history of invasive fungal disease. She initially underwent transseptal sphenoidotomy for presumed aspergillosis and had no other therapy. She did well but 14 months later developed recurrent symptoms. Examination revealed fungal mycelium protruding through the surgically enlarged sphenoid ostium. An endoscopic approach was used to remove the fungoma and strip the sphenoid mucosa. Cultures grew S. apiospermum as well as Serratia liquefasciens. No invasion was seen on pathology. Postoperatively, the patient received ciprofloxacin. This patient has been observed for 11 months and shows no evidence of infection. Previous approaches to treatment have included primarily surgical debridement. Antifungal chemotherapy has been added only to patients who clearly demonstrated invasion or patients with immune compromise. This represents the first report of this pathogen in which an endoscopic approach was used.
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Affiliation(s)
- David J. Terris
- Division of Otolaryngology/Head and Neck Surgery, Stanford University Medical Center, Stanford, California
| | - Joseph R. Steiniger
- Division of Otolaryngology/Head and Neck Surgery, Albany Medical College, Albany, New York
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Dinh A, Demay O, Rottman M, Gaudot F, Bougnoux ME, Bouchand F, Coignard H, Rouzaud C, Davido B, Duran C, Nich C. Case of femoral pseudarthrosis due to Scedosporium apiospermum in an immunocompetent patient with successful conservative treatment and review of literature. Mycoses 2018; 61:400-409. [PMID: 29274090 DOI: 10.1111/myc.12739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 12/11/2017] [Accepted: 12/16/2017] [Indexed: 11/28/2022]
Abstract
Scedosporium apiospermum is a ubiquitous filamentous fungus, commonly found in soil, sewage and polluted waters. It is rarely pathogenic but can cause a broad spectrum of clinical diseases, which can be localised or disseminate to distant organs. The disseminated form of the disease is mostly seen among immunocompromised patients. However, some rare cases of disseminated disease have been reported in immunocompetent individuals. Treatment of these infections is challenging because of their natural resistance to many antifungal agents. Here, we report the case of a 57-year-old immunocompetent patient diagnosed with femoral pseudarthrosis due to S. apiospermum, despite having no obvious clinical sign of infection. Previously, the patient had undergone four iterative femoral surgeries following a road traffic accident which occurred 20 years before. During its last surgery for pseudarthrosis, no clinical or biological signs of infection were present. Per operative samples tested positive for S. apiospermum. The patient was successfully treated with oral voriconazole during 6 months with an excellent tolerance. We also provide a review of literature on bone and joint infections due to Scedosporium spp. (S. apiospermum, Scedosporium boydii and Scedosporium aurantiacum), discussing the evolution of their management and outcome which seems to improve since the use of voriconazole.
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Affiliation(s)
- Aurélien Dinh
- Infectious Diseases Unit, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Olivier Demay
- Orthopaedic Surgery Department, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Martin Rottman
- Microbiology Laboratory, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Fabrice Gaudot
- Orthopaedic Surgery Department, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | | | - Frédérique Bouchand
- Pharmacy Department, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Hélène Coignard
- Infectious Diseases Department, Necker Teaching Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Claire Rouzaud
- Infectious Diseases Department, Necker Teaching Hospital, AP-HP, Paris Descartes University, Paris, France
| | - Benjamin Davido
- Infectious Diseases Unit, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Clara Duran
- Infectious Diseases Unit, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
| | - Christophe Nich
- Orthopaedic Surgery Department, Raymond Poincaré Teaching Hospital, AP-HP, Versailles Saint-Quentin University, Garches, France
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Ruan Q, Liu Q, Yu S, Yang F, Chen S, Zhang W. A 60-Year-Old Man With Fever and Headache After a Near-Drowning Event. Clin Infect Dis 2018; 66:314-315. [DOI: 10.1093/cid/cix630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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8
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Patterson TF, Andriole VT, Zervos MJ, Therasse D, Kauffman CA. The epidemiology of pseudallescheriasis complicating transplantation: Nosocomial and community-acquired infection. Mycoses 2017; 33:296-302. [DOI: 10.1111/myc.1990.33.6.296] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/1990] [Indexed: 11/28/2022]
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9
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Tabatabaei SA, Tabatabaei M, Soleimani M, Tafti ZF. Fungal keratitis caused by rare organisms. J Curr Ophthalmol 2017; 30:91-96. [PMID: 29564417 PMCID: PMC5859421 DOI: 10.1016/j.joco.2017.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 08/02/2017] [Accepted: 08/04/2017] [Indexed: 11/29/2022] Open
Abstract
Purpose To report two rare cases of filamentous fungal keratitis. Methods Two non-consecutive patients presented with suspicious fungal keratitis. After performing the smear and culture, medical therapy was started for them. They underwent slit photography and in vivo confocal microscopy (IVCM) in their follow-up visits. Results The patients were 33-year-old and 56-year-old farmer men. They both mentioned a history of ocular trauma by plants. During their follow-up visits, corneal infiltration density and fungal hyphae density decreased in slit-lamp biomicroscopy and IVCM, respectively. The corresponding organisms were Pseudallescheria boydii (P. boydii) and Colletotrichum coccodes. Conclusions It is important to be aware of these rare organisms and their antibiotic susceptibility. There was not any specific confocal feature for the presented fungal keratitis that was different from other filamentous fungal hyphae; however, confocal scan is a good choice to follow the response to the treatment.
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Affiliation(s)
- Seyed Ali Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Disseminated Scedosporium apiospermum Infection in a Patient With Chronic Granulomatous Disease. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2015. [DOI: 10.1097/ipc.0000000000000229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Serda Kantarcioglu A, Sybren de Hoog G, Guarro J. Clinical characteristics and epidemiology of pulmonary pseudallescheriasis. Rev Iberoam Micol 2012; 29:1-13. [DOI: 10.1016/j.riam.2011.04.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 03/20/2011] [Accepted: 04/01/2011] [Indexed: 01/15/2023] Open
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Cumbo-Nacheli G, de Sanctis J, Holden D. Pseudallescheria Boydii pneumonia in an immunocompetent host. AMERICAN JOURNAL OF CASE REPORTS 2012; 13:163-5. [PMID: 23569518 PMCID: PMC3616179 DOI: 10.12659/ajcr.883276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 07/09/2012] [Indexed: 12/04/2022]
Abstract
Background: Pseudallescheria boydii pneumonia is rarely reported among immunocompetent patients. Case Report: We report a case of a 62 year old white female with pseudallescheria boydii pneumonia. The patient was non-immunocompromised, had a history of mycobacterium avium complex (MAC) infection prior to presentation. After successful response to initial antitubercular therapy, the patient developed recurrent symptoms and bibasilar nodular infiltrates. Second line therapy for MAC failed to improve symptomatology. Pseudallescheria boydii pneumonia was diagnosed from a bronchoscopic biopsy. Treatment with voriconazole resolved her symptomatology and radiological infiltrates. Conclusions: This case highlights the importance of a high index of suspicion for superimposed fungal infections in patients who are refractory to medical treatment of bacterial pneumonitis such as MAC. Further diagnostic interventions are encouraged when insufficient clinical improvement is observed. Prompt initiation of an antifungal regimen is warranted.
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Eldin C, Chiche L, Thomas G, Dicostanzo MP, Durand JM, Harle JR, Ranque S. Scedosporium apiospermum catheter-related soft-tissue infection: a case report and review of the literature. Med Mycol 2011; 50:627-30. [PMID: 22142218 DOI: 10.3109/13693786.2011.639035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We report a case of catheter-related Scedosporium apiospermum soft-tissue infection. This ubiquitous filamentous fungus can cause human infection after traumatic subcutaneous implantation of its conidia or their inhalation in near-drowning cases. It has also been reported as an etiological agent in a growing number of hospital-acquired infections.
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Affiliation(s)
- Carole Eldin
- Service de Médecine Interne, CHU la Conception, Marseille, France
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Gottesman-Yekutieli T, Shwartz O, Edelman A, Hendel D, Dan M. Pseudallescheria boydii infection of a prosthetic hip joint--an uncommon infection in a rare location. Am J Med Sci 2011; 342:250-3. [PMID: 21681069 DOI: 10.1097/maj.0b013e31821f9691] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pseudallescheria boydii infection of the hip joint was diagnosed 2.5 years after implantation of a prosthetic joint in a woman with rheumatoid arthritis. Cure was achieved with a 10-month course of voriconazole coupled with removal of the prosthesis and repeat surgical debridement. Pseudallescheria boydii is an environmental mold that can cause osteoarticular infection, most often not only after local trauma but also after local injections and surgical procedures. Hip involvement was rarely reported, and this is the first description of a prosthetic joint infection with Scedosporium sp.
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Takeuchi M, Yoshida C, Ota Y, Fujiwara Y. Deep skin infection of Scedosporium apiospermum in a patient with refractory idiopathic thrombocytopenic purpura. Intern Med 2011; 50:1339-43. [PMID: 21673473 DOI: 10.2169/internalmedicine.50.4890] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Infection of Scedosporium apiospermum is very rare but is now emerging as an important cause of both localized and disseminated infections in immunocompromised patients. A 62-year-old woman, who had undergone steroid therapy for refractory idiopathic thrombocytopenic purpura and had a history of diffuse large B cell lymphoma, developed a deep skin ulcer complicated with lymphangitis. After culture study demonstrated the presence of S. apiospermum, voriconazole (VRCZ) was administered and prompt improvement was observed. Because it is difficult to distinguish S. apiospermum from Aspergillus by histopathology and S. apiospermum is resistant to amphotericin B, VRCZ should be selected as the first choice of antifungal agent when mold is considered to be the causative organism.
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Affiliation(s)
- Makoto Takeuchi
- Division of Hematology, National Hospital Organization Minami-Okayama Medical Center, Japan.
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Abstract
A 31-year-old African American woman with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (recent CD4 count of 66/mm) presented to the emergency room with a tension pneumothorax that required an emergent chest tube placement. Computed tomography scan showed fungus balls in multiple lung cavities and surrounding infiltrates. The patient showed remarkable improvement with voriconazole suggesting aspergillosis. However, the patient was serologically negative for Aspergillus and other common fungal infections. Because of a persistent air leak, surgical intervention was needed. The histological finding was consistent with invasive mycosis, and cultures were positive for Scedosporium apiospermum. Literature review showed that, among patients with HIV/AIDS, Scedosporium can present from focal localized to systemic disease, is resistant to traditional antifungal agents, and may respond to prompt management with voriconazole.
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Gelabert-González M, Arcos-Algaba A, Serramito-García R, García-Allut A, Llovo-Taboada J, Peñalver-Barral M, Reyes-Santías R. Absceso cerebral por Scedosporium apiospermum. Presentación de un caso con revisión de la literatura. Neurocirugia (Astur) 2010. [DOI: 10.1016/s1130-1473(10)70068-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Multiple subcutaneous mycetomas caused by Pseudallescheria boydii: response to therapy with oral potassium iodide solution. J Infect 2009; 60:178-81. [PMID: 19761792 DOI: 10.1016/j.jinf.2009.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 09/02/2009] [Accepted: 09/10/2009] [Indexed: 11/23/2022]
Abstract
We describe the case of a sixteen-year-old male who presented with multiple subcutaneous mycetomas proven on culture to be secondary to Pseudallescheria boydi., The lesions responded completely to oral potassium iodide solution. To our knowledge this has never been reported in humans.
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Hajdu S, Obradovic A, Presterl E, Vécsei V. Invasive mycoses following trauma. Injury 2009; 40:548-54. [PMID: 18656189 DOI: 10.1016/j.injury.2008.03.034] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2007] [Revised: 03/16/2008] [Accepted: 03/18/2008] [Indexed: 02/02/2023]
Abstract
Invasive fungal infection may afflict people with trauma in two ways: either by entry into tissue via penetrating trauma or by haematogenous spread in critically ill people with polytrauma. Penetrating injury allows the advance of ubiquitously present fungi into the human body. Miniscule foreign material fosters the establishment and growth of fungi within the traumatically changed tissue. The seriousness of the infection depends upon the type of injury, the body area and the person's general condition. Usually, the infection is confined to the cutis and subcutis; the fascia, muscles and bones are rarely affected. In the presence of immunocompromise, however, the fungus may spread rapidly and cause systemic disease. The following overview will focus on fungal infection associated with open wounds and fractures, particularly eye injury and with near-drowning, tropical mycetoma and nosocomial conditions. Post-traumatic invasive fungal infections are rare, but the surgeon should be alert to this possibility in cases with chronic inflammation and deferred healing of injuries, with or without systemic inflammatory response.
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Affiliation(s)
- S Hajdu
- Department of Trauma Surgery, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Wien, Austria.
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20
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Fatal mycotic aneurysm caused by Pseudallescheria boydii after near drowning. Int J Legal Med 2009; 124:243-7. [DOI: 10.1007/s00414-009-0336-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Accepted: 02/25/2009] [Indexed: 10/21/2022]
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Horré R, Marklein G. Isolation and clinical significance ofPseudallescheriaandScedosporiumspecies. Med Mycol 2009; 47:415-21. [DOI: 10.1080/13693780902801259] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Lam SM, Lau ACW, Ma MW, Yam LYC. Pseudallescheria boydii or Aspergillus fumigatus in a lady with an unresolving lung infiltrate, and a literature review. Respirology 2008; 13:478-80. [PMID: 18399878 DOI: 10.1111/j.1440-1843.2007.01148.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 53-year-old lady with blood-stained sputum and pleuritic pain had a lingular opacity on CXR which failed to resolve. A bronchial aspirate and transbronchial biopsy revealed features of bronchocentric granulomatosis with dichotomous branching hyphae suggestive of Aspergillus infection. However, subsequent fungal culture grew Pseudallescheria boydii. This case demonstrates the similarity of clinical and histological features caused by these two fungi. This appears to be the first reported case of pulmonary pseudallescheria with a bronchocentric granulomatous response.
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Affiliation(s)
- Sin-Man Lam
- Division of Respiratory and Critical Care Medicine, Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
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Kantarcioglu AS, Guarro J, de Hoog GS. Central nervous system infections by members of the Pseudallescheria boydii species complex in healthy and immunocompromised hosts: epidemiology, clinical characteristics and outcome. Mycoses 2008; 51:275-90. [DOI: 10.1111/j.1439-0507.2008.01489.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Scedosporium spp. are increasingly recognized as causes of resistant life-threatening infections in immunocompromised patients. Scedosporium spp. also cause a wide spectrum of conditions, including mycetoma, saprobic involvement and colonization of the airways, sinopulmonary infections, extrapulmonary localized infections, and disseminated infections. Invasive scedosporium infections are also associated with central nervous infection following near-drowning accidents. The most common sites of infection are the lungs, sinuses, bones, joints, eyes, and brain. Scedosporium apiospermum and Scedosporium prolificans are the two principal medically important species of this genus. Pseudallescheria boydii, the teleomorph of S. apiospermum, is recognized by the presence of cleistothecia. Recent advances in molecular taxonomy have advanced the understanding of the genus Scedosporium and have demonstrated a wider range of species than heretofore recognized. Studies of the pathogenesis of and immune response to Scedosporium spp. underscore the importance of innate host defenses in protection against these organisms. Microbiological diagnosis of Scedosporium spp. currently depends upon culture and morphological characterization. Molecular tools for clinical microbiological detection of Scedosporium spp. are currently investigational. Infections caused by S. apiospermum and P. boydii in patients and animals may respond to antifungal triazoles. By comparison, infections caused by S. prolificans seldom respond to medical therapy alone. Surgery and reversal of immunosuppression may be the only effective therapeutic options for infections caused by S. prolificans.
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Cooley L, Spelman D, Thursky K, Slavin M. Infection with Scedosporium apiospermum and S. prolificans, Australia. Emerg Infect Dis 2007; 13:1170-7. [PMID: 17953087 PMCID: PMC2828065 DOI: 10.3201/eid1308.060576] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
S. prolificans has become a major pathogen in immunocompromised patients. Scedosporium apiospermum and S. prolificans are fungi of increasing clinical importance, particularly in persons with underlying diseases. We reviewed the records of 59 patients in Australia from whom Scedosporium spp. were isolated from June 30, 1997, through December 31, 2003. S. apiospermum was isolated predominantly from the respiratory tracts of 28 of 31 patients with underlying lung diseases and resulted in 2 infections and 1 death. The annual number of S. apiospermum isolates remained constant. S. prolificans was isolated from 28 patients only after November 1999. Eight patients with acute myeloid leukemia or hematopoietic stem cell transplants had invasive infection; 4 had fungemia and 6 died from infection. S. prolificans caused locally invasive infection in 2 immunocompetent patients and was found in the respiratory tract of 18 patients with underlying respiratory disease but did not cause fungemia or deaths in these patients. Scedosporium spp. showed distinct clinical and epidemiologic features.
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26
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Invasive Mykosen und Trauma. Wien Med Wochenschr 2007; 157:482-9. [DOI: 10.1007/s10354-007-0463-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Accepted: 07/11/2007] [Indexed: 10/22/2022]
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Katragkou A, Dotis J, Kotsiou M, Tamiolaki M, Roilides E. Scedosporium apiospermum infection after near-drowning. Mycoses 2007; 50:412-21. [PMID: 17714363 DOI: 10.1111/j.1439-0507.2007.01388.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Scedosporium apiospermum and its teleomorph (sexual form) Pseudallescheria boydii are ubiquitous saprophytic fungi, which under specific conditions, such as near-drowning, may cause therapy-refractory and life-threatening infections. We reviewed 22 cases (eight children and 14 adults) of S. apiospermum infection after near-drowning reported in the literature including an additional paediatric case from our institution. Scedosporiosis after near-drowning was associated with high mortality (16/23, 70%) even in immunocompetent hosts. It affected mainly young (mean age 24 years) and immunocompetent (83% with no apparent immune defect) males (male to female ratio 2.5 : 1). Scedosporiosis after near-drowning was a slow progressive disease (mean survival time 87 days) involving virtually all body organs. However, central nervous system (CNS) dissemination predominated (21/23, 91%) presenting mainly as multiple brain abscesses (15/23, 65%). All 23 patients showed preceding clinical and/or radiological evidence of lung disease indicating the mode of invasion. Diagnosis was delayed (median time to diagnosis 28 days) and was made by culture (16/23, 69.5%) or culture and tissue examination (7/23, 30.5%). The majority of the patients (20/23, 87%) received antifungal treatment and underwent neurosurgery. While the optimal treatment remains undefined, the most recent reports indicated voriconazole as a potentially effective option. Better knowledge of scedosporiosis after near-drowning could lead to improved intervention and ultimately to more favourable outcome.
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Affiliation(s)
- Aspasia Katragkou
- Third Department of Pediatrics, Aristotle University, Thessaloniki, Greece
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28
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Hoshino S, Tachibana I, Kijima T, Yoshida M, Kumagai T, Osaki T, Kamei K, Kawase I. A 60-Year-Old Woman With Cough, Fever, and Upper-Lobe Cavitary Consolidation. Chest 2007; 132:708-10. [PMID: 17699146 DOI: 10.1378/chest.07-0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Shigenori Hoshino
- Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan
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29
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Rogasi PG, Zanazzi M, Nocentini J, Fantoni E, Trotta M, Faggi E, Fontanelli A, Bertoni E, Salvadori M, Leoncini F. Disseminated Scedosporium Apiospermum Infection in Renal Transplant Recipient: Long-Term Successful Treatment With Voriconazole: A Case Report. Transplant Proc 2007; 39:2033-5. [PMID: 17692684 DOI: 10.1016/j.transproceed.2007.05.044] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Scedosporium apiospermum, the asexual form of Pseudallescheria boydii, is a ubiquitous fungus that represents an unfrequent complication of immune suppression. It accounts for 20% of all non-Aspergillus mold infections in organ transplant recipients. The infection can be localized or disseminated in multiple organs, including lungs, brain, joints, tendons, and skin, and is difficult to treat, due to resistance of S apiospermum to amphotericin B and other antifungal agents. The mortality rate is about 50%. To our knowledge, there are no prospective studies or registries of transplant recipients to guide diagnosis and there are no evidence-based recommendations for the optimal management of this infection. We report a case of S apiospermum infection in a woman with renal transplantation. The first occurrence of infection was a solitary nodule on the forearm, which was surgically excised. Two following relapses were disseminated to the knee, the Achilles tendon, and the skin of the left leg. The infection was successfully treated with voriconazole, but due to the severe iatrogenic immune suppression, a strong reduction in immunosuppressant drugs was needed.
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Affiliation(s)
- P G Rogasi
- Malattie Infettive, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
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30
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Jayamohan Y, Ribes JA. Pseudallescheriasis: a summary of patients from 1980-2003 in a tertiary care center. Arch Pathol Lab Med 2006; 130:1843-6. [PMID: 17149961 DOI: 10.5858/2006-130-1843-pasopf] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2006] [Indexed: 11/06/2022]
Abstract
CONTEXT Pseudallescheria boydii is being increasingly isolated in immunocompromised patients. OBJECTIVE To present 24 years of data on patients from whom P. boydii was isolated. DESIGN Retrospective review of archival laboratory data and patient charts at a tertiary care hospital with a full service mycology laboratory. All patients evaluated from whom P. boydii was isolated between 1980 and 2003 were included in this study. RESULTS Twenty-four patients from whom P. boydii had been isolated were identified. The majority of cases represented pulmonary involvement, particularly in cystic fibrosis patients. Three additional patients had infections in surgical or traumatic lesions of the head and 4 had disseminated disease. Invasive disease was associated with underlying malignancy or transplantation and resulted in death secondary to the fungal infection in the majority of cases. CONCLUSIONS Pseudallescheria boydii may cause significant disease in humans. Invasive infections with P. boydii are often misdiagnosed and inadequately treated. Aggressive treatment of locally invasive disease may be of value in preventing rapid and fatal dissemination with this organism.
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Affiliation(s)
- Yasodah Jayamohan
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY 40536-0298, USA
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31
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Bates DD, Minis JW. Invasive Fungal Sinusitis Caused by Pseudallescheria Boydii: Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2006. [DOI: 10.1177/014556130608501112] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fungal sinusitis secondary to Pseudallescheria boydii is rare, as only 25 cases have been previously reported in the literature. Although P boydii resembles Aspergillus on pathologic examination, it is typically resistant to amphotericin B. Therefore, culture is necessary to differentiate the two. Patients with P boydii sinusitis should generally be treated with a combination of surgery and antifungal therapy. Combination treatment is particularly important for immunocompromised patients with fungal invasion because mortality among these patients is high. The prognosis is better for immunocompetent patients, even those with fungal invasion. We describe a new case of invasive fungal sinusitis secondary to P boydii infection, and we review the literature on this emerging pathogen.
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Affiliation(s)
- Dwight D. Bates
- Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, N.C
| | - J. Whitman Minis
- Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, N.C
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32
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Abstract
Since its discovery as an agent of mycetoma nearly a century ago, Pseudallescheria boydii with its asexual (synanamorphic) form, Scedosporium apiospermum, is now recognized as an important emerging opportunistic pathogen causing invasive mycosis in immunocompromised patients. The clinical spectrum of pseudallescheriasis is wide. Invasive disease of the lung, CNS and dissemination are serious manifestations in immunocompromised patients. This organism responds poorly to amphotericin B, and its histopathologic resemblance to aspergillosis often results in a delay in diagnosis. In vitro data, animal models and accumulating clinical experience support the use of voriconazole as a primary treatment for pseudallescheriasis. This paper reviews the microbiology, ecology, epidemiologic trends, clinical manifestations and current treatment options of pseudallescheriasis.
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Affiliation(s)
- Thomas A O'Bryan
- The Pennsylvania State University, College of Medicine, Hershey, PA 17033, USA.
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33
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Kumashi PR, Safdar A, Chamilos G, Chemaly RF, Raad II, Kontoyiannis DP. Fungal osteoarticular infections in patients treated at a comprehensive cancer centre: a 10-year retrospective review. Clin Microbiol Infect 2006; 12:621-6. [PMID: 16774557 DOI: 10.1111/j.1469-0691.2006.01471.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study reviewed retrospectively the clinical characteristics of 28 cancer patients with fungal osteoarticular infections (FOAIs) between 1995 and 2005. Most patients (26; 93%) had haematological malignancies (19 had leukaemia); half (14) were allogeneic stem-cell transplant recipients. Twelve patients (43%) had severe neutropenia (< or = 100/mm3) with a mean duration of 65 days (range 10-500 days), and ten (36%) patients had received a significant dose of corticosteroids. Most (19; 68%) FOAIs were caused by contiguous extension, while nine (32%) were associated with haematogenous spread. Pain, joint instability and local drainage were seen in 28 (100%), six (21%), and seven (25%) patients, respectively. Sixteen (57%) patients had symptoms for < 1 month. The sinuses (ten; 36%) and the vertebral spine (six; 21%) were the most common sites involved. Moulds were the predominant pathogens: Aspergillus fumigatus (two); non-fumigatus Aspergillus spp. (eight); non-specified Aspergillus spp. (three); Fusarium spp. (six); Zygomycetes (five); Scedosporium apiospermum (two); and Exserohilum sp. (one). Candida was the causative pathogen in four cases (including two cases of mixed FOAIs). Arthritis and post-operative FOAIs were both uncommon manifestations, occurring in two patients each. All patients received systemic antifungal therapy (combinations in 20 cases), and 19 cases underwent adjunctive surgery. The crude mortality rates (at 12 weeks) were 44% (9/20) in the patients who underwent surgery and antifungal therapy vs. 33% (2/6) in patients who received antifungal therapy alone (p not significant). FOAI is a rare, yet severe, manifestation of localised or systemic mycoses, caused predominantly by moulds, and is seen typically in patients with haematological malignancies.
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Affiliation(s)
- P R Kumashi
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA
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34
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Panichpisal K, Nugent K, Sarria JC. Central nervous system pseudallescheriasis after near-drowning. Clin Neurol Neurosurg 2006; 108:348-52. [PMID: 16325994 DOI: 10.1016/j.clineuro.2005.10.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Revised: 10/18/2005] [Accepted: 10/31/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Clinical characteristics of central nervous system (CNS) pseudallescheriasis after near-drowning have not been systematically analyzed. METHODS Review of cases reported in the English-language literature. RESULTS Sixteen patients were identified. The average period between the near-drowning episode and onset of clinical manifestations was 37 days. Common manifestations included fever, altered mental status, headache, seizures, and hemiparesis. All patients developed brain abscesses; however, imaging studies were normal at presentation in 6 patients. Cerebrospinal fluid neutrophilic pleocytosis, elevated protein, and decreased glucose were commonly observed. Most patients were treated with surgical resection and systemic amphotericin B or miconazole. Voriconazole was used in 2 patients. Twelve patients (75%) died. The average time between the near-drowning episode and death was 12 weeks. Four survivors received prompt treatment. CONCLUSIONS CNS pseudallescheriasis after near-drowning is highly lethal. Early diagnosis and aggressive medical and surgical interventions may improve survival.
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Affiliation(s)
- Kessarin Panichpisal
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
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35
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Goldani LZ, Zavascki AP, Maia AL. Fungal Thyroiditis: An Overview. Mycopathologia 2006; 161:129-39. [PMID: 16482384 DOI: 10.1007/s11046-005-0239-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2005] [Accepted: 11/24/2005] [Indexed: 11/27/2022]
Abstract
The authors review the epidemiology, clinical manifestations, diagnosis, and treatment of fungal thyroiditis cases previously reported in the medical literature. Aspergillus was by far the most common cause of fungal thyroiditis. Immunocompromised patients, such as those with leukemia, lymphoma, autoimmune diseases, and organ-transplant patients on pharmacological immunosuppression were particularly at risk. Fungal thyroiditis was diagnosed at autopsy as part of disseminated infection in a substantial number of patients without clinical manifestations and laboratory evidence of thyroid dysfunction. Local signs and symptoms of infection were indistinguishable from other infectious thyroiditis and included fever, anterior cervical pain, thyroid enlargement sometimes associated with dysphagia and dysphonia, and clinical and laboratory features of transient hyperthyroidism due to the release of thyroid hormone from follicular cell damage, followed by residual hypothyroidism. Antemortem diagnosis of fungal thyroiditis was made by direct microscopy and culture of a fine-needle aspirate, or/and biopsy in most cases. Since most patients with fungal thyroiditis had disseminated fungal infection with delay in diagnosis and treatment, the overall mortality was high.
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Affiliation(s)
- Luciano Z Goldani
- Section of Infectious Diseases, Universidade Federal do Rio Grande do Sul, Brazil.
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36
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Guarro J, Kantarcioglu AS, Horré R, Rodriguez-Tudela JL, Cuenca Estrella M, Berenguer J, de Hoog GS. Scedosporium apiospermum: changing clinical spectrum of a therapy-refractory opportunist*. Med Mycol 2006; 44:295-327. [PMID: 16772225 DOI: 10.1080/13693780600752507] [Citation(s) in RCA: 225] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Current knowledge on the opportunist Scedosporium apiospermum (teleomorph: Pseudallescheria boydii), generated over a period of more than 120 years, is reviewed. The natural environmental habitat of the fungus is unknown; nutrient-rich, brackish waters like river estuaria have been suggested. The fungus is strongly promoted by agricultural and particularly by industrial pollution.
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Affiliation(s)
- Josep Guarro
- Unitat de Microbiologia, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Spain
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37
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Buzina W, Feierl G, Haas D, Reinthaler FF, Holl A, Kleinert R, Reichenpfader B, Roll P, Marth E. Lethal brain abscess due to the fungusScedosporium apiospermum(teleomorphPseudallescheria boydii) after a near-drowning incident: case report and review of the literature. Med Mycol 2006; 44:473-7. [PMID: 16882615 DOI: 10.1080/13693780600654588] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
A 39-year-old healthy man developed a brain abscess weeks after a near-drowning incident. Scedosporium apiospermum, the anamorph of Pseudallescheria boydii, was isolated from the abscess. The patient died 153 days after the accident despite antifungal therapy. We discuss the role of antifungals and review the literature for comparable cases.
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Affiliation(s)
- W Buzina
- Medical Mycology, Institute of Hygiene, Medical University Graz, Universitaetsplatz, Graz, Austria.
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38
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Winn RM, Gil-Lamaignere C, Roilides E, Simitsopoulou M, Lyman CA, Maloukou A, Walsh TJ. Effects of interleukin-15 on antifungal responses of human polymorphonuclear leukocytes against Fusarium spp. and Scedosporium spp. Cytokine 2005; 31:1-8. [PMID: 15935692 DOI: 10.1016/j.cyto.2004.07.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2004] [Revised: 07/18/2004] [Accepted: 07/18/2004] [Indexed: 10/25/2022]
Abstract
Fusarium spp. and Scedosporium spp. have emerged as important fungal pathogens that are frequently resistant to antifungal compounds. We investigated the effects of human interleukin-15 (IL-15) on human polymorphonuclear leukocyte (PMNL) activity against Fusarium solani and Fusarium oxysporum as well as Scedosporium prolificans and Scedosporium apiospermum. IL-15 (100 ng/ml) significantly enhanced PMNL-induced hyphal damage of both Fusarium spp. and S. prolificans after incubation for 22 h (P < 0.01) but not S. apiospermum. In addition, IL-15 enhanced PMNL oxidative respiratory burst evaluated as superoxide anion production in response to S. prolificans but not to the other fungi after 2 h incubation. IL-15 increased interleukin-8 (IL-8) release from PMNLs challenged with hyphae of F. solani and S. prolificans (P< or = 0.04). Release of tumor necrosis factor-alpha was not affected. The species-dependent enhancement of hyphal damage and induction of IL-8 release suggest that IL-15 plays an important role in the immunomodulation of host response to these emerging fungal pathogens.
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Affiliation(s)
- Richard M Winn
- 3rd Department of Pediatrics, Aristotle University of Thessaloniki, Hippokration Hospital, GR-54642 Thessaloniki, Greece
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39
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Bashir G, Shakeel S, Wani T, Kakru DK. Pulmonary pseudallescheriasis in a patient with healed tuberculosis. Mycopathologia 2005; 158:289-91. [PMID: 15645170 DOI: 10.1007/s11046-004-2224-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2004] [Accepted: 06/07/2004] [Indexed: 11/24/2022]
Abstract
Pulmonary pseudallescheriasis in an immunocompetent patient without a pre-existing cavity or cyst is a rare phenomenon. We report a case of invasive pulmonary pseudallescheriasis in a lobectomised patient treated for tuberculosis. Filamentous fungi with pyriform conidia were seen in the bronchoalveolar lavage fluid . The fungus was identified as Pseudallescheria boydii on culture.
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Affiliation(s)
- Gulnaz Bashir
- Department of Microbiology, SKIMS, Srinagar, Kashmir, India.
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40
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Riddell J, Chenoweth CE, Kauffman CA. Disseminated Scedosporium apiospermum infection in a previously healthy woman with HELLP syndrome. Mycoses 2005; 47:442-6. [PMID: 15504131 DOI: 10.1111/j.1439-0507.2004.01015.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A previously healthy 33-year-old female died of disseminated infection with Scedosporium apiospermum in association with Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome following the delivery of twins. Her postpartum course was complicated by multisystem organ failure managed with extracorporeal membrane oxygenation (ECMO). She also developed bowel and left lower extremity ischemia requiring surgical resection. Blood cultures yielded S. apiospermum, and histologic findings revealed in vivo adventitious sporulation, an unusual occurrence with this pathogen. Autopsy showed extensive fungal infection of brain, lungs, thyroid, heart, and kidneys.
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Affiliation(s)
- J Riddell
- Division of Infectious Diseases, Department of Internal Medicine, Veterans Affairs Ann Arbor Healthcare System and University of Michigan Medical School, Ann Arbor, MI, USA
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41
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German JW, Kellie SM, Pai MP, Turner PT. Treatment of a chronic Scedosporium apiospermum vertebral osteomyelitis. Neurosurg Focus 2004; 17:E9. [PMID: 15636579 DOI: 10.3171/foc.2004.17.6.9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Scedosporium apiospermum is a rare cause of fungal vertebral osteomyelitis that may result in chronic infection requiring multiple surgical interventions and long-term medical therapy. This case is the seventh one reported in the literature and is the first to include salvage surgery of a previous major spinal reconstruction. This report is also the first to describe the use of the new antifungal agent voriconazole. In treating this case of chronic vertebral osteomyelitis, several principles are emphasized from both the surgical and medical perspectives. From a surgical perspective, the use of salvage surgery, temporary avoidance of spinal instrumentation, and an appropriate choice of graft materials are emphasized. From a medical perspective, confirmation of the diagnosis, the need for long-term antifungal therapy, the need for long-term patient compliance, and the use of the new antifungal agent voriconazole are emphasized. Application of these principles has led to an adequate 2-year outcome.
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Affiliation(s)
- John W German
- Division of Neurosurgery, and College of Pharmacy, University of New Mexico, Albuquerque, New Mexico, USA.
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42
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Kanafani ZA, Comair Y, Kanj SS. Pseudallescheria boydii cranial osteomyelitis and subdural empyema successfully treated with voriconazole: a case report and literature review. Eur J Clin Microbiol Infect Dis 2004; 23:836-40. [PMID: 15558341 DOI: 10.1007/s10096-004-1233-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Described here is a case of Pseudallescheria boydii cranial osteomyelitis and subdural empyema following craniotomy, which was successfully treated with surgical debridement and voriconazole. Other reported cases of Pseudallescheria boydii osteomyelitis are reviewed. The reported case suggests that voriconazole may represent a new therapeutic option for this infection.
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Affiliation(s)
- Z A Kanafani
- Division of Infectious Diseases, American University of Beirut Medical Center, Hamra, P.O. Box 113-6044, 110 32090 Beirut, Lebanon
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43
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Perlroth MG, Miller J. Pseudoallescheria boydii pneumonia and empyema: a rare complication of heart transplantation cured with voriconazole. J Heart Lung Transplant 2004; 23:647-9. [PMID: 15135387 DOI: 10.1016/s1053-2498(03)00298-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2002] [Accepted: 06/18/2003] [Indexed: 11/22/2022] Open
Abstract
Pseudoallescheria boydii pneumonia is a rare occurrence, usually resistant to amphotericin B and other anti-fungal agents. We report a complete response to voriconazole in an immunosuppressed host.
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Affiliation(s)
- Mark G Perlroth
- Division of Cardiovascular Disease, Department of of Medicine, Stanford University, Stanford, California 94305, USA.
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44
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Abstract
More yeasts and molds are now recognized to cause more human disease than ever before. This development is not due to a change in the virulence of these fungi, but rather to changes in the human host. These changes include immunosuppression secondary to the pandemic of HIV, the use of life-saving advances in chemotherapy and organ transplantation, and the use of corticosteroids and other immunosuppressive agents to treat a variety of diseases. Fungi that were once considered common saprophytes are now recognized as potential pathogens in these patients. This situation necessitates better communication than ever between the clinician, pathologist, and clinical mycologist to ensure the prompt and accurate determination of the cause of fungal diseases.
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Affiliation(s)
- Gary W Procop
- Section of Clinical Microbiology, The Cleveland Clinic Foundation, L40, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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45
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Walsh TJ, Groll A, Hiemenz J, Fleming R, Roilides E, Anaissie E. Infections due to emerging and uncommon medically important fungal pathogens. Clin Microbiol Infect 2004; 10 Suppl 1:48-66. [PMID: 14748802 DOI: 10.1111/j.1470-9465.2004.00839.x] [Citation(s) in RCA: 374] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The emergence of less common but medically important fungal pathogens contributes to the rate of morbidity and mortality, especially in the increasingly expanding population of immunocompromised patients. These pathogens include septate filamentous fungi (e.g., Fusarium spp., Scedosporium spp., Trichoderma spp.), nonseptate Zygomycetes, the endemic dimorphic pathogen Penicillium marneffei, and non-Cryptococcus, non-Candida pathogenic yeast (e.g., Trichosporon spp.). The medical community is thus called upon to acquire an understanding of the microbiology, epidemiology and pathogenesis of these previously uncommon pathogens in order to become familiar with the options for prevention and treatment.
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Affiliation(s)
- T J Walsh
- Immunocompromised Host Section, Pediatric Oncology Branch, The National Cancer Institute, Bethesda, MD 20892-1928, USA.
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González GM, Tijerina R, Najvar LK, Bocanegra R, Rinaldi MG, Loebenberg D, Graybill JR. Activity of posaconazole against Pseudallescheria boydii: in vitro and in vivo assays. Antimicrob Agents Chemother 2003; 47:1436-8. [PMID: 12654687 PMCID: PMC152491 DOI: 10.1128/aac.47.4.1436-1438.2003] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Thirty isolates of Pseudallescheria boydii were tested to compare the in vitro activity of posaconazole with those of fluconazole and itraconazole, using NCCLS methods. Posaconazole was evaluated in an immunosuppressed mouse model of disseminated pseudallescheriasis. Posaconazole was more effective than itraconazole and as effective as fluconazole in preventing death and significantly reducing the CFU of P. boydii from tissues.
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Affiliation(s)
- Gloria M González
- Division of Infectious Diseases (7881), Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.
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Montejo M, Muñiz ML, Zárraga S, Aguirrebengoa K, Amenabar JJ, López-Soria L, Gonzalez R. Case Reports. Infection due to Scedosporium apiospermum in renal transplant recipients: a report of two cases and literature review of central nervous system and cutaneous infections by Pseudallescheria boydii/Sc. apiospermum. Mycoses 2002; 45:418-27. [PMID: 12421295 DOI: 10.1046/j.1439-0507.2002.00790.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Two cases of infections due to Scedosporium apiospermum in renal transplant recipients, one localized in the central nervous system, the other in the skin, are presented, and a literature review of 21 cases of central nervous system and cutaneous infections due to Pseudallescheria boydii/Sc. apiospermum is given.
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Levine NB, Kurokawa R, Fichtenbaum CJ, Howington JA, Kuntz C. An immunocompetent patient with primary Scedosporium apiospermum vertebral osteomyelitis. JOURNAL OF SPINAL DISORDERS & TECHNIQUES 2002; 15:425-30. [PMID: 12394669 DOI: 10.1097/00024720-200210000-00014] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Scedosporium apiospermum, the asexual anamorph of Pseudallescheria boydii, is a ubiquitous saprophytic fungus that usually causes cutaneous/subcutaneous infection but may manifest as an invasive disease, often in immunocompromised hosts. Following an extensive literature review, we think that this case represents the first documented report of a primary infection of the spine in an immunocompetent patient. Despite extensive surgical debridement and itraconazole therapy, the patient died of multisystem organ failure of unknown etiology. Our case and three previously reported cases of P. boydii vertebral osteomyelitis highlight the importance of obtaining repeat cultures in patients with culture-negative vertebral osteomyelitis who fail to adequately respond to empiric standard antibacterial and/or antimycobacterial therapy. Combined surgical debridement and antifungal therapy have been required for eradication of P. boydii spinal infections in two previously reported immunocompromised patients, although the optimal antifungal regimen for this infection has not been established.
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Affiliation(s)
- Nicholas B Levine
- Department of Neurosurgery, Neuroscience Institute, University of Cincinnati College of Medicine, Ohio 45267-0515, USA
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Castiglioni B, Sutton DA, Rinaldi MG, Fung J, Kusne S. Pseudallescheria boydii (Anamorph Scedosporium apiospermum). Infection in solid organ transplant recipients in a tertiary medical center and review of the literature. Medicine (Baltimore) 2002; 81:333-48. [PMID: 12352630 DOI: 10.1097/00005792-200209000-00001] [Citation(s) in RCA: 177] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
(Sca) is a ubiquitous filamentous fungus capable of causing invasive disease. We reviewed our electronic microbiology records and the English-language literature. Between 1976 and December 1999 we identified 23 solid organ transplant recipients with Sca infection, 7 of which occurred between December 1987 and December 1999 at our institution. Overall incidence was 1 per 1,000 patients, with a trend of higher incidence in patients receiving lung transplants compared with other transplant organs (p = 0.06). The 23 patients included liver (4), kidney (8), heart (8), lung (2), and heart/lung (1) recipients. Male to female ratio was 19:4, and the mean age was 46 +/- 12 (SD) years. Fungal infection was diagnosed at a median of 4 months (range, 0.4-156 mo) after transplant. The clinical presentation included disseminated disease ( 8), skin lesions (3), lung disease (5), endophthalmitis (1), meningitis (1), brain abscess with or without extension to eye (3), fungal mycotic aneurysm (1), and sinusitis (1). Seven (30%) patients had intravascular infection, and 11 (48%) patients had central nervous system involvement. Antifungal therapy was accompanied by surgical debridement in 9 cases. Three additional patients were found to have airway colonization only and received itraconazole prophylaxis, without evidence of disease. Of 22 patients with known outcome, 16 (72.7%) died. Five of 6 patients who survived had localized infections: skin lesions (n = 3), sinus fungus ball (n = 1), and solitary lung nodule (n = 1). All patients with disseminated disease and 10 of 11 patients with central nervous system disease died. An exception was 1 patient with a brain abscess, successfully treated with voriconazole and surgical drainage. Sca infection is rare but is associated with high mortality. Early diagnosis by culture is important because Sca is resistant to amphotericin B, routinely used in the empiric therapy of invasive fungal infections. Treatment with the combination of an antifungal and surgery may have a better outcome. Voriconazole promises to be an effective antifungal agent. Cultures positive for Sca should not be ignored, and long-term antifungal prophylaxis in candidates and transplant recipients should be considered.
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Affiliation(s)
- Barbara Castiglioni
- Department of Medicine, University of Pittsburgh Medical Center, Thomas E. Starzl Transplantation Institute, Pennsylvania 15213, USA
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Mellinghoff IK, Winston DJ, Mukwaya G, Schiller GJ. Treatment of Scedosporium apiospermum brain abscesses with posaconazole. Clin Infect Dis 2002; 34:1648-50. [PMID: 12032903 DOI: 10.1086/340522] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2001] [Revised: 01/25/2002] [Indexed: 11/03/2022] Open
Abstract
A 41-year-old man with acute lymphoblastic leukemia developed multiple Scedosporium apiospermum brain abscesses. The infection progressed despite neurosurgical drainage and treatment with itraconazole, amphotericin B, and ketoconazole, but the brain abscesses completely resolved after treatment with posaconazole alone.
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Affiliation(s)
- Ingo K Mellinghoff
- Division of Hematology-Oncology, Department of Medicine, University of California Los Angeles School of Medicine, Los Angeles, CA, 90095, USA
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