1
|
Phuna ZX, Madhavan P. A CLOSER LOOK AT THE MYCOBIOME IN ALZHEIMER'S DISEASE: FUNGAL SPECIES, PATHOGENESIS AND TRANSMISSION. Eur J Neurosci 2022; 55:1291-1321. [DOI: 10.1111/ejn.15599] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Zhi Xin Phuna
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University Malaysia Subang Jaya Selangor
| | - Priya Madhavan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University Malaysia Subang Jaya Selangor
| |
Collapse
|
2
|
Vélez-Pereira AM, De Linares C, Canela MA, Belmonte J. Logistic regression models for predicting daily airborne Alternaria and Cladosporium concentration levels in Catalonia (NE Spain). INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:1541-1553. [PMID: 31377867 DOI: 10.1007/s00484-019-01767-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 05/21/2023]
Abstract
Alternaria and Cladosporium are the most common airborne fungal spores responsible for health problems, as well as for crop pathologies. The study of their behavior in the air is a necessary step for establishing control and prevention measures. The aim of this paper is to develop a logistic regression model for predicting the daily concentrations of airborne Alternaria and Cladosporium fungal spores from meteorological variables. To perform the logistic regression analysis, the concentration levels are binarized using concentration thresholds. The fungal spore data have been obtained at eight aerobiological monitoring stations of the Aerobiological Network of Catalonia (NE Spain). The meteorological data used were the maximum and minimum daily temperatures and daily rainfall provided by the meteorological services. The relationship between the meteorological variables and the fungal spore levels has been modeled by means of logistic regression equations, using data from the period 1995-2012. Values from years 2013-2014 were used for validation. In the case of Alternaria, three equations for predicting the presence and the exceedance of the thresholds 10 and 30 spores/m3 have been established. For Cladosporium, four equations for the thresholds 200, 500, 1000, and 1500 spores/m3 have been established. The temperature and cumulative rainfall in the last 3 days showed a positive correlation with airborne fungal spore levels, while the rain on the same day had a negative correlation. Sensitivity and specificity were calculated to measure the predictive power of the model, showing a reasonable percentage of correct predictions (ranging from 48 to 99%). The simple equations proposed allow us to forecast the levels of fungal spores that will be in the air the next day, using only the maximum and minimum temperatures and rainfall values provided by weather forecasting services.
Collapse
Affiliation(s)
- Andrés M Vélez-Pereira
- Department of Environmental Engineering, Engineering Faculty, Universidad Tecnológica de Bolívar, Cartagena, Colombia
- Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Concepción De Linares
- Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain.
- Department of Animal Biology, Plant Biology and Ecology, Universitat Autònoma de Barcelona, Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain.
| | - Miguel-Angel Canela
- Department of Managerial Decision Sciences, IESE Business School, Barcelona, Spain
| | - Jordina Belmonte
- Institut de Ciència i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Animal Biology, Plant Biology and Ecology, Universitat Autònoma de Barcelona, Bellaterra, 08193, Cerdanyola del Vallès, Barcelona, Spain
| |
Collapse
|
3
|
Batra N, Kaur H, Mohindra S, Singh S, Shamanth AS, Rudramurthy SM. Cladosporium sphaerospermum causing brain abscess, a saprophyte turning pathogen: Case and review of published reports. J Mycol Med 2019; 29:180-184. [PMID: 31056403 DOI: 10.1016/j.mycmed.2019.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 04/12/2019] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
Emergence of saprophytic fungi thriving in dead plant material and soil as opportunistic human pathogens is of great concern. Cladosporium species are environmental saprophytes reported to cause various superficial and invasive fungal infections worldwide. C. sphaerospermum, a predominantly indoor fungus has been reported from cases of meningitis, subcutaneous and pulmonary fungal infections in the past. Herein we report the first case of cerebral abscess due to C. sphaerospermum in an immunocompetent host who was successfully managed by combined medical and surgical therapy.
Collapse
Affiliation(s)
- N Batra
- Department of Medical Microbiology, Post graduate institute of medical education and research, Chandigarh, India
| | - H Kaur
- Department of Medical Microbiology, Post graduate institute of medical education and research, Chandigarh, India.
| | - S Mohindra
- Department of Neurosurgery, Post graduate institute of medical education and research, Chandigarh, India
| | - S Singh
- Department of Medical Microbiology, Post graduate institute of medical education and research, Chandigarh, India
| | - A S Shamanth
- Department of Medical Microbiology, Post graduate institute of medical education and research, Chandigarh, India
| | - S M Rudramurthy
- Department of Medical Microbiology, Post graduate institute of medical education and research, Chandigarh, India
| |
Collapse
|
4
|
Unilateral Cervical Lymphadenopathy due to Cladosporium oxysporum: A Case Report and Review of the Literature. Case Rep Pathol 2017; 2017:5036514. [PMID: 29209546 PMCID: PMC5676383 DOI: 10.1155/2017/5036514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 10/11/2017] [Indexed: 11/18/2022] Open
Abstract
Phaeohyphomycosis is a fungal infection caused by Dermatiacae group of fungi, by Cladosporium spp. The term phaeohyphomycosis was introduced by Ajello et al. in 1974 to designate infections by brown pigmented filamentous fungi. Cladosporium oxysporum is a very rare etiological agent in humans. Phaeohyphomycosis of the cervical lymph node in an immunocompetent individual is a very rare clinical entity. To the best of our knowledge we report the first case of phaeohyphomycosis caused by Cladosporium oxysporum in the absence of other systemic manifestations in a 16-year-old male.
Collapse
|
5
|
Spatial dynamics of dark septate endophytes in the roots and rhizospheres of Hedysarum scoparium in northwest China and the influence of edaphic variables. FUNGAL ECOL 2017. [DOI: 10.1016/j.funeco.2017.01.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
6
|
Cladosporium Species Recovered from Clinical Samples in the United States. J Clin Microbiol 2015; 53:2990-3000. [PMID: 26179305 DOI: 10.1128/jcm.01482-15] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/10/2015] [Indexed: 11/20/2022] Open
Abstract
Cladosporium species are ubiquitous, saprobic, dematiaceous fungi, only infrequently associated with human and animal opportunistic infections. We have studied a large set of Cladosporium isolates recovered from clinical samples in the United States to ascertain the predominant species there in light of recent taxonomic changes in this genus and to determine whether some could possibly be rare potential pathogens. A total of 92 isolates were identified using phenotypic and molecular methods, which included sequence analysis of the internal transcribed spacer (ITS) region and a fragment of the large subunit (LSU) of the nuclear ribosomal DNA (rDNA), as well as fragments of the translation elongation factor 1 alpha (EF-1α) and actin (Act) genes. The most frequent species was Cladosporium halotolerans (14.8%), followed by C. tenuissimum (10.2%), C. subuliforme (5.7%), and C. pseudocladosporioides (4.5%). However, 39.8% of the isolates did not correspond to any known species and were deemed to comprise at least 17 new lineages for Cladosporium. The most frequent anatomic site of isolation was the respiratory tract (54.5%), followed by superficial (28.4%) and deep tissues and fluids (14.7%). Species of the two recently described cladosporiumlike genera Toxicocladosporium and Penidiella are reported for the first time from clinical samples. In vitro susceptibility testing of 92 isolates against nine antifungal drugs showed a variety of results but high activity overall for the azoles, echinocandins, and terbinafine.
Collapse
|
7
|
Panelli S, Buffoni JN, Bonacina C, Feligini M. Identification of moulds from the Taleggio cheese environment by the use of DNA barcodes. Food Control 2012. [DOI: 10.1016/j.foodcont.2012.05.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Pharmacokinetics of orally administered terbinafine in African penguins (Spheniscus demersus) for potential treatment of aspergillosis. J Zoo Wildl Med 2010; 41:263-74. [PMID: 20597218 DOI: 10.1638/2009-0211r.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to determine the pharmacokinetic parameters of orally administered terbinafine hydrochloride based on 3, 7, and 15 mg/kg single- as well as multiple-dosage trials in order to calculate dosing requirements for potential treatment of aspergillosis in African penguins (Spheniscus demersus). Ten adult African penguins were used in each of these trials, with a 2-wk washout period between trials. Mean plasma concentrations of terbinafine peaked in approximately 4 hrs at 0.11 +/- 0.017 microg/ml (mean +/- SD) following administration of 3 mg/kg terbinafine, while 7 mg/kg and 15 mg/kg dosages resulted in peak plasma concentrations of 0.37 +/- 0.105 and 0.33 +/- 0.054 microg/ml, respectively. The volume of distribution increased with increasing dosages, being 37 +/- 28.5, 40 +/- 28.1, and 52 +/- 18.6 mg/L for 3, 7, and 15 mg/kg doses, respectively. The mean half-life was biphasic with initial terminal half-life (t(1/2)) values of 9.9 +/- 4.5, 17.2 +/- 4.9 and 16.9 +/- 5.4 hrs, for 3, 7, and 15 mg/kg doses, respectively. A rapid first elimination phase was followed by a slower second phase, and final elimination was estimated to be 136 +/- 9.7 and 131 +/- 9.9 hrs, for 7 and 15 mg/kg doses, respectively. Linearity was demonstrated for area under the curve but not for peak plasma concentrations for the three dosages used. Calculations based on pharmacokinetic parameter values indicate that a 15 mg/kg terbinafine q24h dosage regimen would result in steady-state trough plasma concentrations above the minimum inhibitory concentration (0.8-1.6 microg/ ml), and this dosage is recommended as a potential treatment option for aspergillosis in penguins. However, additional research is required to determine both treatment efficacy and safety.
Collapse
|
9
|
Krishnan-Natesan S. Terbinafine: a pharmacological and clinical review. Expert Opin Pharmacother 2009; 10:2723-33. [DOI: 10.1517/14656560903307462] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
10
|
Pec J, Minarikova E, Zaborska D, Adamicova K, Krkoska D, Pec M. Treatment of dermal and subcutaneous pheohyphomycosis of 55 years' duration. Int J Dermatol 2008; 47:526-9. [PMID: 18412878 DOI: 10.1111/j.1365-4632.2008.03415.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
11
|
Ikeda S, Fuji SI, Sato T, Ytow N, Ezura H, Minamisawa K, Fujimura T. Community Analysis of Seed-Associated Microbes in Forage Crops using Culture-Independent Methods. Microbes Environ 2006. [DOI: 10.1264/jsme2.21.112] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Shin-ichi Fuji
- Faculty of Bioresource Sciences, Akita Prefectural University
| | - Toshiro Sato
- Faculty of Bioresource Sciences, Akita Prefectural University
| | | | | | | | | |
Collapse
|
12
|
Boggild AK, Poutanen SM, Mohan S, Ostrowski MA. Disseminated phaeohyphomycosis due toOchroconis gallopavumin the setting of advanced HIV infection. Med Mycol 2006; 44:777-82. [PMID: 17127636 DOI: 10.1080/13693780600900098] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Disseminated phaeohyphomycosis is a rare and typically fatal infection caused by members of the dematiaceous fungi, and occurs almost universally in the setting of immunocompromise. We herein report a case of systemic phaeohyphomycosis caused by Ochroconis gallopavum in a patient with advanced HIV disease. A possible risk factor for this infection in our patient was heavy marijuana use. This case highlights both the diagnostic and management challenges posed by these infections. To our knowledge, this is the first reported case of disseminated phaeohyphomycosis due to Ochroconis gallopavum in a patient with HIV.
Collapse
Affiliation(s)
- Andrea K Boggild
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.
| | | | | | | |
Collapse
|
13
|
Gugnani HC, Ramesh V, Sood N, Guarro J, Paliwal-Joshi A, Singh B. Cutaneous phaeohyphomycosis caused byCladosporium oxysporumand its treatment with potassium iodide. Med Mycol 2006; 44:285-8. [PMID: 16830425 DOI: 10.1080/13693780500294824] [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: 10/24/2022] Open
Abstract
Human infections due to Cladosporium oxysporum are rarely known. This case report describes cutaneous phaeohyphomycosis cause by C. oxysporum in a 30-year-old female. Lesions presented as multiple coalescing ulcers on the left foot. Diagnosis was based on histology and recovery of the fungus in culture. The patient was successfully treated with potassium iodide.
Collapse
Affiliation(s)
- H C Gugnani
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
| | | | | | | | | | | |
Collapse
|
14
|
Lewejohann J, Muhl E, Birth M, Kujath P, Bruch HP. [Pulmonary zygomycosis--a rare angioinvasive fungal infection]. Mycoses 2005; 48 Suppl 1:99-107. [PMID: 15826297 DOI: 10.1111/j.1439-0507.2005.01118.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Zygomycosis caused by Rhizopus species is an aggressive and rapidly progressive opportunistic fungal infection in immunocompromised patients. It comprises mucocutaneous, rhinocerebral, pulmonary, urological and disseminated infections. Predisposing factors are immunosuppression owing to severe diseases, immunological defects or metabolic disturbances like diabetic ketoacidosis. Rhizopus infections are characterized by angioinvasive growth, necroses of infected tissue and perineural invasion. The histopathologic demonstrable invasion of blood vessels is remarkable for a fungal infection. The mortality of zygomycosis is very high, especially for disseminated disease and when immunosuppression cannot be corrected. We report about two cases of pulmonary zygomycosis, caused by Rhizopus spp.: patient 1, female 73 years old: Delayed clinical course according to hip arthroplasty infection and infection of a femoropopliteal bypass of the right leg, eventually exarticulation of the right hip joint, Pseudomonas pneumonia, severe sepsis caused by staphylococci, acute respiratory distress syndrome (ARDs), acute renal failure and multiple use of antibiotics. Subsequently detection of Rhizopus spp. in the bronchoalveolar lavage and treatment with amphotericin B for this reason. Patient 2, male 68 years old: transplantation of kidney in past medical history, presenting with acute renal failure and with quite a few infections before. In the sequel development of abscessing pneumonia on the right side with a pleural empyema. Rhizopus spp. were detected by microbiological testing in the empyema fluid. These findings required surgical intervention, resection of the lower lobe of the right lung and within the same operation of the renal graft because of rejection. The patient was treated with caspofungin. The further course was delayed by several septic phases. Both patients died later on in spite of all efforts. The very rarely seen pulmonary zygomycosis caused by infection with Rhizopus spp. developed in both patients owing to immunosuppression, in one patient iatrogenically induced by immunosuppressive drugs after organ transplantation, in the other as a result of prolonged severe sepsis. In comparison with other mycoses treatment of Rhizopus infections remains difficult. The affinity to blood vessels, where the fungi multiply, and their feature of vascular invasion with thrombosis and infarction complicate therapeutic efforts.
Collapse
Affiliation(s)
- J Lewejohann
- Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, D-23538 Lübeck, Germany.
| | | | | | | | | |
Collapse
|
15
|
Agger WA, Andes D, Burgess JW. Exophiala jeanselmei Infection in a Heart Transplant Recipient Successfully Treated with Oral Terbinafine. Clin Infect Dis 2004; 38:e112-5. [PMID: 15156466 DOI: 10.1086/421020] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2003] [Accepted: 02/18/2004] [Indexed: 11/03/2022] Open
Abstract
An immunosuppressed heart transplant recipient developed Exophiala jeanselmei infection on the second toe. After unsuccessful treatment with different antifungal drugs, the infection responded to a high-dose regimen of oral terbinafine (an antifungal agent not yet approved in the United States for use against the dematiaceous fungi) and warm packs. This is, to our knowledge, the only known case of successful terbinafine treatment of E. jeanselmei infection.
Collapse
|
16
|
Yano S, Koyabashi K, Kato K. Intrabronchial lesion due to Cladosporium sphaerospermum in a healthy, non-asthmatic woman. Mycoses 2003; 46:348-50. [PMID: 12950908 DOI: 10.1046/j.1439-0507.2003.00885.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An intrabronchial lesion caused by to Cladosporium sphaerospermum in a healthy and non-asthmatic 59-year-old woman is reported. Intrabronchial infusion of amphotericin B was repeated three times followed by oral administration of prednisolone and itraconazole. The findings on chest radiographs subsequently improved. The possibility of intrabronchial lesions caused by C. sphaerosporum even in a healthy and non-asthmatic person is remarkable.
Collapse
Affiliation(s)
- S Yano
- Department of Pulmonary Medicine, National Sanatorium, Matsue Hospital, Matsue, 5-8-31 Agenogi, Matsue City, Shimane 690-8556, Japan.
| | | | | |
Collapse
|
17
|
Abstract
We report on a 65-year-old diabetic patient, who developed a deep fungal infection in the beard region after initial therapy with systemic antibiotics and topical corticosteroids. We were able to isolate Trichophyton mentagrophytes and treated him successfully with terbinafine 250 mg day(-1) orally in combination with topical ciclopirox and polyhexanide. In follicular inflammation in diabetics, deep mycosis has to be considered and mycologic diagnostics should be performed before starting any other treatment.
Collapse
Affiliation(s)
- K Hohaus
- Hautklinik des Krankenhaus Dresden-Friedrichstadt, Städtisches Klinikum, Friedrichstrasse 41, D-01067 Dresden, Germany
| | | | | |
Collapse
|
18
|
Romano C, Miracco C, Presenti L, Massai L, Fimiani M. Immunohistochemical study of subcutaneous phaeohyphomycoses. Mycoses 2002; 45:368-72. [PMID: 12421283 DOI: 10.1046/j.1439-0507.2002.00781.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Immunohistochemical study of inflammatory infiltrate was carried out in five cases of subcutaneous phaeohyphomycosis before and after therapy. The infections were due to the genus Alternaria in four cases and genus Cladosporium in one. In four cases, infiltrating T cells with helper memory phenotype were slightly more abundant after therapy (70-80% versus 75-90% of T lymphocytes) and those with suppressor cytotoxic phenotype were slightly less abundant (20-25% versus 10-15%). In one case, CD8+, Tia-1+ lymphocytes constituted 50% of the T-cell infiltrate before and after therapy. In all cases, the infiltrate contained many CD79 a+ plasma cells, which increased slightly after therapy, and a high CD1a positivity of dendritic cells (presumably Langerhans cells) before and after therapy. The CD1a+ cells were detected in the epidermis and in granulomatous infiltrate; in the dermis and subcutis, many were close to fungal structures. In four cases, intra-epidermal CD1a+ cell number was slightly lower than in control skin. CD68+ cells were not found in the epidermis.
Collapse
Affiliation(s)
- C Romano
- Institute of Dermatological Sciences, Siena University, Italy.
| | | | | | | | | |
Collapse
|
19
|
Gupta AK, Taborda PR, Sanzovo AD. Alternate week and combination itraconazole and terbinafine therapy for chromoblastomycosis caused by Fonsecaea pedrosoi in Brazil. Med Mycol 2002; 40:529-34. [PMID: 12462534 DOI: 10.1080/mmy.40.5.529.534] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Patients with long-standing chromoblastomycosis may respond poorly to standard treatments such as amphotericin B, oral antifungals, surgical measures or thermotherapy. The objective of this study was to determine the potential of alternate week and combination therapy with itraconazole and terbinafine in the treatment of poorly responsive, or non-responsive, chromoblastomycosis. Four patients with longstanding chromoblastomycosis (8-23 years) caused by Fonsecaea pedrosoi had responded poorly to standard therapies including monotherapy with the oral antifungal agents. In order to try and improve the response to oral itraconazole and terbinafine, alternate week or combination therapy with itraconazole and terbinafine was initiated. Bloodwork including complete blood count and liver function tests were performed every 3-8 weeks to ensure patient safety. Reduction or resolution of lesions of chromoblastomycosis was noted with alternate week or combination treatment using oral itraconazole and terbinafine. Three of four patients experienced no clinical side-effects; the third reported mild, transient gastric discomfort which responded to antacids. Bloodwork generally remained within normal limits throughout the entire course of treatment with no clinically significant changes. The combination therapy was considered effective in treating the poorly responsive chromoblastomycosis of all four patients. Some success with alternative week therapy was also noted in one patient. The favorable response and lack of significant adverse effects suggests that these regimens may be an option for some patients with chromoblastomycosis.
Collapse
Affiliation(s)
- A K Gupta
- Division of Dermatology, Sunnybrook and Women's College Health Science Center, University of Toronto, Toronto, Ontario, Canada.
| | | | | |
Collapse
|
20
|
Affiliation(s)
- T De Araujo
- Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL, USA
| | | | | |
Collapse
|
21
|
Xu X, Low DW, Palevsky HI, Elenitsas R. Subcutaneous phaeohyphomycotic cysts caused by Exophiala jeanselmei in a lung transplant patient. Dermatol Surg 2001; 27:343-6. [PMID: 11298703 DOI: 10.1046/j.1524-4725.2001.00308.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Phaeohyphomycosis is a skin fungal infection caused by dematiaceous fungi that often affects immunocompromised patients. Local recurrence after medication or surgical treatment is common in these patients. We present a case in which a 42-year-old woman status post-bilateral lung transplant developed phaeohyphomycotic cysts with local recurrence and then was successfully treated by local excision with pre- and postsurgery oral itraconazole treatment. OBJECTIVE To demonstrate the utility of pre- and postsurgery oral itraconazole in immunocompromised patients with recurrent phaeohyphomycosis. METHODS Local excision with pre- and postsurgery oral itraconazole treatment. RESULTS Simple excision or excision with postsurgery oral itraconazole resulted in local recurrence in this patient. Local excision with pre- and postsurgery oral itraconazole was effective in preventing the local recurrence. CONCLUSION Phaeohyphomycosis can run a prolonged course in immunocompromised patients with multiple recurrences. Local excision with pre- and postsurgery oral itraconazole can be used to treat these patients with recurrent phaeohyphomycosis.
Collapse
Affiliation(s)
- X Xu
- Department of Pathology and Laboratory Medicine, Hospital of University of Pennsylvania, 6 Founfer's Building, 3400 Spruce St., Philadelphia, PA 19104, USA.
| | | | | | | |
Collapse
|