1
|
Rao S, Boreddy V, Zameer MM, D'Cruz A. Cladophialophora bantiana brain abscess after pediatric liver transplant: A report of a long-term survivor. INDIAN JOURNAL OF TRANSPLANTATION 2023. [DOI: 10.4103/ijot.ijot_23_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
|
2
|
Radcliffe C, Radcliffe AJ, Azar MM, Grant M. Dematiaceous fungal infections in solid organ transplantation: systematic review and bayesian meta-analysis. Transpl Infect Dis 2022; 24:e13819. [PMID: 35253959 DOI: 10.1111/tid.13819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/03/2022] [Accepted: 02/19/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Dematiaceous fungi cause a number of infectious syndromes referred to as phaeohyphomycosis among both immunocompetent and immunocompromised hosts. We performed a systematic review to characterize these infections in solid organ transplant recipients (SOTR). METHODS We searched PubMed database (last searched 1/6/2022) for English-language reports on dematiaceous fungal infections in SOTR. Included reports needed individualized demographic, treatment, and outcome data; pediatric reports were excluded. A universally applicable bias assessment was performed on reports. Models for infection type and outcome were created using the Bayesian paradigm. RESULTS We included 149 reports on 201 cases of dematiaceous fungal infections in SOTR. The mean age was 54 years, 72% were men, and kidney recipients accounted for 61% of cases. Skin and soft tissue infection (SSTI) was the most common infectious syndrome (73%). Death from infection occurred in 7% of cases (14/201), with disseminated (32%) cases having the highest mortality. Our model for infection type predicted the relative probability of central nervous system infection to be highest in liver recipients. Across all transplant types, higher relative probabilities of disseminated and pulmonary infections occur in the early post-transplant period, and the predicted probabilities for these infection types decreased after 100 months post-transplantation. DISCUSSION We identified SSTI as the most common dematiaceous fungal infections in SOTR. Disseminated infections carried the worst prognosis. The evidence in this review is limited by the heterogeneity of included cases. No funding source was used, and this review's protocol was not registered. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
| | | | - Marwan M Azar
- Yale University School of Medicine, New Haven, CT, USA.,Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA
| | - Matthew Grant
- Yale University School of Medicine, New Haven, CT, USA.,Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
3
|
Cortés P, Jane Hata D, Libertin C, Meza Villegas DM, Harris DM. Cladophialophora bantiana and Nocardia farcinica infection simultaneously occurring in a kidney transplant recipient: Case report and literature review. IMMUNITY INFLAMMATION AND DISEASE 2021; 9:1146-1152. [PMID: 34129286 PMCID: PMC8589401 DOI: 10.1002/iid3.480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 11/30/2022]
Abstract
Solid organ transplant recipients are at increased risk of acquiring devastating infections with unusual pathogens. Nocardia are aerobic actinomycetes that affect the lungs, brain, skin and soft tissue. Cladophialophora species are dematiaceous fungi that overwhelmingly cause infections in the brain. Both organisms carry a high mortality rate. We present the first reported renal transplant case with Cladophialophora bantiana involving the renal allograft with concurrent invasive nocardiosis involving the lungs and brain.
Collapse
Affiliation(s)
- Pedro Cortés
- Division of Community Internal Medicine, Mayo Clinic Jacksonville, Florida, USA
| | - D Jane Hata
- Division of Laboratory Medicine and Pathology, Mayo Clinic Jacksonville, Florida, USA
| | - Claudia Libertin
- Division of Infectious Diseases, Mayo Clinic Jacksonville, Florida, USA
| | - Diana M Meza Villegas
- Division of Laboratory Medicine and Pathology, Mayo Clinic Jacksonville, Florida, USA
| | - Dana M Harris
- Division of Community Internal Medicine, Mayo Clinic Jacksonville, Florida, USA
| |
Collapse
|
4
|
Lo SG, Wong SF, Mak JW, Choo KK, Ng KP. Gene expression changes in human bronchial epithelial cells (BEAS-2B) and human pulmonary alveolar epithelial cells (HPAEpiC) after interaction with Cladosporium sphaerospermum. Med Mycol 2020; 58:333-340. [PMID: 31309220 DOI: 10.1093/mmy/myz061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/07/2019] [Accepted: 05/17/2019] [Indexed: 12/21/2022] Open
Abstract
Cladosporium is one of the most abundant spore. Fungi of this genus can cause respiratory allergy and intrabronchial lesion. We studied the differential expression of host genes after the interaction of Cladosporium sphaerospermum conidia with Human Bronchial Epithelial Cells (BEAS-2B) and Human Pulmonary Alveolar Epithelial Cells (HPAEpiC). C. sphaerospermum conidia were harvested and co-cultured with BEAS-2B cells or HPAEpiC cells for 48 hours respectively. This culture duration was chosen as it was associated with high germination rate. RNA was extracted from two biological replicates per treatment. RNA of BEAS-2B cells was used to assess changes in gene expression using AffymetrixGeneChip® Human Transcriptome Array 2.0. After co-culture with Cladosporium spores, 68 individual genes were found differentially expressed (P ≤ 0.05) and up-regulated ≥ 1.5 folds while 75 genes were found differentially expressed at ≤ -1.5 folds compared with controls. Reverse transcription and qPCR were performed on the RNA collected from both BEAS-2B cells and HPAEpiC cells to validate the microarray results with 7 genes. Based on the findings, infected pulmonary epithelial cells exhibited an increase in cell death-related genes and genes associated with innate immunity.
Collapse
Affiliation(s)
- Sing Gee Lo
- International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Shew Fung Wong
- International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Joon Wah Mak
- International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Khi Khi Choo
- International Medical University, 57000 Kuala Lumpur, Malaysia
| | - Kee Peng Ng
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| |
Collapse
|
5
|
Kantarcioglu AS, Guarro J, De Hoog S, Apaydin H, Kiraz N. An updated comprehensive systematic review of Cladophialophora bantiana and analysis of epidemiology, clinical characteristics, and outcome of cerebral cases. Med Mycol 2018; 55:579-604. [PMID: 28007938 DOI: 10.1093/mmy/myw124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 11/01/2016] [Indexed: 12/28/2022] Open
Abstract
Cladophialophora bantiana is a phaeoid fungus that only rarely has been isolated from sources other than the human brain. It has a particular tropism for the central nervous system (CNS). We have integrated and updated large-scale data related to several aspects of C. Bantiana and reviewed all the available reports on its cerebral infections, focusing on their geographical distribution, infection routes, immune status of infected individuals, type and location of infections, clinical manifestations and treatment and outcome, briefly looking over the spectrum of other disease entities associated with C. bantiana, that is, extra-cerebral and animal infections and on the environmental sources of this fungus. Among the agents of phaeohyphomycosis, a term used to describe an infection caused by a dark pigmented fungus, C. bantiana has some significant specific features. A total of 120 case reports were identified with a significantly higher percentage of healthy subjects than immune-debilitated patients (58.3% vs. 41.7%). Infections due to C. bantiana occur worldwide. The main clinical manifestations are brain abscess (97.5%), coinfection of brain tissue and meninges (14.2%) and meningitis alone (2.5%). Among immunocompetent patients, cerebral infection occurred in the absence of pulmonary lesions. The mortality rate is 65.0% regardless of the patient's immune status. The therapeutic options used include surgery or antifungals alone, and the combination of both, in most cases the fatal outcome being rapid after admission. Since the fungus is a true pathogen, laboratory workers should be made aware that BioSafety Level-3 precautions might be necessary.
Collapse
Affiliation(s)
- A Serda Kantarcioglu
- Mycology Unit, Department of Medical Microbiology, Cerrahpasa Medical Faculty, 343098 Cerrahpasa, Istanbul, Turkey
| | - Josep Guarro
- Unitat de Microbiologia, Facultat de Medicina i Ciencies de la Salut, IISPV, Universitat Rovira i Virgili, E-43201 Reus, Spain
| | - Sybren De Hoog
- Centraalbureau voor Schimmelcultures, Utrecht, and Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands
| | - Hulya Apaydin
- Department of Neurology, Cerrahpasa Medical Faculty, 34098 Cerrahpasa, Istanbul, Turkey
| | - Nuri Kiraz
- Mycology Unit, Department of Medical Microbiology, Cerrahpasa Medical Faculty, 343098 Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
6
|
Reynaud Q, Dupont D, Nove-Josserand R, Durupt S, Persat F, Ader F, Grenet D, Durieu I. Rare and unusual presentation of Cladophialophora infection in a pulmonary transplant cystic fibrosis patient. Transpl Infect Dis 2017; 19. [PMID: 28994224 DOI: 10.1111/tid.12789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 06/19/2017] [Accepted: 06/21/2017] [Indexed: 11/26/2022]
Abstract
A 35-year-old woman with severe cystic fibrosis was admitted for sudden loss of strength in both legs, revealing a myelitis. The medullary lesion biopsy revealed phaeohyphomycosis caused by Cladophialophora species. Myelitis caused by Cladophialophora bantiana is a rare disease associated with high mortality.
Collapse
Affiliation(s)
- Quitterie Reynaud
- Cystic Fibrosis Adult Referral Care Center, Department of Internal Medicine, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | - Damien Dupont
- Institut de Parasitologie et de Mycologie médicale, Hospices Civils de Lyon, Lyon, France
| | - Raphaële Nove-Josserand
- Cystic Fibrosis Adult Referral Care Center, Department of Internal Medicine, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | - Stephane Durupt
- Cystic Fibrosis Adult Referral Care Center, Department of Internal Medicine, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | - Florence Persat
- Institut de Parasitologie et de Mycologie médicale, Hospices Civils de Lyon, Lyon, France
| | - Florence Ader
- Service de Maladie Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
| | | | - Isabelle Durieu
- Cystic Fibrosis Adult Referral Care Center, Department of Internal Medicine, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| |
Collapse
|
7
|
Tourret J, Benabdellah N, Drouin S, Charlotte F, Rottembourg J, Arzouk N, Fekkar A, Barrou B. Unique case report of a chromomycosis and Listeria in soft tissue and cerebellar abscesses after kidney transplantation. BMC Infect Dis 2017; 17:288. [PMID: 28427354 PMCID: PMC5397669 DOI: 10.1186/s12879-017-2386-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 04/06/2017] [Indexed: 01/23/2023] Open
Abstract
Background Chromomycosis is a rare mycotic infection encountered in tropical and subtropical regions. The disease presents as a slowly-evolving nodule that can become infected with bacteria. Here, we describe a unique association of abscesses caused by a chromomycosis and Listeria monocytogenes in a kidney transplant recipient, and didactically expose how the appropriate diagnosis was reached. Case presentation A 49-year old male originating from the Caribbean presented a scalp lesion which was surgically removed in his hometown where it was misdiagnosed as a sporotrichosis on histology, 3 years after he received a kidney transplant. He received no additional treatment and the scalp lesion healed. One year later, an abscess of each thigh due to both F. pedrosoi and L. monocytogenes was diagnosed in our institution. A contemporary asymptomatic cerebellar abscess was also found by systematic MRI. An association of amoxicillin and posaconazole allowed a complete cure of the patient without recurring to surgery. Histological slides from the scalp lesion were re-examined in our institution and we retrospectively concluded to a first localisation of the chromomycosis. We discuss the possible pathophysiology of this very unusual association. Conclusion In this case of disseminated listeriosis and chromomycosis, complete cure of the patients could be reached with oral anti-infectious treatment only.
Collapse
Affiliation(s)
- J Tourret
- Département d'Urologie, Néphrologie et Transplantation, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix. 47-83, Bd de l'Hôpital, 75013, Paris, France. .,Sorbonne Universités, UPMC Univ Paris 06, Paris, France. .,Sorbonne Paris Cité, Univ Paris Nord, IAME, INSERM UMR 1137, Paris, France.
| | - N Benabdellah
- Département d'Urologie, Néphrologie et Transplantation, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix. 47-83, Bd de l'Hôpital, 75013, Paris, France
| | - S Drouin
- Département d'Urologie, Néphrologie et Transplantation, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix. 47-83, Bd de l'Hôpital, 75013, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - F Charlotte
- Service d'Anatomie Cytologie Pathologique, Paris, France
| | - J Rottembourg
- Département d'Urologie, Néphrologie et Transplantation, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix. 47-83, Bd de l'Hôpital, 75013, Paris, France
| | - N Arzouk
- Département d'Urologie, Néphrologie et Transplantation, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix. 47-83, Bd de l'Hôpital, 75013, Paris, France
| | - A Fekkar
- Service de Parasitologie Mycologie, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, Paris, France.,INSERM U1135, CNRS ERL 8255, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - B Barrou
- Département d'Urologie, Néphrologie et Transplantation, AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix. 47-83, Bd de l'Hôpital, 75013, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| |
Collapse
|
8
|
Anesi JA, Baddley JW. Approach to the Solid Organ Transplant Patient with Suspected Fungal Infection. Infect Dis Clin North Am 2015; 30:277-96. [PMID: 26739603 DOI: 10.1016/j.idc.2015.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In solid organ transplant (SOT) recipients, invasive fungal infections (IFIs) are associated with significant morbidity and mortality. Detection of IFIs can be difficult because the signs and symptoms are similar to those of viral or bacterial infections, and diagnostic techniques have limited sensitivity and specificity. Clinicians must rely on knowledge of the patient's risk factors for fungal infection to make a diagnosis. The authors describe their approach to the SOT recipient with suspected fungal infection. The epidemiology of IFIs in the SOT population is reviewed, and a syndromic approach to suspected IFI in SOT recipients is described.
Collapse
Affiliation(s)
- Judith A Anesi
- Division of Infectious Diseases, University of Pennsylvania, 3400 Spruce Street, 3 Silverstein, Suite E, Philadelphia, PA 19104, USA
| | - John W Baddley
- Department of Medicine, University of Alabama at Birmingham, 1900 University Boulevard, 229 THT, Birmingham, AL 35294, USA; Medical Service, Birmingham VA Medical Center, 700 South 19th street, Birmingham, AL 35233, USA.
| |
Collapse
|
9
|
Chakrabarti A, Kaur H, Rudramurthy SM, Appannanavar SB, Patel A, Mukherjee KK, Ghosh A, Ray U. Brain abscess due toCladophialophora bantiana: a review of 124 cases. Med Mycol 2015; 54:111-9. [DOI: 10.1093/mmy/myv091] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 09/08/2015] [Indexed: 11/12/2022] Open
|
10
|
Abstract
Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes, including chromoblastomycosis, mycetoma, and phaeohyphomycosis. [corrected]. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease, melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years. The spectrum of diseases with which they are associated has also broadened and includes allergic disease, superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi. Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants. Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.
Collapse
|
11
|
Li DM, de Hoog GS. Cerebral phaeohyphomycosis--a cure at what lengths? THE LANCET. INFECTIOUS DISEASES 2009; 9:376-83. [PMID: 19467477 DOI: 10.1016/s1473-3099(09)70131-8] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cerebral phaeohyphomycosis is a fungal infection of the brain typically caused by Cladophialophora bantiana, Exophiala dermatitidis, and Rhinocladiella mackenziei, all of which belong to the order Chaetothyriales. The disease results in black, necrotic brain tissue, black pus, and black cerebrospinal fluid. Pathogens usually reach the brain through the bloodstream or lymphatic fluid and occasionally through direct spreading or accidental inoculation. Patients can present with hemiparesis, tonic spasm, headache, fever, sensory variation, cerebral irritation, and even psychotic behavioural changes. Radiological images are characterised by ring-enhanced signs and hyperdense and hypodense lesions. Pathological features frequently include black-to-brown necrotic tissue or dark-coloured pus, granulomatous inflammation, giant cell vasculitis, and pigmented fungal elements, which are easily seen on a direct potassium hydroxide smear, a rapid method for diagnosis. Black fungi can be cultured from a biopsy specimen. Combined antifungal chemotherapy, surgical debridement, and careful immunological interventions are strongly recommended to eradicate these intractable infections.
Collapse
Affiliation(s)
- Dong Ming Li
- Peking University Third Hospital, Beijing, China.
| | | |
Collapse
|
12
|
Post-transplant Colonization With Non-Aspergillus Molds and Risk of Development of Invasive Fungal Disease in Lung Transplant Recipients. J Heart Lung Transplant 2008; 27:850-5. [DOI: 10.1016/j.healun.2008.05.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 05/19/2008] [Accepted: 05/23/2008] [Indexed: 11/19/2022] Open
|
13
|
Central Nervous System Infections in Transplant Recipients by Cladophialophora bantiana. South Med J 2008; 101:292-6. [DOI: 10.1097/smj.0b013e318164e289] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
14
|
Abstract
Fungal infections in solid organ transplant recipients continue to be a significant cause of morbidity and mortality. Candida spp. and Aspergillus spp. account for most invasive fungal infections. The incidence of fungal infection varies with type of solid organ transplant. Liver transplant recipients have highest reported incidence of candida infections while lung transplant recipients have highest rate of Aspergillus infections. Recent epidemiological studies suggest the emergence of resistant strains of candida as well as mycelial fungi other than Aspergillus in these patients. The current review incorporates the recent changes in the epidemiology of fungal infections in solid organ transplant recipients and highlights the newer data on the diagnosis, prophylaxis and treatment of fungal infections in these patients.
Collapse
Affiliation(s)
- Fernanda P Silveira
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | | |
Collapse
|
15
|
Roche M, Redmond RM, O'Neill S, Smyth E. A case of multiple cerebral abscesses due to infection with Cladophialophora bantiana. J Infect 2005; 51:e285-8. [PMID: 15908005 DOI: 10.1016/j.jinf.2005.02.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Accepted: 02/28/2005] [Indexed: 10/25/2022]
Abstract
Cladophialophora bantiana is a highly neurotropic fungus which has been reported to cause a variety of infections in the immunocompromised and transplant populations. We describe a case of multiple cerebral abscesses caused by this dematiaceous fungus in a patient with probable Duncan's syndrome. The patient also had extensive extra-cerebral disease, which is unusual for infection with this organism. We discuss previously described cases of infection with Cladophialophora bantiana, and review the current and evolving treatment options.
Collapse
Affiliation(s)
- M Roche
- Department of Medical Microbiology, Beaumont Hospital, Dublin 9, Ireland.
| | | | | | | |
Collapse
|
16
|
Vishnoi S, Naidu J, Singh S, Vishnoi R. Pathogenicity of Curvularia geniculata ( C. senegalensis ) for albino rats: study of clinical isolate from blood of a cancer patient. J Mycol Med 2005. [DOI: 10.1016/j.mycmed.2005.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
17
|
Fischer L, Sterneck M. Invasive Pilzinfektionen bei Patienten nach Lebertransplantation. Invasive fungal infections in patients after liver transplantation. Mycoses 2005; 48 Suppl 1:27-35. [PMID: 15826284 DOI: 10.1111/j.1439-0507.2005.01107.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Advances in surgical technique, immunosuppression, and medical management have greatly improved clinical results after liver transplantation (LTx). Fungal infections in LTx-patients still represent serious complications and are associated with a significant decrease in survival. The majority of fungal infections in LTx-patients are caused by Candida species, which is explained by the major abdominal surgery. Aspergillus infections are second common, whereas other fungal infections such as pneumocystosis, cryptococcosis, or zygomycosis represent rare events. The high mortality of invasive fungal infections in LTx-recipients is explained by the severity of the underlying medical condition and by difficulties in diagnosis and medical therapy. Currently available diagnostic tests do not allow a timely and reliable diagnosis of invasive fungal infections in LTx-patients. Amphotericin B has been the standard treatment for invasive candidiasis and aspergillosis for many years but the high frequency of side effects limits its application. Fluconazole is widely used due to better tolerability and fewer drug interactions. Disadvantages are the lack of activity against Aspergillus species and the selection of resistant Candida strains. Progress is to be expected from new antimycotic agents belonging to azoles (voriconazole) and echinocandins (caspofungin) as these are less toxic and have a broad range of antimycotic activity. Analysis of prognostic factors allows identifying LTx-patients at high risk for invasive fungal infection. Antimycotic prophylaxis or pre-emptive therapy may improve clinical outcome in this patient subgroup.
Collapse
Affiliation(s)
- L Fischer
- Klinik für hepatobiliäre Chirurgie und viszerale Transplantation, Universitätsklinikum Hamburg Eppendorf, D-20246 Hamburg, Germany.
| | | |
Collapse
|
18
|
Levin TP, Baty DE, Fekete T, Truant AL, Suh B. Cladophialophora bantiana brain abscess in a solid-organ transplant recipient: case report and review of the literature. J Clin Microbiol 2004; 42:4374-8. [PMID: 15365048 PMCID: PMC516289 DOI: 10.1128/jcm.42.9.4374-4378.2004] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cerebral phaeohyphomycosis caused by Cladophialophora bantiana is a rare disease. We describe a heart and bilateral lung transplant recipient who was unsuccessfully treated for a C. bantiana brain abscess. This report compares the present case to those of other solid-organ transplant recipients with the same infection and to those of patients who did not receive transplants.
Collapse
Affiliation(s)
- Todd P Levin
- Department of Medicine, Temple University Hospital, Philadelphia, PA, USA.
| | | | | | | | | |
Collapse
|
19
|
Revankar SG, Sutton DA, Rinaldi MG. Primary Central Nervous System Phaeohyphomycosis: A Review of 101 Cases. Clin Infect Dis 2004; 38:206-16. [PMID: 14699452 DOI: 10.1086/380635] [Citation(s) in RCA: 240] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2003] [Accepted: 09/01/2003] [Indexed: 11/03/2022] Open
Abstract
Phaeohyphomycosis refers to infections caused by darkly pigmented fungi. These fungi rarely cause life-threatening disease. We reviewed 101 cases of culture-proven primary central nervous system phaeohyphomycosis reported in the English-language literature from 1966 to 2002. The most frequently isolated species was Cladophialophora bantiana. The next most frequent isolate was Ramichloridium mackenziei, seen exclusively in patients from the Middle East. More than one-half of the cases occurred in patients with no known underlying immunodeficiency. Mortality rates were high regardless of immune status. Therapy is not standardized, although the combination of amphotericin B, flucytosine, and itraconazole may improve survival rates. Newer azoles, such as voriconazole, also have a broad spectrum of activity against these fungi, although clinical experience is limited. Complete excision of brain lesions may provide better results than simple aspiration. An aggressive medical and surgical approach is warranted in treating these infections to optimize outcomes.
Collapse
Affiliation(s)
- Sanjay G Revankar
- Dallas Veterans Affairs Medical Center, University of Texas Southwestern Medical Center, Dallas, Texas 75216, USA.
| | | | | |
Collapse
|
20
|
Lee YM, Tambyah PA, Lee KH, Tan KC, Lim SG. Successful treatment of Xylohypha bantiana brain abscess mimicking invasive cerebral aspergillosis in a liver transplant recipient. J Infect 2003; 47:348-51. [PMID: 14556762 DOI: 10.1016/s0163-4453(03)00099-9] [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: 11/19/2022]
Abstract
Invasive aspergillosis is a highly lethal disease in immunocompromised hosts especially with central nervous system involvement. In a review of 2380 liver transplants performed over 14 years, 13 out of 15 fungal brain abscesses were due to Aspergillus species and only one patient survived [Arch Surg, 132 (1997) 304]. Dematiaceous fungi while less readily recognised, often have a more favorable outcome [Transplantation, 63 (1997) 160]. We report a Xylophypha bantiana cerebral abscess in a liver transplant recipient initially identified as a branching mould on histology that had a successful outcome due to aggressive appropriate treatment.
Collapse
Affiliation(s)
- Y M Lee
- Division of Gastroenterology, Department of Medicine, National University Hospital, Singapore, Singapore 119074.
| | | | | | | | | |
Collapse
|
21
|
Saberi H, Kashfi A, Hamidi S, Tabatabai SAF, Mansouri P. Cerebral phaeohyphomycosis masquerading as a parafalcian mass: case report. ACTA ACUST UNITED AC 2003; 60:354-9; discussion 359. [PMID: 14505864 DOI: 10.1016/s0090-3019(03)00135-6] [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] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cerebral phaeohyphomycosis caused by Fonsecaea pedrosoi is a rarity. However, about four cases have been reported in the literature. The disease remains mostly fatal despite employment of new treatment modalities. CASE An 18-year-old boy presented seizures of recent onset. Two years back, he developed cutaneous phaeohyphomycosis after a splinter scratch on his chest wall. Imaging revealed a contrast enhancing parafalcian solid mass. Right frontal parasagittal craniotomy was performed and the lesion resected as much as possible, followed by IV amphotericin B and oral itraconazole treatment. The patient has been doing well during a 15-month follow-up period. DISCUSSION Cerebral phaeohyphomycosis is an extremely rare lesion, which could masquerade as a parafalcian mass. Radical surgical removal together with antimicrobials remains the cornerstone treatment of cerebral phaeohyphomycosis.
Collapse
Affiliation(s)
- Hooshang Saberi
- Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | | |
Collapse
|
22
|
Raut A, Muzumdar D, Narlawar R, Nagar A, Ahmed N, Hira P. Cerebral abscess caused by Cladosporium bantianum infection--case report. Neurol Med Chir (Tokyo) 2003; 43:413-5. [PMID: 12968811 DOI: 10.2176/nmc.43.413] [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] Open
Abstract
A 26-year-old woman currently treated for systemic lupus erythematosus with steroid therapy presented with sudden onset of right hemiplegia. Computed tomography of the brain showed a large frontoparietal ring-enhanced lesion with perifocal edema. Stereotactic aspiration of the lesion revealed Cladosporium bantianum. The size of the abscess did not reduce in spite of optimum antifungal treatment. The abscess was subsequently excised through a frontoparietal craniotomy. At follow up after 24 months, there was no recurrence of the abscess. Cerebral Cladosporium bantianum infection is usually refractory to antifungal agents and the prognosis is very poor. This patient had the longest survival period in a case of Cladosporium brain abscess so far reported.
Collapse
Affiliation(s)
- Abhijit Raut
- Department of Radiology, Seth G.S. Medical College and King Edward VII Memorial Hospital, Parel, Mumbai, India.
| | | | | | | | | | | |
Collapse
|
23
|
Affiliation(s)
- Renu Mathew
- Department of Microbiology, SRI Ramachandra Medical College and Research Institute, Porur, Chennai--600 116, India
| | | | | |
Collapse
|
24
|
Keyser A, Schmid FX, Linde HJ, Merk J, Birnbaum DE. Disseminated Cladophialophora bantiana infection in a heart transplant recipient. J Heart Lung Transplant 2002; 21:503-5. [PMID: 11927230 DOI: 10.1016/s1053-2498(01)00357-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Cerebral phaeohyphomycosis caused by Cladophialophora bantiana, a dematiaceous fungus, is a rare disease. The majority of cases have been reported among immunocompetent patients; only 4 cases have been published that describe transplantation patients. The overall prognosis is poor. Surgical therapy in combination with chemotherapy with itraconazole is recommended. We report the case of a heart transplant recipient with cutaneous, cerebral, and lung manifestation of Cladophialophora bantiana who died despite surgical and systemic, high-dosage itraconazole treatment.
Collapse
Affiliation(s)
- Andreas Keyser
- Department of Cardiothoracic Surgery, University Hospital of Regensburg, Regensburg, Germany
| | | | | | | | | |
Collapse
|
25
|
Abstract
During the past two decades opportunistic fungal infections have emerged as important causes of morbidity and mortality in patients with severe underlying illnesses and compromised host defenses. While Aspergillus and Candida spp. collectively account for the majority of these infections, recent epidemiological trends indicate a shift towards infections by Aspergillus spp., nonalbicans Candida spp., as well as previously uncommon opportunistic fungi. Apart from an expanding number of different Zygomycetes, previously uncommon hyaline filamentous fungi (such as Fusarium species, Acremonium species, Paecilomyces species, Pseudallescheria boydii, and Scedosporium prolificans), dematiaceous filamentous fungi (such as Bipolaris species, Cladophialophora bantiana, Dactylaria gallopava, Exophiala species, and Alternaria species) and yeast-like pathogens (such as Trichosporon species, Blastoschizomyces capitatus, Malassezia species, Rhodotorula rubra and others) are increasingly encountered as causing life threatening invasive infections that are often refractory to conventional therapies. On the basis of past and current trends, the spectrum of fungal pathogens will continue to evolve in the settings of an expanding population of immunocompromised hosts, selective antifungal pressures, and shifting conditions in hospitals and the environment. An expanded and refined drug arsenal, further elucidation of pathogenesis and resistance mechanisms, establishment of in vitro/in vivo correlations, incorporation of pharmacodynamics, combination- and immunotherapies offer hope for substantial progress in prevention and treatment.
Collapse
Affiliation(s)
- A H Groll
- Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD 20892, USA.
| | | |
Collapse
|
26
|
Sood P, Dogra V, Thakur A, Mishra B, Mandal A, Sinha S. Brain abscess due to Xylohypha bantiana. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 2002; 32:708-9. [PMID: 11200391 DOI: 10.1080/003655400459720] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A case of brain abscess due to Xylohypha bantiana without any obvious predisposing factors and with the uncommon clinical feature of seizures is presented.
Collapse
Affiliation(s)
- P Sood
- Department of Microbiology, G. B. Pant Hospital, New Delhi, India
| | | | | | | | | | | |
Collapse
|
27
|
Kanj SS, Amr SS, Roberts GD. Ramichloridium mackenziei brain abscess: report of two cases and review of the literature. Med Mycol 2001; 39:97-102. [PMID: 11270415 DOI: 10.1080/mmy.39.1.97.102] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
We report two cases of brain abscesses caused by Ramichloridium mackenziei, a neurotropic dematiaceous fungus that seems to be geographically restricted to the Middle East. One of the patients had chronic myelomonocytic leukemia but did not receive any chemotherapeutic agents. The other patient was a normal host. Both cases had a fatal outcome despite aggressive antifungal therapy and surgical intervention. Herein, we review all previously described cases in the literature, and discuss the epidemiology, mycology and histopathology of this life-threatening organism.
Collapse
Affiliation(s)
- S S Kanj
- Department of Internal Medicine, American University of Beirut Medical Center, Lebanon
| | | | | |
Collapse
|
28
|
|
29
|
Walsh TJ, Groll AH. Emerging fungal pathogens: evolving challenges to immunocompromised patients for the twenty-first century. Transpl Infect Dis 1999; 1:247-61. [PMID: 11428996 DOI: 10.1034/j.1399-3062.1999.010404.x] [Citation(s) in RCA: 223] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Opportunistic fungi have emerged during the past decade as important causes of morbidity and mortality in immunocompromised patients. Candida species constitute the third to fourth most common causes of nosocomial blood stream infections, and Aspergillus species have emerged as the most common infectious cause of pneumonic mortality in bone marrow/stem cell transplant recipients. Among HIV-infected patients, meningoencephalitis due to Cryptococcus neoformans ranks among the most common AIDS-defining infections. Hyaline septated filamentous fungi, such as Fusarium species, Acremonium species, Paecilomyces species, and Trichoderma species, are increasingly reported as causing invasive mycoses refractory to conventional therapy. Dematiaceous septated filamentous fungi, such as Pseudallescheria boydii, Bipolaris species, and Cladophialophora bantiana cause pneumonia, sinusitis, and CNS infection unresponsive to current therapy. An increasing number of different members of the class of Zygomycetes are reported as causing lethal infections, despite aggressive medical and surgical interventions. Yet the treatment for zygomycosis has not changed in approximately 40 years. The prevalence of the endemic mycoses, such as those due to Penicillium marneffei, Coccidioides immitis, and Histoplasma capsulatum, has been reported to expand rapidly in response to environmental exposures and increased numbers of vulnerable hosts in endemic regions of the world. Dermatophytoses are occurring with increasing prevalence and morbidity in elderly and immunocompromised patients. As we enter the next millennium, we may anticipate that emergent fungal infections will continue to develop in the settings of permissive environmental conditions, selective antifungal pressure, and an expanding population of immunocompromised hosts.
Collapse
Affiliation(s)
- T J Walsh
- Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland 20892, USA.
| | | |
Collapse
|
30
|
Abstract
We present a case of cutaneous infection due to Cladophialophora bantiana, an agent of phaeohyphomycosis. The patient developed a nodule with pustule formation on the dorsum of the left hand; no trauma was reported. The lesion was successfully treated with itraconazole and surgical excision. Histopathologically, there was a blastomycosis-like tissue reaction pattern. Pigmented organisms were readily identified in tissue sections, and the cultural characteristics were those of Cladophialophora bantiana. This organism, known primarily for intracerebral involvement, can rarely produce cutaneous and subcutaneous infection. Immunosuppression should be suspected but is not always clinically apparent, as was demonstrated by our case.
Collapse
Affiliation(s)
- J W Patterson
- Department of Pathology, University of Virginia Medical Center, Charlottesville 22908, USA.
| | | | | |
Collapse
|
31
|
Guppy KH, Thomas C, Thomas K, Anderson D. Cerebral Fungal Infections in the Immunocompromised Host: A Literature Review and a New Pathogen-Chaetomium atrobrunneum: Case Report. Neurosurgery 1998. [DOI: 10.1227/00006123-199812000-00122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
32
|
Guppy KH, Thomas C, Thomas K, Anderson D. Cerebral fungal infections in the immunocompromised host: a literature review and a new pathogen--Chaetomium atrobrunneum: case report. Neurosurgery 1998; 43:1463-9. [PMID: 9848862 DOI: 10.1097/00006123-199812000-00122] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE AND IMPORTANCE A case of a cerebral abscess, occurring in a patient who had undergone bone marrow transplant, caused by a new pathogen, Chaetomium atrobrunneum, and a review of the literature are presented. Although Aspergillus species are by far the most common fungi found in cerebral abscesses in immunocompromised patients, an increasing number of fungi commonly found in nature but not usually associated with infections in humans have been isolated from cerebral abscesses in these patients. CLINICAL PRESENTATION A 31-year-old male patient, who had undergone a recent bone marrow transplantation for multiple myeloma, presented 3 months after transplantation with right-sided hemiplegia caused by a left parietal hemorrhagic lesion. INTERVENTION A biopsy guided by computed tomography showed that the abscess contained the fungus C. atrobrunneum. The final identification of the organism was based on cultures, scanning electron microscopic studies, and consultation with the Fungus Testing Laboratory at the University of Texas Health Science Center, San Antonio, TX. The patient was treated with several antifungal medications but developed uncontrolled cerebral edema, which led to further neurological deterioration and eventual death. CONCLUSION Cerebral abscesses in the immunocompromised patient may no longer be assumed to be caused solely by Aspergillus species. The literature reveals several rare cases of uncommon fungi found in these abscesses. Only four cases of cerebral infections caused by the genus Chaetomium have been reported. The case presented represents the first time a patient who had undergone a bone marrow transplant with a cerebral abscess was found to be caused by the pathogen C. atrobrunneum.
Collapse
Affiliation(s)
- K H Guppy
- Department of Neurosurgery, Loyola University Medical Center, Marywood, Illinois 60153, USA
| | | | | | | |
Collapse
|
33
|
JACYK W, BRUYN J, HOLM N, GRYFFENBERG H, KARUSSEIT V. Cutaneous infection due to Cladophialophora bantiana in a patient receiving immunosuppressive therapy. Br J Dermatol 1997. [DOI: 10.1111/j.1365-2133.1997.tb14960.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
34
|
JACYK W, DU BRUYN J, HOLM N, GRYFFENBERG H, KARUSSEIT V. Cutaneous infection due to Cladophialophora bantiana
in a patient receiving immunosuppressive therapy. Br J Dermatol 1997. [DOI: 10.1046/j.1365-2133.1997.d01-1216.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
35
|
Salama AD, Rogers T, Lord GM, Lechler RI, Mason PD. Multiple Cladosporium brain abscesses in a renal transplant patient: aggressive management improves outcome. Transplantation 1997; 63:160-2. [PMID: 9000680 DOI: 10.1097/00007890-199701150-00030] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Infection remains one of the major complications of nonspecific immunosuppression in renal transplant patients and accounts for significant morbidity and mortality. The incidence of infectious complications has been shown to be related to the degree of immunosuppression and correlated with the total steroid dosage, use of antilymphocyte serum, and number of rejection episodes. We present the case of a patient who received a large cumulative immunosuppressive load as treatment for her original disease and for numerous rejection episodes following renal transplantation, and who later developed multiple brain abscesses. These were shown to be due to the saprophytic black fungus Cladosporium bantianum. This case emphasizes the importance of aggressively pursuing the diagnosis in immunosuppressed individuals--appropriate treatment may be instituted early and may save lives. There have been no previous cases of patients surviving this condition without neurosurgical resection of the lesions.
Collapse
Affiliation(s)
- A D Salama
- Renal Unit and Department of Infectious Disease, Hammersmith Hospital, London, UK
| | | | | | | | | |
Collapse
|
36
|
Walz R, Bianchin M, Chaves M, Cerski M, Severo L, Londero A. Cerebral phaeohyphomycosis caused byCladophialophora bantianain a Brazilian drug abuser. Med Mycol 1997. [DOI: 10.1080/02681219780001541] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
37
|
Abstract
Solid-organ transplantation is a therapeutic option for many human diseases. Infections are a major complication of solid-organ transplantation. All candidates should undergo a thorough infectious-disease screening prior to transplantation. There are three time frames, influenced by surgical factors, the level of immunosuppression, and environmental exposures, during which infections of specific types most frequently occur posttransplantation. Most infections during the first month are related to surgical complications. Opportunistic infections typically occur from the second to the sixth month. During the late posttransplant period (beyond 6 months), transplantation recipients suffer from the same infections seen in the general community. Opportunistic bacterial infections seen in transplant recipients include those caused by Legionella spp., Nocardia spp., Salmonella spp., and Listeria monocytogenes. Cytomegalovirus is the most common cause of viral infections. Herpes simplex virus, varicella-zoster virus, Epstein-Barr virus and others are also significant pathogens. Fungal infections, caused by both yeasts and mycelial fungi, are associated with the highest mortality rates. Mycobacterial, pneumocystis, and parasitic diseases may also occur.
Collapse
Affiliation(s)
- R Patel
- Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
| | | |
Collapse
|
38
|
Brenner SA, Morgan J, Rickert PD, Rimland D. Cladophialophora bantiana isolated from an AIDS patient with pulmonary infiltrates. JOURNAL OF MEDICAL AND VETERINARY MYCOLOGY : BI-MONTHLY PUBLICATION OF THE INTERNATIONAL SOCIETY FOR HUMAN AND ANIMAL MYCOLOGY 1996; 34:427-9. [PMID: 8971633 DOI: 10.1080/02681219680000751] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cladophialophora bantiana causes a rare phaeohyphomycosis, usually manifested by brain abscesses but rarely by skin or pulmonary lesions. It has not been reported as a common colonizer or as a cause of pulmonary symptoms in patients with AIDS. We present a case in which C. bantiana was repeatedly isolated from the sputum of a patient with AIDS having pulmonary infiltrates.
Collapse
Affiliation(s)
- S A Brenner
- Division of Infectious Disease, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | | |
Collapse
|
39
|
Buxi TB, Prakash K, Vohra R, Bhatia D. Imaging in phaeohyphomycosis of the brain: case report. Neuroradiology 1996; 38:139-41. [PMID: 8692424 DOI: 10.1007/bf00604800] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A case of multiple, conglomerated brain abscesses due to Xylohypha bantiana, with unique imaging features, is presented. This is the first culture-proven case of brain infection due to this fungus in the neuroimaging literature.
Collapse
Affiliation(s)
- T B Buxi
- New Delhi Scan Research Institute, Sir Ganga Ram Hospital, India
| | | | | | | |
Collapse
|
40
|
Kralovic SM, Rhodes JC. Phaeohyphomycosis caused by Dactylaria (human dactylariosis): report of a case with review of the literature. J Infect 1995; 31:107-13. [PMID: 8666840 DOI: 10.1016/s0163-4453(95)92060-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Phaeohyphomycosis due to Dactylaria (Ochroconis) spp. is a rare infection of man. It was first reported in 1986. All patients have had significant immunosuppression. To our knowledge, this is the second case of phaeohyphomycosis caused by Dactylaria constricta var. gallopava in a liver transplant patient and it developed even though he had been receiving fungal prophylaxis with fluconazole. Moreover, this case may represent nosocomial acquisition. In addition, we have reviewed the English language literature of previously reported patients with phaeohyphomycosis caused by Dactylaria spp.
Collapse
Affiliation(s)
- S M Kralovic
- Department of Internal Medicine, University of Cincinnati College of Medicine, Ohio, USA
| | | |
Collapse
|
41
|
Türker A, Altinörs N, Aciduman A, Demiralp O, Uluoglu U. MRI findings and encouraging fluconazole treatment results of intracranial Cladosporium trichoides infection. Infection 1995; 23:60-2. [PMID: 7744496 DOI: 10.1007/bf01710062] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The authors report on a 31-year-old male patient harboring multiple intracranial mass lesions which proved histologically to be due to infection with Cladosporium trichoides upon removal of one of the lesions. Aggressive antifungal chemotherapy with fluconazole (400 mg/d for 3 months) in combination with surgery resulted in good clinical and radiologic outcome which prompted us to report this case.
Collapse
Affiliation(s)
- A Türker
- Clinic of Neurosurgery, Social Security Hospital, Ankara, Turkey
| | | | | | | | | |
Collapse
|
42
|
Matsumoto T, Ajello L, Matsuda T, Szaniszlo PJ, Walsh TJ. Developments in hyalohyphomycosis and phaeohyphomycosis. JOURNAL OF MEDICAL AND VETERINARY MYCOLOGY : BI-MONTHLY PUBLICATION OF THE INTERNATIONAL SOCIETY FOR HUMAN AND ANIMAL MYCOLOGY 1994; 32 Suppl 1:329-49. [PMID: 7722796 DOI: 10.1080/02681219480000951] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|