1
|
Watanabe M, Okuda R, Ishida Y, Sagawa S, Muraoka T, Ikeda S, Sawazumi T, Takemura T, Hagiwara E, Ogura T. Hypersensitivity pneumonitis with Paecilomyces as suspected inciting antigen. Respir Med Case Rep 2024; 49:102013. [PMID: 38559328 PMCID: PMC10975500 DOI: 10.1016/j.rmcr.2024.102013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
A 73-year-old man visited our hospital for persistent cough. Chest high-resolution CT (HRCT) showed infiltration shadows in lower lobes and diffuse ground glass opacities in the upper lobes. Blood tests showed elevated white blood cell, C-reactive protein, surfactant protein D, and Krebs von den Lungen-6 levels. After an antigen avoidance test, his HRCT and blood test findings improved; we diagnosed him with hypersensitivity pneumonitis (HP). A culture of the rotting interior walls within his home revealed Paecilomyces, which we believe caused his HP. Given the few patients with Paecilomyces-induced HP, systematic approach was important to identify the inciting antigen.
Collapse
Affiliation(s)
- Masayuki Watanabe
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Ryo Okuda
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Yuriko Ishida
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Shinobu Sagawa
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Tatsuya Muraoka
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Satoshi Ikeda
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Tomoe Sawazumi
- Department of Pathology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Tamiko Takemura
- Department of Pathology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Eri Hagiwara
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan
| |
Collapse
|
2
|
Pechacek J, Webb T, Ferré EMN, Schmitt MM, DiMaggio T, Kobrin D, Rajasimhan S, Colton B, Lewis RE, Andes D, Herrera A, Hammoud D, Seyedmousavi S, Hasni S, Bolaños J, Afzali B, Lionakis MS. Successful Treatment of Paecilomyces variotii Pneumonia and Lupus Nephritis With Posaconazole-Cyclophosphamide Co-administration Without Drug Interaction-Induced Toxicity. Open Forum Infect Dis 2023; 10:ofad410. [PMID: 37564740 PMCID: PMC10411043 DOI: 10.1093/ofid/ofad410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023] Open
Abstract
Paecilomyces variotii is an opportunistic mold that causes pulmonary infections in immunosuppressed humans that are often treated with triazole therapy. Lupus nephritis is a major cause of progressive kidney disease in patients with systemic lupus erythematosus, often requiring cyclophosphamide-based therapies. Triazole-cyclophosphamide co-administration is challenging as triazoles increase cyclophosphamide concentrations, which can worsen cyclophosphamide toxicity. We describe herein a patient with Paecilomyces variotii pneumonia and concomitant lupus nephritis who was successfully treated with posaconazole and echinocandin-bridged interruptions to allow for cyclophosphamide therapy. This regimen was well-tolerated without cyclophosphamide toxicity and achieved improvements in both fungal pneumonia and renal function.
Collapse
Affiliation(s)
- Joseph Pechacek
- Fungal Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Taura Webb
- Fungal Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Kidney Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Elise M N Ferré
- Fungal Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Monica M Schmitt
- Fungal Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Thomas DiMaggio
- Fungal Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Dale Kobrin
- Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Disease, National Institutes of Health, Bethesda, Maryland, USA
| | - Suraj Rajasimhan
- Pharmacy Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Ben Colton
- Pharmacy Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Russell E Lewis
- Dipartimento di Medicine Molecolare, University of Padua, Padua, Italy
| | - David Andes
- Division of Infectious Diseases, Department of Medical Microbiology and Immunology, Department of Medicine, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Alejandro Herrera
- Virtua Infectious Disease, Virtua Voorhees, Virtua Medical Group, Vorhees, New Jersey, USA
| | - Dima Hammoud
- Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - Seyedmojtaba Seyedmousavi
- Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Sarfaraz Hasni
- Lupus Clinical Trials Unit, National Institute of Arthritis and Musculoskeletal and Skin Disease, National Institutes of Health, Bethesda, Maryland, USA
| | - Jonathan Bolaños
- Kidney Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Behdad Afzali
- Kidney Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Michail S Lionakis
- Fungal Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
3
|
Non- Aspergillus Hyaline Molds: A Host-Based Perspective of Emerging Pathogenic Fungi Causing Sinopulmonary Diseases. J Fungi (Basel) 2023; 9:jof9020212. [PMID: 36836326 PMCID: PMC9964096 DOI: 10.3390/jof9020212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
The incidence of invasive sino-pulmonary diseases due to non-Aspergillus hyaline molds is increasing due to an enlarging and evolving population of immunosuppressed hosts as well as improvements in the capabilities of molecular-based diagnostics. Herein, we review the following opportunistic pathogens known to cause sinopulmonary disease, the most common manifestation of hyalohyphomycosis: Fusarium spp., Scedosporium spp., Lomentospora prolificans, Scopulariopsis spp., Trichoderma spp., Acremonium spp., Paecilomyces variotii, Purpureocillium lilacinum, Rasamsonia argillacea species complex, Arthrographis kalrae, and Penicillium species. To facilitate an understanding of the epidemiology and clinical features of sino-pulmonary hyalohyphomycoses in the context of host immune impairment, we utilized a host-based approach encompassing the following underlying conditions: neutropenia, hematologic malignancy, hematopoietic and solid organ transplantation, chronic granulomatous disease, acquired immunodeficiency syndrome, cystic fibrosis, and healthy individuals who sustain burns, trauma, or iatrogenic exposures. We further summarize the pre-clinical and clinical data informing antifungal management for each pathogen and consider the role of adjunctive surgery and/or immunomodulatory treatments to optimize patient outcome.
Collapse
|
4
|
Salah H, Houbraken J, Boekhout T, Almaslamani M, Taj-Aldeen SJ. Molecular epidemiology of clinical filamentous fungi in Qatar beyond Aspergillus and Fusarium with notes on the rare species. Med Mycol 2023; 61:6967136. [PMID: 36592959 PMCID: PMC9874029 DOI: 10.1093/mmy/myac098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/12/2022] [Accepted: 12/30/2022] [Indexed: 01/04/2023] Open
Abstract
Due to an increasing number of patients at risk (i.e., those with a highly compromised immune system and/or receiving aggressive chemotherapy treatment), invasive fungal infections (IFI) are increasingly being reported and associated with high mortality rates. Aspergillus spp., particularly A. fumigatus, is the major cause of IFI caused by filamentous fungi around the world followed by Fusarium spp., however, other fungi are emerging as human pathogens. The aim of this study was to explore the epidemiology and prevalence of the non-Aspergillus and non-Fusarium filamentous fungi in human clinical samples over an 11-year period in Qatar using molecular techniques. We recovered 53 filamentous fungal isolates from patients with various clinical conditions. Most patients were males (75.5%), 9.4% were immunocompromised, 20.7% had IFI, and 11.3% died within 30 days of diagnosis. The fungal isolates were recovered from a variety of clinical samples, including the nasal cavity, wounds, respiratory samples, body fluids, eye, ear, tissue, abscess, and blood specimens. Among the fungi isolated, 49% were dematiaceous fungi, followed by Mucorales (30%), with the latter group Mucorales being the major cause of IFI (5/11, 45.5%). The current study highlights the epidemiology and spectrum of filamentous fungal genera, other than Aspergillus and Fusarium, recovered from human clinical samples in Qatar, excluding superficial infections, which can aid in the surveillance of uncommon and emerging mycoses.
Collapse
Affiliation(s)
- Husam Salah
- To whom correspondence should be addressed. Husam Salah, M.Sc. Division
of Microbiology, Department of Laboratory Medicine and Pathology, Hamad Medical
Corporation, Doha, Qatar, PO Box 3050. Tel: +97-444-391-047. E-mail: ;
| | - Jos Houbraken
- Applied and Industrial Mycology, Westerdijk Fungal Biodiversity
Institute, Utrecht, Netherlands
| | - Teun Boekhout
- Yeast Research, Westerdijk Fungal Biodiversity Institute,
Utrecht, Netherlands,Institute of Biodiversity and Ecosystem Dynamics (IBED), University of
Amsterdam, Amsterdam, The
Netherlands
| | | | - Saad J Taj-Aldeen
- Division of Microbiology, Department of Laboratory Medicine and
Pathology, Hamad Medical Corporation, Doha,
Qatar,Department of Biology, College of Science, University of
Babylon, Hilla, Iraq
| |
Collapse
|
5
|
Species Identification and In Vitro Antifungal Susceptibility of Paecilomyces/Purpureocillium Species Isolated from Clinical Respiratory Samples: A Multicenter Study. J Fungi (Basel) 2022; 8:jof8070684. [PMID: 35887446 PMCID: PMC9321559 DOI: 10.3390/jof8070684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/01/2022] [Accepted: 06/23/2022] [Indexed: 02/01/2023] Open
Abstract
Paecilomyces spp. are emerging fungal pathogens, where Paecilomyces lilacinus and Paecilomyces variotii are the most reported species. Taxonomic and phylogenetic revisions in this genus have shown that P. variotii represents a species complex, whereas P. lilacinus is related to another genus called Purpureocillium. The aims of this study were to identify clinical isolates of Paecilomyces spp. at the species level, and to determine their antifungal susceptibility profiles. 70 clinical Paecilomyces spp. isolates were identified by MALDI-TOF Mass Spectrometry (MS) and by multilocus rDNA genes sequencing including ITS and the D1/D2 genes. Among the 70 Paecilomyces spp. isolates, 28 were identified as P. lilacinum, 26 as P. variotii stricto sensu, and 16 as P. maximus. For antifungal susceptibility testing, Minimal Inhibitory Concentrations (MICs) or Minimal Effective Concentrations (MECs) were determined for 8 antifungals. All P. lilacinum isolates had high MICs and MECs of amphotericin B and echinocandins, respectively, unlike P. variotii and P. maximus. For azole drugs, MICs were molecule- and species- dependent. The differences in in vitro susceptibility to antifungals underline the importance of accurate species identification. The MALDI–TOF MS can be a good alternative in routine laboratory to ensure fast identification of Paecilomyces spp. and P. lilacinum.
Collapse
|
6
|
Bupha-Intr O, Butters C, Reynolds G, Kennedy K, Meyer W, Patil S, Bryant P, Morrissey CO. Consensus guidelines for the diagnosis and management of invasive fungal disease due to moulds other than Aspergillus in the haematology/oncology setting, 2021. Intern Med J 2021; 51 Suppl 7:177-219. [PMID: 34937139 DOI: 10.1111/imj.15592] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Invasive fungal disease (IFD) due to moulds other than Aspergillus is a significant cause of mortality in patients with malignancies or post haemopoietic stem cell transplantation. The current guidelines focus on the diagnosis and management of the common non-Aspergillus moulds (NAM), such as Mucorales, Scedosporium species (spp.), Lomentospora prolificans and Fusarium spp. Rare but emerging NAM including Paecilomyces variotii, Purpureocillium lilacinum and Scopulariopsis spp. are also reviewed. Culture and histological examination of tissue biopsy specimens remain the mainstay of diagnosis, but molecular methods are increasingly being used. As NAM frequently disseminate, blood cultures and skin examination with biopsy of any suspicious lesions are critically important. Treatment requires a multidisciplinary approach with surgical debridement as a central component. Other management strategies include control of the underlying disease/predisposing factors, augmentation of the host response and the reduction of immunosuppression. Carefully selected antifungal therapy, guided by susceptibility testing, is critical to cure. We also outline novel antifungal agents still in clinical trial which offer substantial potential for improved outcomes in the future. Paediatric recommendations follow those of adults. Ongoing epidemiological research, improvement in diagnostics and the development of new antifungal agents will continue to improve the poor outcomes that have been traditionally associated with IFD due to NAM.
Collapse
Affiliation(s)
- Olivia Bupha-Intr
- Department of Infection Services, Wellington Regional Hospital, Wellington, New Zealand
| | - Coen Butters
- Department of General Paediatric and Adolescent Medicine, John Hunter Children's Hospital, Newcastle, New South Wales, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Gemma Reynolds
- Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia
| | - Karina Kennedy
- Department of Infectious Diseases and Microbiology, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia.,ANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Research and Education Network, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Sushrut Patil
- Malignant Haematology and Stem Cell Transplantation Service, Department of Clinical Haematology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Penelope Bryant
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Infectious Diseases, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Catherine O Morrissey
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.,Department of Infectious Diseases, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | | |
Collapse
|
7
|
Sprute R, Salmanton-García J, Sal E, Malaj X, Falces-Romero I, Hatvani L, Heinemann M, Klimko N, López-Soria L, Meletiadis J, Shruti M, Steinmann J, Seidel D, Cornely OA, Stemler J. Characterization and outcome of invasive infections due to Paecilomyces variotii: analysis of patients from the FungiScope® registry and literature reports. J Antimicrob Chemother 2021; 76:765-774. [PMID: 33254240 PMCID: PMC7879145 DOI: 10.1093/jac/dkaa481] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/26/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives To provide a basis for clinical management decisions in Paecilomyces variotii infection. Methods Unpublished cases of invasive P. variotii infection from the FungiScope® registry and all cases reported in the literature were analysed. Results We identified 59 cases with P. variotii infection. Main baseline factors were presence of indwelling devices in 29 cases (49.2%), particularly peritoneal catheters (33.9%) and prosthetic heart valves (10.2%), haematological or oncological diseases in 19 (32.2%), major surgery in 11 (18.6%), and diabetes mellitus in 10 cases (16.9%). The most prevalent infection sites were peritoneum (n = 20, 33.3%) and lungs (n = 16, 27.1%). Pain and fever were frequent (n = 35, 59.3% and n = 33, 55.9%, respectively). Diagnosis was established by culture in 58 cases (98.3%). P. variotii caused breakthrough infection in 8 patients. Systemic antifungals were given in 52 patients (88.1%). Amphotericin B was administered in 39, itraconazole in 15, and posaconazole in 8 patients. Clinical isolates were frequently resistant to voriconazole, whereas the above-mentioned antifungals showed good in vitro activity. Infections of the blood and CNS caused high mortality. Overall mortality was 28.8% and death was attributed to P. variotii in 10 cases. Conclusions P. variotii causes life-threatening infections, especially in immunocompromised and critically ill patients with indwelling devices. Patients undergoing peritoneal dialysis are at particular risk. Multidisciplinary management is paramount, including molecular techniques for diagnosis and treatment with efficacious systemic antifungals. Amphotericin B, itraconazole and posaconazole are regarded as treatments of choice. Combination with flucytosine may be considered. Surgical debridement and removal of indwelling devices facilitate favourable outcome.
Collapse
Affiliation(s)
- Rosanne Sprute
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Ertan Sal
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Xhorxha Malaj
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Iker Falces-Romero
- Clinical Microbiology and Parasitology Department, University Hospital La Paz, Madrid, Spain
| | - Lóránt Hatvani
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Melina Heinemann
- Division of Infectious Diseases, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nikolai Klimko
- Department of Clinical Mycology, Allergy and Immunology, North Western State Medical University, St Petersburg, Russia
| | - Leyre López-Soria
- Clinical Microbiology Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain
| | - Joseph Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Malik Shruti
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Joerg Steinmann
- Institute for Clinical Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Medical University, Nuremberg Hospital, Nuremberg, Germany
| | - Danila Seidel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany.,University of Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany
| | - Jannik Stemler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| |
Collapse
|
8
|
Asif AA, Roy M, Ahmad S. Paecilomyces Pneumonia Despite Voriconazole Prophylaxis: A Case Report and Literature Review. Eur J Case Rep Intern Med 2021; 8:002651. [PMID: 34268271 PMCID: PMC8276918 DOI: 10.12890/2021_002651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 11/05/2022] Open
Abstract
Paecilomyces species are a rare cause of fungal pulmonary infections in immunocompromised hosts. Paecilomyces variotii and Paecilomyces lilacinus are the two most common species of clinical significance. Both species differ in their susceptibility to antifungal agents. We present a rare case of a 47-year-old immunocompromised woman who developed Paecilomyces pneumonia despite being on voriconazole prophylaxis. We also present a review of the literature on other reported cases. LEARNING POINTS Paecilomyces species differ in their susceptibility to antifungal agents.Breakthrough invasive mould infections are increasingly being documented in immunocompromised patients on voriconazole prophylaxis.Posaconazole has been shown to be effective against both Paecilomyces species.
Collapse
Affiliation(s)
- Abuzar A Asif
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, OSF Saint Francis Medical Center, Peoria, USA
| | - Moni Roy
- Department of Internal Medicine, University of Illinois College of Medicine at Peoria, OSF Saint Francis Medical Center, Peoria, USA
| | - Sharjeel Ahmad
- Section of Infectious Diseases, University of Illinois College of Medicine at Peoria, OSF Saint Francis Medical Center, Peoria, USA
| |
Collapse
|
9
|
Chen C, Fu R, Wang J, Li X, Chen X, Li Q, Lu D. Genome sequence and transcriptome profiles of pathogenic fungus Paecilomyces penicillatus reveal its interactions with edible fungus Morchella importuna. Comput Struct Biotechnol J 2021; 19:2607-2617. [PMID: 34025947 PMCID: PMC8120865 DOI: 10.1016/j.csbj.2021.04.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 12/15/2022] Open
Abstract
Paecilomyces penicillatus is one of the pathogens of morels, which greatly affects the yield and quality of Morchella spp.. In the present study, we de novo assembled the genome sequence of the fungus P. penicillatus SAAS_ppe1. We analyzed the transcriptional profile of P. penicillatus SAAS_ppe1 infection of Morchella importuna at different stages (3 days and 6 days after infection) and the response of M. importuna using the transcriptome. The assembled genome sequence of P. penicillatus SAAS_ppe1 was 39.78 Mb in length (11 scaffolds; scaffold N50, 6.50 Mb), in which 99.7% of the expected genes were detected. A total of 7.48% and 19.83% clean transcriptional reads from the infected sites were mapped to the P. penicillatus genome at the early and late stages of infection, respectively. There were 3,943 genes differently expressed in P. penicillatus at different stages of infection, of which 24 genes had increased expression with the infection and infection stage, including diphthamide biosynthesis, aldehyde reductase, and NAD (P)H-hydrate epimerase (P < 0.05). Several genes had variable expression trends at different stages of infection, indicating P. penicillatus had diverse regulation patterns to infect M. importuna. GO function, involving cellular components, and KEGG pathways, involving glycerolipid metabolism, and plant-pathogen interaction were significantly enriched during infection by P. penicillatus. The expression of ten genes in M. importuna increased during the infection and infection stage, and these may regulate the response of M. importuna to P. penicillatus infection. This is the first comprehensive study on P. penicillatus infection mechanism and M. importuna response mechanism, which will lay a foundation for understanding the fungus-fungus interactions, gene functions, and variety breeding of pathogenic and edible fungi.
Collapse
Affiliation(s)
- Cheng Chen
- Institute of Plant Protection, Sichuan Academy of Agricultural Sciences, Key Laboratory of Integrated Pest Management on Crops in Southwest, Ministry of Agriculture, Chengdu, PR China
| | - Rongtao Fu
- Institute of Plant Protection, Sichuan Academy of Agricultural Sciences, Key Laboratory of Integrated Pest Management on Crops in Southwest, Ministry of Agriculture, Chengdu, PR China
| | - Jian Wang
- Institute of Plant Protection, Sichuan Academy of Agricultural Sciences, Key Laboratory of Integrated Pest Management on Crops in Southwest, Ministry of Agriculture, Chengdu, PR China
| | - Xingyue Li
- Institute of Plant Protection, Sichuan Academy of Agricultural Sciences, Key Laboratory of Integrated Pest Management on Crops in Southwest, Ministry of Agriculture, Chengdu, PR China
| | - Xiaojuan Chen
- Institute of Plant Protection, Sichuan Academy of Agricultural Sciences, Key Laboratory of Integrated Pest Management on Crops in Southwest, Ministry of Agriculture, Chengdu, PR China
| | - Qiang Li
- Key Laboratory of Coarse Cereal Processing, Ministry of Agriculture and Rural Affairs, School of Food and Biological Engineering, Chengdu University, Chengdu, PR China
| | - Daihua Lu
- Institute of Plant Protection, Sichuan Academy of Agricultural Sciences, Key Laboratory of Integrated Pest Management on Crops in Southwest, Ministry of Agriculture, Chengdu, PR China
| |
Collapse
|
10
|
Criado PR, Belda Junior W, da Matta VLR. First report of cutaneous mycetoma by Paecilomyces variotii and the successful treatment with combined itraconazole and terbinafine along with resection surgeries. Australas J Dermatol 2021; 62:e397-e399. [PMID: 33759175 DOI: 10.1111/ajd.13592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/09/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022]
Abstract
Mycetoma is a progressively mutilating infectious disease of the subcutaneous tissue that affects the skin and deep structures, which is poorly responsive to chemotherapy. Here, we report a skin mycetoma caused by Paecilomyces variotii, an uncommon fungus of human infections, and the therapeutic approach that resulted in a complete cure of the patient.
Collapse
Affiliation(s)
- Paulo Ricardo Criado
- Laboratory of Pathology of Infectious Diseases (LIM-50), Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,Dermatology Service of Faculdade de Medicina do ABC, Universidade do ABC, Santo André, Sao Paulo, Brazil
| | - Walter Belda Junior
- Laboratory of Pathology of Infectious Diseases (LIM-50), Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,Department of Dermatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Vania Lucia Ribeiro da Matta
- Laboratory of Pathology of Infectious Diseases (LIM-50), Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.,Department of Pathology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
11
|
Chandorkar A, Simkins J. Emerging Fungal Cutaneous Infections in Immunocompromised Patients. CURRENT FUNGAL INFECTION REPORTS 2020. [DOI: 10.1007/s12281-020-00395-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
12
|
Lazarus JE, Branda JA, Gandhi RG, Barshak MB, Zachary KC, Barczak AK. Disseminated Intravascular Infection Caused by Paecilomyces variotii: Case Report and Review of the Literature. Open Forum Infect Dis 2020; 7:ofaa166. [PMID: 32617367 PMCID: PMC7314584 DOI: 10.1093/ofid/ofaa166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/07/2020] [Indexed: 11/14/2022] Open
Abstract
Paecilomyces variotii is a ubiquitous environmental saprophyte with worldwide distribution. Commonly found in soil and decomposing organic material [1, 2], P. variotii can also be isolated from drinking water [3] and indoor and outdoor air [4-6]. In immunocompetent hosts, P. variotii has been reported as a cause of locally invasive disease including prosthetic valve endocarditis [7, 8], endophthalmitis [9, 10], rhinosinusitis [11, 12], and dialysis-associated peritonitis [13, 14]. In contrast, disseminated infections are more commonly reported in immunocompromised patients, including those with chronic granulomatous disease [15], solid malignancy [16], acute leukemia [17], lymphoma [18], multiple myeloma [19], and after stem cell transplant for myelodysplasia [20]. In 1 case series examining invasive infections by non-Aspergillus molds, P. variotii was the most common cause after Fusarium spp. [21]. Here, we present the case of an immunocompetent patient with extensive intravascular infection involving prosthetic material. We describe successful induction therapy with combination antifungals and extended suppression with posaconazole with clinical quiescence and eventual normalization of serum fungal biomarkers.
Collapse
Affiliation(s)
- Jacob E Lazarus
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - John A Branda
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Ronak G Gandhi
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Miriam B Barshak
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kimon C Zachary
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Amy K Barczak
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- The Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| |
Collapse
|
13
|
Abstract
The study of hospital wastewater (HWW) microbiology is important to understand the pollution load, growth of particular pathogenic microbes, shift and drift in microbial community, development and spread of antibiotic resistance in microbes, and subsequent change in treatment efficiencies. This chapter investigates the potential microbes such as bacteria, viruses, fungi, and parasites present in HWW along with the diseases associated and methods of treatment used. Due to the indiscriminate release of antibiotics from hospitals, HWW serves as a hotspot for emergence of antibiotic-resistance genes (ARGs) and antibiotic-resistance bacteria. This chapter discusses the ARGs occurrence in HWW, their prevalence in the environment, the molecular tools used for identification, and different mechanisms of horizontal gene transfer. Thus better understanding of the microbiology of HWW could further help in development of advanced treatment technologies for effective removal of microbes and their bioproducts (toxins and infectious nucleic acid) from HWW and contaminated water.
Collapse
|
14
|
Stemler J, Salmanton-García J, Seidel D, Alexander BD, Bertz H, Hoenigl M, Herbrecht R, Meintker L, Meißner A, Mellinghoff SC, Sal E, Zarrouk M, Koehler P, Cornely OA. Risk factors and mortality in invasive Rasamsonia spp. infection: Analysis of cases in the FungiScope ® registry and from the literature. Mycoses 2019; 63:265-274. [PMID: 31769549 DOI: 10.1111/myc.13039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/19/2019] [Accepted: 11/22/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND The new Rasamsonia spp. complex can develop invasive infection in immunosuppression or chronic pulmonary disease. It has potential to be misidentified as other genera due to morphological similarities. Nowadays, there is a gap of knowledge on this fungi. OBJECTIVES To provide knowledge base of risk factors and therapeutic decisions in invasive Rasamsonia spp. complex infection. PATIENTS/METHODS Cases of invasive infection due to Rasamsonia spp. (formerly Geosmithia/Penicillium spp.) from FungiScope® registry and all reported cases from a literature were included. RESULTS We identified 23 invasive infections due to Rasamsonia spp., six (26.1%) in the FungiScope® registry. Main risk factors were chronic granulomatous disease (n = 12, 52.2%), immunosuppressive treatment (n = 10, 43.5%), haematopoietic stem cell transplantation (n = 7, 30.4%), graft-versus-host disease and major surgery (n = 4, 17.4%, each). Predominantly affected organs were the lungs (n = 21, 91.3%), disease disseminated in seven cases (30.4%). Fungal misidentification occurred in 47.8% (n = 11), and sequencing was used in 69.6% of the patients (n = 16) to diagnose. Breakthrough infection occurred in 13 patients (56.5%). All patients received antifungal treatment, mostly posaconazole (n = 11), caspofungin (n = 10) or voriconazole (n = 9). Combination therapy was administered in 13 patients (56.5%). Susceptibility testing showed high minimum inhibitory concentrations for azoles and amphotericin B, but not for echinocandins. No preferable treatment influencing favourable outcome was identified. Overall mortality was 39% (n = 9). CONCLUSION Rasamsonia spp. are emerging fungi causing life-threatening infections, especially in immunocompromised and critically ill patients. Mortality is high. Treatment is challenging and clinicians dealing with this patient population should become aware of this infection constituting a medical emergency.
Collapse
Affiliation(s)
- Jannik Stemler
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), partner site Bonn - Cologne, Cologne, Germany
| | - Jon Salmanton-García
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Danila Seidel
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Barbara D Alexander
- Infectious Diseases Division, Duke University Medical Center, Durham, NC, USA
| | - Hartmut Bertz
- Department of Internal Medicine I, Medical Center of Freiburg University, Faculty of Medicine, Freiburg University, Freiburg, Germany
| | - Martin Hoenigl
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA.,Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Raoul Herbrecht
- Department of Oncology and Hematology, Hôpitaux Universitaires de Strasbourg and Université de Strasbourg, Inserm, UMR-S1113/IRFAC, Strasbourg, France
| | - Lisa Meintker
- Department of Medicine 5 for Hematology and Oncology, Erlangen University Hospital, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Arne Meißner
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Department of Hospital Hygiene and Infection Control, University Hospital of Cologne, Cologne, Germany
| | - Sibylle C Mellinghoff
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), partner site Bonn - Cologne, Cologne, Germany
| | - Ertan Sal
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Marouan Zarrouk
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), partner site Bonn - Cologne, Cologne, Germany
| | - Philipp Koehler
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Oliver A Cornely
- Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), European Diamond Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,German Centre for Infection Research (DZIF), partner site Bonn - Cologne, Cologne, Germany.,Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
| |
Collapse
|
15
|
Nematollahi S, Shoham S. Updates on the Treatment of Non-Aspergillus Hyaline Mold Infections. CURRENT FUNGAL INFECTION REPORTS 2019. [DOI: 10.1007/s12281-019-00364-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
16
|
Marques DP, Carvalho J, Rocha S, Domingos R. A Case of Pulmonary Mycetoma Caused by Paecilomyces variotii. Eur J Case Rep Intern Med 2019; 6:001040. [PMID: 30931270 PMCID: PMC6432827 DOI: 10.12890/2019_001040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 01/09/2019] [Indexed: 11/29/2022] Open
Abstract
Fungal infections caused by Paecilomyces species are rare. Although most cases of human infection occur in immunocompromised patients, this species is also being increasingly recognized as a pathogen in immunocompetent individuals. Paecilomyces variotii and P. lilacinus are the most common pathogens in humans. P. variotii infection usually manifests as peritonitis, pneumonia or endophthalmitis. We present the case of an 84-year-old immunocompromised patient with interstitial lung disease, who developed pulmonary mycetoma with isolation of P. variotii in bronchoalveolar lavage fluid culture. We found one similar case in the literature, but Paecilomyces species was not identified. Therefore, this is the first described case of pulmonary mycetoma caused by P. variotii.
Collapse
Affiliation(s)
| | - Joana Carvalho
- Pulmonology Department, Hospital de Egas Moniz, Lisbon, Portugal
| | - Sara Rocha
- Internal Medicine Department, Hospital de Egas Moniz, Lisbon, Portugal
| | - Raquel Domingos
- Internal Medicine Department, Hospital de Egas Moniz, Lisbon, Portugal
| |
Collapse
|
17
|
Urquhart AS, Mondo SJ, Mäkelä MR, Hane JK, Wiebenga A, He G, Mihaltcheva S, Pangilinan J, Lipzen A, Barry K, de Vries RP, Grigoriev IV, Idnurm A. Genomic and Genetic Insights Into a Cosmopolitan Fungus, Paecilomyces variotii (Eurotiales). Front Microbiol 2018; 9:3058. [PMID: 30619145 PMCID: PMC6300479 DOI: 10.3389/fmicb.2018.03058] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/27/2018] [Indexed: 02/02/2023] Open
Abstract
Species in the genus Paecilomyces, a member of the fungal order Eurotiales, are ubiquitous in nature and impact a variety of human endeavors. Here, the biology of one common species, Paecilomyces variotii, was explored using genomics and functional genetics. Sequencing the genome of two isolates revealed key genome and gene features in this species. A striking feature of the genome was the two-part nature, featuring large stretches of DNA with normal GC content separated by AT-rich regions, a hallmark of many plant-pathogenic fungal genomes. These AT-rich regions appeared to have been mutated by repeat-induced point (RIP) mutations. We developed methods for genetic transformation of P. variotii, including forward and reverse genetics as well as crossing techniques. Using transformation and crossing, RIP activity was identified, demonstrating for the first time that RIP is an active process within the order Eurotiales. A consequence of RIP is likely reflected by a reduction in numbers of genes within gene families, such as in cell wall degradation, and reflected by growth limitations on P. variotii on diverse carbon sources. Furthermore, using these transformation tools we characterized a conserved protein containing a domain of unknown function (DUF1212) and discovered it is involved in pigmentation.
Collapse
Affiliation(s)
- Andrew S Urquhart
- School of BioSciences, University of Melbourne, Melbourne, VIC, Australia
| | - Stephen J Mondo
- U.S. Department of Energy Joint Genome Institute, Walnut Creek, CA, United States
| | - Miia R Mäkelä
- Department of Microbiology, Faculty of Agriculture and Forestry, Viikki Biocenter 1, University of Helsinki, Helsinki, Finland
| | - James K Hane
- CCDM Bioinformatics, Centre for Crop and Disease Management, Curtin University, Bentley, WA, Australia.,Curtin Institute for Computation, Curtin University, Bentley, WA, Australia
| | - Ad Wiebenga
- Fungal Physiology, Westerdijk Fungal Biodiversity Institute and Fungal Molecular Physiology, Utrecht University, Utrecht, Netherlands
| | - Guifen He
- U.S. Department of Energy Joint Genome Institute, Walnut Creek, CA, United States
| | - Sirma Mihaltcheva
- U.S. Department of Energy Joint Genome Institute, Walnut Creek, CA, United States
| | - Jasmyn Pangilinan
- U.S. Department of Energy Joint Genome Institute, Walnut Creek, CA, United States
| | - Anna Lipzen
- U.S. Department of Energy Joint Genome Institute, Walnut Creek, CA, United States
| | - Kerrie Barry
- U.S. Department of Energy Joint Genome Institute, Walnut Creek, CA, United States
| | - Ronald P de Vries
- Fungal Physiology, Westerdijk Fungal Biodiversity Institute and Fungal Molecular Physiology, Utrecht University, Utrecht, Netherlands
| | - Igor V Grigoriev
- U.S. Department of Energy Joint Genome Institute, Walnut Creek, CA, United States
| | - Alexander Idnurm
- School of BioSciences, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
18
|
Dedeaux A, Grooters A, Wakamatsu-Utsuki N, Taboada J. Opportunistic Fungal Infections in Small Animals. J Am Anim Hosp Assoc 2018; 54:327-337. [DOI: 10.5326/jaaha-ms-6768] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Opportunistic fungal infections have long been recognized as rare causes of disease in immunocompetent dogs and cats. Recently, the escalating use of multiagent immunosuppression protocols (especially those that include cyclosporine) has resulted in an increased number of patients with opportunistic fungal infection encountered by small animal practitioners and has altered the typical case phenotype. Based on histologic and cytologic features such as pigmentation, hyphal diameter, and distribution in tissue, these opportunistic mycoses can be placed into categories such as phaeohyphomycosis, hyalohyphomycosis, and eumycotic mycetoma. This review aims to summarize the clinical presentations, methods for diagnosis, treatment recommendations, and prognosis for both immunocompetent and immunosuppressed patients with opportunistic fungal infections. An example case description is included to illustrate the most common current clinical presentation.
Collapse
Affiliation(s)
- Andrea Dedeaux
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| | - Amy Grooters
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| | - Nobuko Wakamatsu-Utsuki
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| | - Joseph Taboada
- From the Department of Veterinary Clinical Sciences (A.D., A.G., J.T.) and Department of Pathobiological Sciences (N.W-U.), Louisiana State University, Baton Rouge, Louisiana
| |
Collapse
|
19
|
Moreira DC, Oliveira MME, Borba CM. Human Pathogenic Paecilomyces from Food. Microorganisms 2018; 6:microorganisms6030064. [PMID: 29976858 PMCID: PMC6164242 DOI: 10.3390/microorganisms6030064] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/29/2018] [Accepted: 07/02/2018] [Indexed: 11/16/2022] Open
Abstract
Paecilomyces spp. and Byssochlamys spp. are heat-resistant fungi important to industry because they can cause food and beverage spoilage, incurring economic loss. The consequences of food or beverage fungal colonization is the loss of nutritional value, structure and taste, and the possibility of producing toxic secondary metabolites that may result in medical problems. Furthermore, these fungi can infect animals and humans and it is unknown if contaminated foods may be fomites. P. variotii is the principal agent of food spoilage or contamination and it is most frequently associated with human hyalohyphomycosis with clinical manifestations including peritonitis, cutaneous and disseminated infections, among others. Byssochlamys spp. had not been identified as a cause of systemic infection until the case of a dog with a fungal infection, after immunosuppressive therapy. P. variotii has clinical importance because it causes severe infection in immunosuppressed patients and also because the number of immunocompetent infected patients is increasing. This review draws attention to the ability of these species to grow at high temperatures, to colonize food products, and to cause human disease.
Collapse
Affiliation(s)
- Danielly C Moreira
- Laboratory of Taxonomy, Biochemistry and Bioprospecting of Fungi, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Av. Brasil, 4365, 21045-900 Rio de Janeiro, RJ, Brazil.
| | - Manoel M E Oliveira
- Laboratory of Mycology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365, 21045-900 Rio de Janeiro, RJ, Brazil.
| | - Cintia M Borba
- Laboratory of Taxonomy, Biochemistry and Bioprospecting of Fungi, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Av. Brasil, 4365, 21045-900 Rio de Janeiro, RJ, Brazil.
| |
Collapse
|
20
|
Eren D, Eroglu E, Ulu Kilic A, Atalay MA, Mumcu N, Sipahioglu MH, Canoz O, Koc AN, Oymak O. Cutaneous ulcerations caused by Paecilomyces variotii in a renal transplant recipient. Transpl Infect Dis 2018; 20:e12871. [PMID: 29512304 DOI: 10.1111/tid.12871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 10/06/2017] [Accepted: 12/03/2017] [Indexed: 01/12/2023]
Abstract
Skin infections caused by Paecilomyces species have been rarely described in patients with solid organ transplantation. Cutaneous manifestations are highly variable and include erythematous macules, nodules, pustules, and vesicular and necrotic lesions. The diagnosis of these infections is generally made by examination of a skin biopsy. Management of these fungal infections is difficult due to the immunocompromised state of the patients. Moreover, antifungal therapy and immunosuppressive drug interactions should be considered during treatment management. Herein, we reported a case of cellulitis caused by Paecilomyces variotii in a 56-year-old man who had undergone a kidney transplantation. Erythematous macular and nodular lesions on the left hand and left foot appeared first; within 2 months the skin lesions became ulcerated, hemorrhagic, and progressively painful and the patient was admitted to our hospital. The diagnosis was made by skin biopsy and tissue culture. The skin lesions resolved by the sixth week of the treatment with voriconazole.
Collapse
Affiliation(s)
- Davut Eren
- Department of Internal Medicine, Erciyes University Medical School, Kayseri, Turkey
| | - Eray Eroglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical School, Kayseri, Turkey
| | - Aysegul Ulu Kilic
- Department of Infectious Disease and Clinical Microbiology, Erciyes University Medical School, Kayseri, Turkey
| | - Mustafa Altay Atalay
- Department of Medical Microbiology, Erciyes University Medical School, Kayseri, Turkey
| | - Necati Mumcu
- Department of Infectious Disease and Clinical Microbiology, Erciyes University Medical School, Kayseri, Turkey
| | - Murat Hayri Sipahioglu
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical School, Kayseri, Turkey
| | - Ozlem Canoz
- Department of Pathology, Erciyes University Medical School, Kayseri, Turkey
| | - Ayse Nedret Koc
- Department of Medical Microbiology, Erciyes University Medical School, Kayseri, Turkey
| | - Oktay Oymak
- Division of Nephrology, Department of Internal Medicine, Erciyes University Medical School, Kayseri, Turkey
| |
Collapse
|
21
|
Borman AM, Fraser M, Palmer MD, Szekely A, Houldsworth M, Patterson Z, Johnson EM. MIC Distributions and Evaluation of Fungicidal Activity for Amphotericin B, Itraconazole, Voriconazole, Posaconazole and Caspofungin and 20 Species of Pathogenic Filamentous Fungi Determined Using the CLSI Broth Microdilution Method. J Fungi (Basel) 2017; 3:E27. [PMID: 29371545 PMCID: PMC5715917 DOI: 10.3390/jof3020027] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 05/23/2017] [Accepted: 05/24/2017] [Indexed: 01/21/2023] Open
Abstract
For filamentous fungi (moulds), species-specific interpretive breakpoints and epidemiological cut-off values (ECVs) have only been proposed for a limited number of fungal species-antifungal agent combinations, with the result that clinical breakpoints are lacking for most emerging mould pathogens. In the current study, we have compiled minimum inhibitory concentration (MIC) data for 4869 clinical mould isolates and present full MIC distributions for amphotericin B, itraconazole, voriconazole, posaconazole, and caspofungin with these isolates which comprise 20 species/genera. In addition, we present the results of an assessment of the fungicidal activity of these same five antifungal agents against a panel of 123 mould isolates comprising 16 of the same species.
Collapse
Affiliation(s)
- Andrew M Borman
- Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK.
| | - Mark Fraser
- Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK.
| | - Michael D Palmer
- Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK.
| | - Adrien Szekely
- Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK.
| | - Marian Houldsworth
- Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK.
| | - Zoe Patterson
- Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK.
| | - Elizabeth M Johnson
- Public Health England United Kingdom, Mycology Reference Laboratory, Myrtle Road, Bristol BS2 8EL, UK.
| |
Collapse
|
22
|
Paecilomyces variotii Fungemia in a Patient with Lymphoma Needing Liver Transplant. Mycopathologia 2017; 182:761-765. [DOI: 10.1007/s11046-017-0131-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 03/03/2017] [Indexed: 10/19/2022]
|
23
|
Uzunoglu E, Sahin AM. Paecilomyces variotii peritonitis in a patient on continuous ambulatory peritoneal dialysis. J Mycol Med 2017; 27:277-280. [PMID: 28363816 DOI: 10.1016/j.mycmed.2017.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 01/26/2017] [Accepted: 02/01/2017] [Indexed: 11/17/2022]
Abstract
Paecilomyces variotii (P. variotii) is an extremely rare cause of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. When diagnosed, it usually portends poor prognosis. Patient's survival depends on early laboratory diagnosis and proper treatment. We herein report a P. variotii peritonitis in a patient on CAPD which is a quite rare clinical entity. Laboratory diagnosis was confirmed via both morphological analysis and DNA sequencing. Antifungal susceptibility tests were performed and interpreted according to the Clinical Laboratory Standards Institute M38-A2 guidelines. After laboratory diagnosis, the patient was treated succesfully with liposomal amphotericin B and itraconazole combination and the peritoneal catheter was removed. This case is worthy of reporting since P. variotii is an uncommon cause of peritonitis and leads to dilemmas in both laboratory diagnosis and treatment strategies.
Collapse
Affiliation(s)
- E Uzunoglu
- Giresun University, Medical Faculty, Medical Microbiology Department, 28100 Giresun, Turkey.
| | - A M Sahin
- Ozdemir State Hospital, Infectious Disease and Clinical Microbiology Clinic, Giresun, Turkey
| |
Collapse
|