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Ituarte BE, Cañete-Gibas C, Wiederhold NP, Olarte L. Kneiffiella palmae: A non- Aspergillus fungal infection isolated from a pulmonary nodule in a child with chronic granulomatous disease. Med Mycol Case Rep 2023; 41:36-40. [PMID: 37706048 PMCID: PMC10495388 DOI: 10.1016/j.mmcr.2023.08.001] [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: 05/30/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 09/15/2023] Open
Abstract
We report the first known human case of Kneiffiella palmae in the medical literature. K. palmae was isolated from a pulmonary nodule in a 7-year-old male with chronic granulomatous disease. The mold was identified as K. palmae at a national reference laboratory, where 17 other human respiratory samples tested positive for K. palmae from 2013 to 2021. Optimal antimicrobial treatment is unknown, but azoles and amphotericin B demonstrated in vitro activity against each tested isolate.
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Affiliation(s)
- Bianca E. Ituarte
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, 64108, USA
| | - Connie Cañete-Gibas
- University of Texas Health Science Center at San Antonio Texas, 7703 Floyd Curl Drive, San Antonio, 78229, USA
| | - Nathan P. Wiederhold
- University of Texas Health Science Center at San Antonio Texas, 7703 Floyd Curl Drive, San Antonio, 78229, USA
| | - Liset Olarte
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, 64108, USA
- Children's Mercy Hospital, 2401 Gillham Road, Kansas City, 64108, USA
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2
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Shrivastava J, Shah K, Shah N. Chrysosporium: A rare cause of allergic fungal rhinosinusitis. INDIAN J PATHOL MICR 2023; 66:611-613. [PMID: 37530352 DOI: 10.4103/ijpm.ijpm_555_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Allergic fungal rhinosinusitis (AFRS) forms a significant group of patients presenting with the commonest health problem encountered in rhinology. Patients commonly present with typical symptoms of sinusitis, and the diagnosis is often made after imaging and/or intraoperatively. Infections caused by Chrysosporium species are very rare and are very rarely been reported to cause sinusitis in humans. Usually, human chrysosporial infections are mild and unmarked by symptoms. We report a rare case of allergic fungal sinusitis (AFS) caused by Chrysosporium species in a 41-year-old male with the history of diabetes mellitus.
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Affiliation(s)
- Juhi Shrivastava
- Department of Microbiology, Smt SMS Multispeciality Hospital, Ahmedabad, Gujarat, India
| | - Kinal Shah
- Department of Microbiology, Smt SMS Multispeciality Hospital, Ahmedabad, Gujarat, India
| | - Navin Shah
- Department of Microbiology, Smt SMS Multispeciality Hospital, Ahmedabad, Gujarat, India
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3
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Gamaletsou MN, Rammaert B, Brause B, Bueno MA, Dadwal SS, Henry MW, Katragkou A, Kontoyiannis DP, McCarthy MW, Miller AO, Moriyama B, Pana ZD, Petraitiene R, Petraitis V, Roilides E, Sarkis JP, Simitsopoulou M, Sipsas NV, Taj-Aldeen SJ, Zeller V, Lortholary O, Walsh TJ. Osteoarticular Mycoses. Clin Microbiol Rev 2022; 35:e0008619. [PMID: 36448782 PMCID: PMC9769674 DOI: 10.1128/cmr.00086-19] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Osteoarticular mycoses are chronic debilitating infections that require extended courses of antifungal therapy and may warrant expert surgical intervention. As there has been no comprehensive review of these diseases, the International Consortium for Osteoarticular Mycoses prepared a definitive treatise for this important class of infections. Among the etiologies of osteoarticular mycoses are Candida spp., Aspergillus spp., Mucorales, dematiaceous fungi, non-Aspergillus hyaline molds, and endemic mycoses, including those caused by Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides species. This review analyzes the history, epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, inflammatory biomarkers, diagnostic imaging modalities, treatments, and outcomes of osteomyelitis and septic arthritis caused by these organisms. Candida osteomyelitis and Candida arthritis are associated with greater events of hematogenous dissemination than those of most other osteoarticular mycoses. Traumatic inoculation is more commonly associated with osteoarticular mycoses caused by Aspergillus and non-Aspergillus molds. Synovial fluid cultures are highly sensitive in the detection of Candida and Aspergillus arthritis. Relapsed infection, particularly in Candida arthritis, may develop in relation to an inadequate duration of therapy. Overall mortality reflects survival from disseminated infection and underlying host factors.
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Affiliation(s)
- Maria N. Gamaletsou
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Blandine Rammaert
- Université de Poitiers, Faculté de médecine, CHU de Poitiers, INSERM U1070, Poitiers, France
| | - Barry Brause
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Marimelle A. Bueno
- Far Eastern University-Dr. Nicanor Reyes Medical Foundation, Manilla, Philippines
| | | | - Michael W. Henry
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Aspasia Katragkou
- Nationwide Children’s Hospital, Columbus, Ohio, USA
- The Ohio State University School of Medicine, Columbus, Ohio, USA
| | | | - Matthew W. McCarthy
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
| | - Andy O. Miller
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Zoi Dorothea Pana
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Ruta Petraitiene
- Weill Cornell Medicine of Cornell University, New York, New York, USA
| | | | - Emmanuel Roilides
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | | | - Maria Simitsopoulou
- Hippokration General Hospital, Aristotle University School of Health Sciences, Thessaloniki, Greece
- Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Nikolaos V. Sipsas
- Laiko General Hospital of Athens and Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Valérie Zeller
- Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France
| | - Olivier Lortholary
- Université de Paris, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Paris, France
- Institut Pasteur, Unité de Mycologie Moléculaire, CNRS UMR 2000, Paris, France
| | - Thomas J. Walsh
- Hospital for Special Surgery, Weill Cornell Medicine, New York, New York, USA
- Weill Cornell Medicine of Cornell University, New York, New York, USA
- New York Presbyterian Hospital, New York, New York, USA
- Center for Innovative Therapeutics and Diagnostics, Richmond, Virginia, USA
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4
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Disseminated Pulmonary Mycosis Caused by Candida tropicalis in an 11-Year-Old Male Patient with Chronic Granulomatous Disease. Case Rep Pediatr 2022; 2022:7089907. [PMID: 36193209 PMCID: PMC9526550 DOI: 10.1155/2022/7089907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/17/2022] [Accepted: 09/07/2022] [Indexed: 11/18/2022] Open
Abstract
Invasive fungal infection is a major threat to chronic granulomatous disease (CGD) patients. We present a rare case of invasive mycosis in a CGD boy. An 11-year-old preadolescent boy presented with fever, hypoxia, and dyspnea. Physical examination revealed left neck enlarged lymph nodes with healed scars. The chest revealed bilateral diminished air entry with bilateral coarse crackles. Peripheral blood leukocyte count was 28.260/μL with 84% neutrophil, 11% lymphocyte, and 4.4% monocyte. The patient's condition deteriorated regardless of the empirical antibacterial against MRSA and suspected tuberculosis. A sputum sample was submitted for mycological investigation, and budding yeasts with pseudohyphae were detected in the direct smear and were isolated in pure culture using Sabouraud agar. Candida tropicalis was identified from cultural and microscopic features and confirmed by the Vitek 2 automated system. This result confirmed the invasive mycosis, obviously due to the underlying primary immunodeficiency, chronic granulomatous disease (CGD). Amphotericin was added, and he also received IV methylprednisolone for seven days. The patient improved and was weaned off oxygen with no fever. However, the patient was referred to a higher center for further workup, which confirmed CGD's diagnosis. He is on the list for HLA-identical bone marrow transplantation (BMT).
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Matsuzaki T, Kasai H, Ikeda H, Tajiri Y, Suzuki K, Watanabe A, Kamei K, Urushibara T. Voriconazole treatment of pulmonary mycosis caused by Chrysosporium zonatum after treatment for pulmonary tuberculosis. Respirol Case Rep 2021; 9:e00763. [PMID: 33976892 PMCID: PMC8103074 DOI: 10.1002/rcr2.763] [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: 03/04/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 12/01/2022] Open
Abstract
Chrysosporium zonatum is a soil-dwelling fungus that rarely causes pulmonary infections, and a small number of cases have been reported to date. A 74-year-old man, who had previously been treated for tuberculosis, presented with symptoms of low-grade fever, anorexia, cough, and bloody sputum. Chest computed tomography (CT) showed a thick-walled cavitary lesion in the right upper lobe, in which there was a suspected mycotic mass. Initially, the patient was suspected to have chronic aspergillosis due to positive serum anti-Aspergillus antibodies. However, bronchoscopic culture revealed the growth of C. zonatum. Symptoms and imaging findings improved with administration of voriconazole for 18 months. Infection by C. zonatum is very rare and is difficult to differentiate from aspergillosis by clinical features. Clinicians should be aware of the possibility of coinfection with C. zonatum and Aspergillus sp. Voriconazole may be an effective treatment option.
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Affiliation(s)
- Takuya Matsuzaki
- Department of Respiratory MedicineKimitsu Chuo HospitalKisarazuJapan
| | - Hajime Kasai
- Department of Respiratory MedicineKimitsu Chuo HospitalKisarazuJapan
- Department of Respirology, Graduate School of MedicineChiba UniversityChibaJapan
- Health Professional Development CenterChiba University HospitalChibaJapan
| | - Hideki Ikeda
- Department of Respiratory MedicineKimitsu Chuo HospitalKisarazuJapan
| | - Yuki Tajiri
- Department of Respiratory MedicineKimitsu Chuo HospitalKisarazuJapan
| | - Kenichi Suzuki
- Department of Respiratory MedicineKimitsu Chuo HospitalKisarazuJapan
| | - Akira Watanabe
- Medical Mycology Research CenterChiba UniversityChibaJapan
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Gopal KA, Kalaivani V, Anandan H. Pulmonary Infection by Chrysosporium Species in a Preexisting Tuberculous Cavity. Int J Appl Basic Med Res 2020; 10:62-64. [PMID: 32002389 PMCID: PMC6967350 DOI: 10.4103/ijabmr.ijabmr_382_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/30/2019] [Accepted: 09/27/2019] [Indexed: 11/24/2022] Open
Abstract
We report a case of pulmonary disease due to Chrysosporium species in a preexisting tuberculous cavity in an immunocompromised male patient. The fungus was isolated from broncheoalveolar lavage fluid. The fungus was repeatedly isolated in culture, and the patient recovered with anti-tuberculosis treatment. Although the members of the genus Chrysosporium are common soil saprobes, they can occasionally cause systemic infections.
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Affiliation(s)
- K Ajay Gopal
- Department of Medicine, A. V. M. Hospital, Thoothukudi, Tamil Nadu, India
| | - V Kalaivani
- Department of Microbiology, Thoothukudi Medical College, Thoothukudi, Tamil Nadu, India
| | - Heber Anandan
- Department of Clinical Research, Dr. Agarwal's Health Care Limited, Tirunelveli, Tamil Nadu, India
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7
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Dincy PC, Meera T, Susanne PA, Promila RM. Disseminated cutaneous chrysosporium infection. Trop Doct 2019; 49:306-308. [PMID: 31179890 DOI: 10.1177/0049475519845779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cutaneous chrysosporium infection is extremely rare and underdiagnosed. We present an immunocompromised patient who presented with recurrent cutaneous abscesses. Histopathology of the abscess showed thick-walled conidia and septate fungal hyphae within the subcutis and fungal culture grew Chrysosporium species.
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Affiliation(s)
- Peter Cv Dincy
- Professor, Department of Dermatology, Venereology and Leprosy, Christian Medical College, Vellore, India
| | - Thomas Meera
- Professor, Department of Pathology, Christian Medical College, Vellore, India
| | - Pulimood A Susanne
- Professor, Department of Dermatology, Venereology and Leprosy, Christian Medical College, Vellore, India
| | - Raj M Promila
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
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8
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Deshmukh S, Verekar S, Chavan Y. Keratinophilic fungi from the vicinity of salt pan soils of Sambhar lake Rajasthan (India). J Mycol Med 2018; 28:457-461. [DOI: 10.1016/j.mycmed.2018.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/02/2018] [Accepted: 06/06/2018] [Indexed: 11/30/2022]
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9
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Pulmonary Infection Secondary to Chrysosporium zonatum in an Immunocompetent Man. Ann Am Thorac Soc 2018; 13:757-8. [PMID: 27144802 DOI: 10.1513/annalsats.201601-083le] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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10
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Lerm B, Kenyon C, Schwartz IS, Kroukamp H, de Witt R, Govender NP, de Hoog GS, Botha A. First report of urease activity in the novel systemic fungal pathogen Emergomyces africanus: a comparison with the neurotrope Cryptococcus neoformans. FEMS Yeast Res 2018; 17:4093074. [PMID: 28934415 DOI: 10.1093/femsyr/fox069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 08/22/2017] [Indexed: 12/23/2022] Open
Abstract
Cryptococcus neoformans is an opportunistic pathogen responsible for the AIDS-defining illness, cryptococcal meningitis. During the disease process, entry of cryptococcal cells into the brain is facilitated by virulence factors that include urease enzyme activity. A novel species of an Emmonsia-like fungus, recently named Emergomyces africanus, was identified as a cause of disseminated mycosis in HIV-infected persons in South Africa. However, in contrast to C. neoformans, the enzymes produced by this fungus, some of which may be involved in pathogenesis, have not been described. Using a clinical isolate of C. neoformans as a reference, the study aim was to confirm, characterise and quantify urease activity in E. africanus clinical isolates. Urease activity was tested using Christensen's urea agar, after which the presence of a urease gene in the genome of E. africanus was confirmed using gene sequence analysis. Subsequent evaluation of colorimetric enzyme assay data, using Michaelis-Menten enzyme kinetics, revealed similarities between the substrate affinity of the urease enzyme produced by E. africanus (Km ca. 26.0 mM) and that of C. neoformans (Km ca. 20.6 mM). However, the addition of 2.5 g/l urea to the culture medium stimulated urease activity of E. africanus, whereas nutrient limitation notably increased cryptococcal urease activity.
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Affiliation(s)
- Barbra Lerm
- Department of Microbiology, Stellenbosch University, Stellenbosch 7602, Western Cape, South Africa
| | - Chris Kenyon
- Sexually Transmitted Infection Unit, Institute of Tropical Medicine, 2000 Antwerp, Belgium.,Department of Medicine, University of Cape Town, Cape Town 7925, Western Cape, South Africa
| | - Ilan S Schwartz
- Epidemiology for Global Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium.,Rady College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P5, Canada
| | - Heinrich Kroukamp
- Department of Microbiology, Stellenbosch University, Stellenbosch 7602, Western Cape, South Africa
| | - Riaan de Witt
- Department of Microbiology, Stellenbosch University, Stellenbosch 7602, Western Cape, South Africa
| | - Nelesh P Govender
- Department of Medicine, University of Cape Town, Cape Town 7925, Western Cape, South Africa.,National Institute for Communicable Diseases, 2131 Johannesburg, South Africa
| | - G Sybren de Hoog
- CBS-KNAW Fungal Biodiversity Centre, 3508 AD, Utrecht, The Netherlands
| | - Alfred Botha
- Department of Microbiology, Stellenbosch University, Stellenbosch 7602, Western Cape, South Africa
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11
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Slack MA, Thomsen IP. Prevention of Infectious Complications in Patients With Chronic Granulomatous Disease. J Pediatric Infect Dis Soc 2018; 7:S25-S30. [PMID: 29746681 PMCID: PMC5946879 DOI: 10.1093/jpids/piy016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Chronic granulomatous disease (CGD) is a primary immunodeficiency that confers a markedly increased risk of bacterial and fungal infections caused by certain opportunistic pathogens. Current evidence supports the use of prophylactic antibacterial, antifungal, and immunomodulatory therapies designed to prevent serious or life-threatening infections in patients with CGD. In this review, we discuss current strategies for the prevention of infections in children and adults with CGD and the evidence that supports those strategies. In addition, we address current challenges and opportunities for future research in this important area.
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Affiliation(s)
- Maria A Slack
- Division of Allergy and Immunology, Department of Pediatrics, University of Rochester Medical Center and Golisano Children’s Hospital, New York
| | - Isaac P Thomsen
- Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee,Correspondence: I. P. Thomsen, MD, D-7235 MCN, 1161 21st Avenue, South Nashville, TN 37232-2581 ()
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12
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Inborn errors of immunity underlying fungal diseases in otherwise healthy individuals. Curr Opin Microbiol 2017; 40:46-57. [PMID: 29128761 DOI: 10.1016/j.mib.2017.10.016] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 10/20/2017] [Indexed: 01/02/2023]
Abstract
It has been estimated that there are at least 1.5 million fungal species, mostly present in the environment, but only a few of these fungi cause human disease. Most fungal diseases are self-healing and benign, but some are chronic or life-threatening. Acquired and inherited defects of immunity, including breaches of mucocutaneous barriers and circulating leukocyte deficiencies, account for most severe modern-day mycoses. Other types of infection typically accompany these fungal infections. More rarely, severe fungal diseases can strike otherwise healthy individuals. Historical reports of fungi causing chronic peripheral infections (e.g. affecting the nails, skin, hair), and invasive diseases (e.g. brain, lungs, liver), in otherwise healthy patients, can be traced back to the mid-20th century. These fungi typically cause endemic, but not epidemic diseases, are more likely to underlie sporadic than familial cases, and only threaten a small proportion of infected individuals. The basis of this 'idiosyncratic' susceptibility has long remained unexplained, but it has recently become apparent that 'idiopathic' fungal diseases, in children, teenagers, and even adults, may be caused by single-gene inborn errors of immunity. The study of these unusual primary immunodeficiencies (PIDs) has led to the identification of molecules and cells playing a crucial role in human host defenses against certain fungi at particular anatomic sites. A picture is emerging of inborn errors of IL-17 immunity selectively underlying chronic mucocutaneous candidiasis, with little inter-individual variability, and of inborn errors of CARD9 immunity underlying various life-threatening invasive fungal diseases, differing between patients.
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13
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Thanathanee O, Bhoomibunchoo C, Anutarapongpan O, Suwan-apichon O, Yospaiboon Y. Successful treatment of Chrysosporium keratitis with voriconazole. Int Med Case Rep J 2017; 10:93-95. [PMID: 28360537 PMCID: PMC5365330 DOI: 10.2147/imcrj.s131372] [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] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To report a patient with severe Chrysosporium keratitis successfully treated by voriconazole. METHOD Case report. RESULTS A 37-year-old healthy male presented with irritation, pain and reduced vision in his left eye after mud contamination. Examination demonstrated corneal stromal infiltration, endothelial plaque and hypopyon. Corneal scrapings demonstrated numerous septate hyphae, and specimen cultures were positive for Chrysosporium sp. The lesion did not respond to aggressive topical 5% natamycin, 0.15% topical amphotericin B and oral itraconazole. The patient was then treated by topical 1% voriconazole every hour. Intracameral and intrastromal voriconazole injections (50 μg/0.1 mL) were also undertaken. The keratitis was significantly improved after voriconazole. CONCLUSION To the best of the authors' knowledge, this is the first report on the use of voriconazole for Chrysosporium keratitis. Voriconazole may be an effective alternative to conventional antifungal agents in some cases of fungal keratitis. It should be considered before shifting to therapeutic keratoplasty.
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Affiliation(s)
- Onsiri Thanathanee
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chavakij Bhoomibunchoo
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Orapin Anutarapongpan
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Olan Suwan-apichon
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Yosanan Yospaiboon
- KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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14
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Incidence of Keratinophilic Fungi from the Selected Soils of Kaziranga National Park, Assam (India). Mycopathologia 2016; 182:371-377. [DOI: 10.1007/s11046-016-0083-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 10/24/2016] [Indexed: 10/20/2022]
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15
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Taj-Aldeen SJ, Rammaert B, Gamaletsou M, Sipsas NV, Zeller V, Roilides E, Kontoyiannis DP, Miller AO, Petraitis V, Walsh TJ, Lortholary O. Osteoarticular Infections Caused by Non-Aspergillus Filamentous Fungi in Adult and Pediatric Patients: A Systematic Review. Medicine (Baltimore) 2015; 94:e2078. [PMID: 26683917 PMCID: PMC5058889 DOI: 10.1097/md.0000000000002078] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Osteoarticular mycoses due to non-Aspergillus moulds are uncommon and challenging infections. A systematic literature review of non-Aspergillus osteoarticular mycoses was performed using PUBMED and EMBASE databases from 1970 to 2013. Among 145 patients were 111 adults (median age 48.5 [16-92 y]) and 34 pediatric patients (median age 7.5 [3-15 y]); 114 (79.7%) were male and 88 (61.9%) were immunocompromised. Osteomyelitis was due to direct inoculation in 54.5%. Trauma and puncture wounds were more frequent in children (73.5% vs 43.5%; P = 0.001). Prior surgery was more frequent in adults (27.7% vs 5.9%; P = 0.025). Vertebral (23.2%) and craniofacial osteomyelitis (13.1%) with neurological deficits predominated in adults. Lower limb osteomyelitis (47.7%) and knee arthritis (67.8%) were predominantly seen in children. Hyalohyphomycosis represented 64.8% of documented infections with Scedosporium apiospermum (33.1%) and Lomentospora prolificans (15.8%) as the most common causes. Combined antifungal therapy and surgery was used in 69% of cases with overall response in 85.8%. Median duration of therapy was 115 days (range 5-730). When voriconazole was used as single agent for treatment of hyalohyphomycosis and phaeohyphomycosis, an overall response rate was achieved in 94.1% of cases. Non-Aspergillus osteoarticular mycoses occur most frequently in children after injury and in adults after surgery. Accurate early diagnosis and long-course therapy (median 6 mo) with a combined medical-surgical approach may result in favorable outcome.
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Affiliation(s)
- Saad J Taj-Aldeen
- From the Mycology Unit, Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar (SJT-A); Center for Osteoarticular Mycoses, Hospital for Special Surgery (SJT-A, BR, MG, NVS, ER, AOM, VP, TJW, OL); International Osteoarticular Mycoses Study Consortium, NY (SJT-A, BR, MG, NVS, ER, AOM, VP, TJW, OL); Weill Cornell Medical College, Doha, Qatar (SJT-A); Université Paris-Descartes, Sorbonne Paris Cité, APHP, Service des Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Centre d'Infectiologie Necker-Pasteur, Institut Imagine (BR, OL); Institut Pasteur, Mycology Molecular Unit, Paris, France (BR, OL); Transplantation-Oncology Infectious Diseases Program, Department of Medicine, Weill Cornell Medical Center of Cornell University (MG, AOM, VP, TJW); Pediatrics, and Microbiology & Immunology, Weill Cornell Medical Center of Cornell University, New York, NY (MG, NVS, TJW); National and Kapodistrian University of Athens, Athens, Greece (MG, NVS); Osteoarticular Reference Center, Groupe Hospitalier Diaconesses-Croix Saint-Simon, Paris, France (VZ); Infectious Diseases Unit, Department of Pediatrics, Faculty of Medicine, Aristotle University, School of Health Sciences, and Hippokration Hospital, Thessaloniki, Greece (ER); and MD Anderson Cancer Center, Houston, TX (DPK)
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Suchonwanit P, Chaiyabutr C, Vachiramon V. Primary Cutaneous Chrysosporium Infection following Ear Piercing: A Case Report. Case Rep Dermatol 2015; 7:136-40. [PMID: 26269703 PMCID: PMC4519602 DOI: 10.1159/000436989] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Chrysosporium is a large genus of saprophytic fungi that is commonly found in the soil. Infection caused by this organism is rare in humans and typically occurs in immunocompromised patients. Primary cutaneous Chrysosporium infection is relatively rare and has been reported in a heart transplant patient. The prognosis is usually favorable, but very poor in the setting of persistent profound immunosuppression. We herein report a case of primary cutaneous Chrysosporium infection following ear piercing in an immunocompetent patient. It is important for clinicians to consider this condition in patients with slow-onset skin and soft tissue infection following cutaneous injury, even in an immunocompetent setting.
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Affiliation(s)
- Poonkiat Suchonwanit
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chayada Chaiyabutr
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Vasanop Vachiramon
- Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Kamath PM, Prasad V, Shenoy VS, Mukundan A, Shenoy S. Chrysosporium: an uncommon fungus in chronic rhinosinusitis. J Clin Diagn Res 2015; 9:MD01-2. [PMID: 25954641 DOI: 10.7860/jcdr/2015/11676.5688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/31/2015] [Indexed: 11/24/2022]
Abstract
Chronic rhinosinusitis is one of the commonest health problem encountered in rhinology. Of these allergic fungal rhinosinusitis forms a significant group of patients. Patients commonly present with typical symptoms of sinusitis and the diagnosis is often made after imaging and/or intraoperatively. We report a rare case of allergic fungal sinusitis (AFS) caused by Chrysosporium species in a 70-year-old male with no co-morbidities. The fungus was isolated from allergic mucin collected from the sinuses. Therapy with intravenous Voriconazole was given leading to good relief for the patient, and no recurrences have occurred till date. Infections caused by Chrysosporium species are very rare, and is very rarely been reported to cause sinusitis in humans.
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Affiliation(s)
- Panduranga M Kamath
- Professor, Department of Otorhinolaryngology, Head & Neck Surgery, Kasturba Medical College , Mangalore, Manipal University, India
| | - Vishnu Prasad
- Consultant, Department of Otorhinolaryngology, Head & Neck Surgery, Kasturba Medical College , Mangalore, Manipal University, India
| | - Vijendra S Shenoy
- Associate Professor, Department of Otorhinolaryngology, Head & Neck Surgery, Kasturba Medical College , Mangalore, Manipal University, India
| | - Aswin Mukundan
- Junior Resident, Department of Otorhinolaryngology, Head & Neck Surgery, Kasturba Medical College , Mangalore, Manipal University, India
| | - Suchithra Shenoy
- Associate Professor, Department of Microbiology, Kasturba Medical College , Mangalore, Manipal University, India
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Incidence of Keratinophilic Fungi from Selected Soils of Vidarbha Region of Maharashtra State, India. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/148970] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
One hundred and fifty samples were collected from eleven districts of Vidarbha region of Maharashtra state and screened for the presence of keratinophilic fungi using hair baiting technique for isolation. Seventy-one isolates were recovered and identified. The cultures were identified using macro- and micromorphological features. Their identification was also confirmed by the BLAST search of sequences of the ITS1-5.8S-ITS2 rDNA region against the NCBI/Genbank data and compared with deposited sequences for identification purpose. Thirteen species of eight genera were isolated, namely, Auxarthron conjugatum (2.00%), Chrysosporium indicum (14.00%), Chrysosporium evolceanui (2.66%), Chrysosporium tropicum (4.66%), Chrysosporium zonatum (1.33%), Chrysosporium state of Ctenomyces serratus (3.33%), Gymnascella dankaliensis (1.33%), Gymnascella hyalinospora (0.66%), Gymnoascoideus petalosporus (0.66%), Microsporum gypseum complex (9.33%), Trichophyton mentagrophytes (2.00%), T. terrestre (3.33%), and Uncinocarpus queenslandicus (2.00%). This study indicates that the soils of Vidarbha region of Maharashtra may be significant reservoirs of certain keratinophilic fungi.
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Suankratay C, Dhissayakamol O, Uaprasert N, Chindamporn A. Invasive pulmonary infection caused by Chrysosporium articulatum: the first case report. Mycoses 2014; 58:1-3. [PMID: 25366105 DOI: 10.1111/myc.12270] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/27/2022]
Abstract
Chrysosporium species, saprobic soil fungi, comprise more than 60 species. There is some confusion regarding the taxonomy and nomenclature between Chrysosporium and Emmonsia since the causative agents of adiaspiromycosis, the development of big thick-walled spores (adiaspores) in humans or animals, were previously thought to be Chrysosporium. Chrysosporium articulatum has never been reported to cause invasive infection in humans. We report herein the first case of invasive pulmonary infection caused by Chrysosporium articulatum in a 16-year-old man with acute T-cell lymphoblastic leukaemia. He was successfully treated with voriconazole.
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Affiliation(s)
- Chusana Suankratay
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Deshmukh SK, Verekar SA. Isolation of keratinophilic fungi from selected soils of Sanjay Gandhi National Park, Mumbai (India). J Mycol Med 2014; 24:319-27. [PMID: 25442920 DOI: 10.1016/j.mycmed.2014.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 06/16/2014] [Accepted: 08/17/2014] [Indexed: 11/16/2022]
Abstract
One hundred and twenty-five samples were collected from eight different sites in the vicinity of Sanjay Gandhi National Park (SGNP) and screened for the presence of keratinophilic fungi using hair baiting technique for isolation. Seventy-three isolates were recovered and identified. The cultures were identified using macro- and micro-morphological features. Their identification was also confirmed by the BLAST search of sequences of the ITS1-5.8S-ITS2 rDNA region against the NCBI/Genbank data and compared with deposited sequences for identification purpose. Thirteen species of nine genera were isolated viz. Aphanoascus durus (2.4%), Arthroderma corniculatum (1.6%), Auxarthron umbrinum (0.8%), Chrysosporium evolceanui (1.6%), Chrysosporium indicum (16.0%), Chrysosporium tropicum (2.4%), Chrysosporium zonatum (4.0%), Chrysosporium states of Arthroderma tuberculatum (0.8%), Chrysosporium state of Ctenomyces serratus (11.2%), Gymnascella dankaliensis (3.2%), Microsporum gypseum (12.0%), Myriodontium keratinophilum (0.8%) and Trichophyton mentagrophytes (1.6%). Representative of all thirteen species can release the protein in the range of 152.2-322.4 μg/mL in liquid media when grown on human hair in shake flask culture and also decompose 18.4-40.2% of human hair after four weeks of incubation. This study indicates that the soils of SGNP, Mumbai may be significant reservoirs of certain keratinophilic fungi. The keratinolytic activity of these fungi may be playing significant role in superficial infections to man and animals and recycling of keratinic material of this environment.
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Affiliation(s)
- S K Deshmukh
- Department of Natural Products, Piramal Enterprises Limited, 1, Nirlon Complex, Off Western Express Highway, Near NSE Complex, Goregaon (East), Mumbai 400 063, India.
| | - S A Verekar
- Department of Natural Products, Piramal Enterprises Limited, 1, Nirlon Complex, Off Western Express Highway, Near NSE Complex, Goregaon (East), Mumbai 400 063, India
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Koehler P, Tacke D, Cornely OA. Bone and joint infections by Mucorales, Scedosporium, Fusarium and even rarer fungi. Crit Rev Microbiol 2014; 42:158-71. [DOI: 10.3109/1040841x.2014.910749] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Philipp Koehler
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany,
- Center for Integrated Oncology CIO Köln/Bonn, Medical Faculty, University of Cologne, Cologne, Germany,
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Medical Faculty, University of Cologne, Cologne, Germany,
| | - Daniela Tacke
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany,
- Center for Integrated Oncology CIO Köln/Bonn, Medical Faculty, University of Cologne, Cologne, Germany,
| | - Oliver A. Cornely
- Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany,
- Center for Integrated Oncology CIO Köln/Bonn, Medical Faculty, University of Cologne, Cologne, Germany,
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Medical Faculty, University of Cologne, Cologne, Germany,
- Clinical Trials Centre Cologne, ZKS Köln, BMBF 01KN1106, Medical Faculty, University of Cologne, Cologne, Germany, and
- German Centre for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany
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Isolation and molecular identification of keratinophilic fungi from public parks soil in Shiraz, Iran. BIOMED RESEARCH INTERNATIONAL 2013; 2013:619576. [PMID: 23956993 PMCID: PMC3728497 DOI: 10.1155/2013/619576] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 06/27/2013] [Indexed: 11/17/2022]
Abstract
Introduction. Keratinophilic fungi are an important group of fungi that live in soil. The aim of this study was to isolate and identify keratinophilic fungi from the soil of different parks in Shiraz.
Materials and Methods. A total of 196 soil samples from 43 parks were collected. Isolation of the fungi was performed by hair bait technique. The isolated colonies were identified by morphologic feature of macro- and microconidia and molecular method, using DNA sequence analysis. ITS region of ribosomal DNA was amplified and the PCR products were sequenced. Results. 411 isolates from 22 genera were identified. Fusarium (23.8%), Chrysosporium (13.13%), Acremonium (12.65%), Penicillium (12.39%), Microsporum gypseum (1.94%), Bionectria ochroleuca (1.21%), Bipolaris spicifera (1.21%), Scedosporium apiospermum (0.82%), Phialophora reptans (0.82%), Cephalosporium curtipes (0.49%), Scedosporium dehoogii (0.24%), Ochroconis constricta (0.24%), Nectria mauritiicola (0.49%), Chaetomium (0.49%), Scopulariopsis (0.24%), Malbranchea (0.24%), and Tritirachium (0.24%) were the most important isolates. Most of the fungi were isolated from the soils with the PH range of 7 to 8. Conclusion. Our study results showed that many keratinophilic fungi isolated from the parks soil are important for public health and children are an important group at a high risk of being exposed to these fungi.
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Phylogeny of chrysosporia infecting reptiles: proposal of the new family Nannizziopsiaceae and five new species. Persoonia - Molecular Phylogeny and Evolution of Fungi 2013; 31:86-100. [PMID: 24761037 PMCID: PMC3904055 DOI: 10.3767/003158513x669698] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 04/22/2013] [Indexed: 11/30/2022]
Abstract
We have performed a phenotypic and phylogenetic study of a set of fungi, mostly of veterinary origin, morphologically similar to the Chrysosporium asexual morph of Nannizziopsis vriesii (Onygenales, Eurotiomycetidae, Eurotiomycetes, Ascomycota). The analysis of sequences of the D1-D2 domains of the 28S rDNA, including representatives of the different families of the Onygenales, revealed that N. vriesii and relatives form a distinct lineage within that order, which is proposed as the new family Nannizziopsiaceae. The members of this family show the particular characteristic of causing skin infections in reptiles and producing hyaline, thin- and smooth-walled, small, mostly sessile 1-celled conidia and colonies with a pungent skunk-like odour. The phenotypic and multigene study results, based on ribosomal ITS region, actin and β-tubulin sequences, demonstrated that some of the fungi included in this study were different from the known species of Nannizziopsis and Chrysosporium and are described here as new. They are N. chlamydospora, N. draconii, N. arthrosporioides, N. pluriseptata and Chrysosporium longisporum. Nannizziopsis chlamydospora is distinguished by producing chlamydospores and by its ability to grow at 5 °C. Nannizziopsis draconii is able to grow on bromocresol purple-milk solids-glucose (BCP-MS-G) agar alkalinizing the medium, is resistant to 0.2 % cycloheximide but does not grow on Sabouraud dextrose agar (SDA) with 3 % NaCl. Nannizziopsis arthrosporioides is characterised by the production of very long arthroconidia. Nannizziopsis pluriseptata produces 1- to 5-celled sessile conidia, alkalinizes the BCP-MS-G agar and grows on SDA supplemented with 5 % NaCl. Chrysosporium longisporum shows long sessile conidia (up to 13 μm) and does not produce lipase.
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Invasive fungal infection in chronic granulomatous disease: insights into pathogenesis and management. Curr Opin Infect Dis 2013; 25:658-69. [PMID: 22964947 DOI: 10.1097/qco.0b013e328358b0a4] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW Invasive fungal infections (IFIs) remain a major cause of death in patients with chronic granulomatous disease (CGD). We discuss the new insights into the pathogenesis, diagnosis, prevention, and management of invasive fungal infections in patients with CGD. RECENT FINDINGS CGD has the highest prevalence of IFIs among the immunodeficiencies. Infections typically involve the lung, and the most commonly isolated pathogen is Aspergillus spp. However, IFIs due to rare opportunistic filamentous fungi are increasingly reported. Most IFIs are diagnosed on routine chest imaging, and serum markers such as galactomannan and 1,3-β-D-glucan are of limited value in CGD. Routine use of itraconazole for prophylaxis continues to be recommended, although posaconazole may be an alternative. Management of IFIs is typically centered on prolonged courses of antifungal therapy. Surgery may be required for complete resolution, especially in the setting of osteomyelitis or infections due to Aspergillus nidulans or other poorly responsive molds. Hematopoietic stem cell transplantation (HSCT) cures CGD and may be appropriate in select patients with refractory IFIs. SUMMARY Management of IFIs in CGD has significantly improved over the last decade. Earlier diagnosis of IFIs, accurate identification of pathogens, and development of reliable susceptibility testing are areas for future emphasis. HSCT is a promising therapy, even during refractory infections in CGD.
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Dotis J, Pana ZD, Roilides E. Non-Aspergillus fungal infections in chronic granulomatous disease. Mycoses 2013; 56:449-62. [PMID: 23369076 DOI: 10.1111/myc.12049] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Chronic granulomatous disease (CGD) is a congenital immunodeficiency, characterised by significant infections due to an inability of phagocyte to kill catalase-positive organisms including certain fungi such as Aspergillus spp. Nevertheless, other more rare fungi can cause significant diseases. This report is a systematic review of all published cases of non-Aspergillus fungal infections in CGD patients. Analysis of 68 cases of non-Aspergillus fungal infections in 65 CGD patients (10 females) published in the English literature. The median age of CGD patients was 15.2 years (range 0.1-69), 60% of whom had the X-linked recessive defect. The most prevalent non-Aspergillus fungal infections were associated with Rhizopus spp. and Trichosporon spp. found in nine cases each (13.2%). The most commonly affected organs were the lungs in 69.9%. In 63.2% of cases first line antifungal treatment was monotherapy, with amphotericin B formulations being the most frequently used antifungal agents in 45.6% of cases. The overall mortality rate was 26.2%. Clinicians should take into account the occurrence of non-Aspergillus infections in this patient group, as well as the possibility of a changing epidemiology in fungal pathogens. Better awareness and knowledge of these pathogens can optimise antifungal treatment and improve outcome in CGD patients.
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Affiliation(s)
- John Dotis
- 1st Department of Pediatrics, Aristotle University School of Medicine, Hippokration General Hospital, Thessaloniki, Greece
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Henriet S, Verweij PE, Holland SM, Warris A. Invasive fungal infections in patients with chronic granulomatous disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 764:27-55. [PMID: 23654055 DOI: 10.1007/978-1-4614-4726-9_3] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Invasive fungal infections are a major threat for chronic granulomatous disease (CGD) patients. The present study provides a comprehensive overview of published invasive fungal infections in the CGD host through an extensive review of epidemiological, clinical, diagnostic and therapeutic data. In addition to the often mild clinical presentation, the currently used diagnostics for invasive aspergillosis have low sensitivity in CGD patients and cannot be easily translated to this non-neutropenic host. Aspergillus fumigatus and A. nidulans are the most commonly isolated species. A. nidulans infections are seldom reported in other immunocompromised patients, indicating a unique interaction between this fungus and the CGD host. The occurrence of mucormycosis is mainly noted in the setting of treatment of inflammatory complications with immunosuppressive drugs. Candida infections are infrequently seen and do not cause mucocutaneous disease but do show an age-dependent clinical presentation. The CGD patient is susceptible to a wide range of fungal pathogens, indicating the need to determine the causative fungus, often by invasive diagnostics, to guide optimal and rational treatment. This review summarizes current understanding of invasive fungal infections in patients with CGD and will serve as a starting point to guide optimal treatment strategies and to direct further research aimed at improving outcomes.
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Affiliation(s)
- Stefanie Henriet
- Department of Pediatric Infectious Diseases and Immunology, Nijmegen Institute for Infection, Inflammation and Immunity, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Anstead GM, Sutton DA, Graybill JR. Adiaspiromycosis causing respiratory failure and a review of human infections due to Emmonsia and Chrysosporium spp. J Clin Microbiol 2012; 50:1346-54. [PMID: 22259200 PMCID: PMC3318518 DOI: 10.1128/jcm.00226-11] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 01/04/2012] [Indexed: 11/20/2022] Open
Abstract
We report a case of a 27-year-old male who presented with respiratory distress that required mechanical ventilation. Transbronchial biopsy revealed adiaspores of the fungus Emmonsia crescens within granulomata, a condition known as adiaspiromycosis. The patient received amphotericin products and corticosteroids, followed by itraconazole, and made a full recovery. Emmonsia crescens is a saprobe with a wide distribution that is primarily a rodent pathogen. The clinical characteristics of the 20 cases of human pulmonary adiaspiromycosis reported since the last comprehensive case review in 1993 are described here, as well as other infections recently reported for the genus Emmonsia. Pulmonary adiaspiromycosis has been reported primarily in persons without underlying host factors and has a mild to severe course. It remains uncertain if the optimal management of severe pulmonary adiaspiromycosis is supportive or if should consist of antifungal treatment, corticosteroids, or a combination of the latter two. The classification of fungi currently in the genus Emmonsia has undergone considerable revision since their original description, including being grouped with the genus Chrysosporium at one time. Molecular genetics has clearly differentiated the genus Emmonsia from the Chrysosporium species. Nevertheless, there has been a persistent confusion in the literature regarding the clinical presentation of infection with fungi of these two genera; to clarify this matter, the reported cases of invasive Chrysosporium infections were reviewed. Invasive Chrysosporium infections typically occur in impaired hosts and can have a fatal course. Based on limited in vitro susceptibility data for Chrysosporium zonatum, amphotericin B is the most active drug, itraconazole susceptibility is strain-dependent, and fluconazole and 5-fluorocytosine are not active.
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Affiliation(s)
- Gregory M Anstead
- Department of Medicine, Division of Infectious Diseases, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
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De Ravin SS, Challipalli M, Anderson V, Shea YR, Marciano B, Hilligoss D, Marquesen M, Decastro R, Liu YC, Sutton DA, Wickes BL, Kammeyer PL, Sigler L, Sullivan K, Kang EM, Malech HL, Holland SM, Zelazny AM. Geosmithia argillacea: an emerging cause of invasive mycosis in human chronic granulomatous disease. Clin Infect Dis 2011; 52:e136-43. [PMID: 21367720 DOI: 10.1093/cid/ciq250] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chronic granulomatous disease (CGD) is an inherited disorder of the nicotinamide adenine dinucleotide phosphate oxidase that leads to defective production of microbicidal superoxide and other oxidative radicals, resulting in increased susceptibility to invasive infections, especially those due to fungi. METHODS Geosmithia argillacea was identified from cultured isolates by genomic sequencing of the internal transcribed spacer region. Isolates previously identified as Paecilomyces variotii, a filamentous fungus closely resembling G. argillacea, were also examined. RESULTS We identified G. argillacea as the cause of invasive mycosis in 7 CGD patients. In 5 cases, the fungus had been previously identified morphologically as P. variotii. All patients had pulmonary lesions; 1 had disseminated lesions following inhalational pneumonia. Infections involved the chest wall and contiguous ribs in 2 patients and disseminated to the brain in 1 patient. Four patients with pneumonia underwent surgical intervention. All patients responded poorly to medical treatment, and 3 died. CONCLUSIONS We report the first cases of invasive mycosis caused by G. argillacea in CGD patients. G. argillacea infections in CGD are often refractory and severe with a high fatality rate. Surgical intervention has been effective in some cases. G. argillacea is a previously underappreciated and frequently misidentified pathogen in CGD that should be excluded when P. variotii is identified morphologically.
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Affiliation(s)
- Suk See De Ravin
- Laboratory of Host Defense, National Institutes of Allergy and Infectious Diseases, Bethesda, MD, USA.
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Song E, Jaishankar GB, Saleh H, Jithpratuck W, Sahni R, Krishnaswamy G. Chronic granulomatous disease: a review of the infectious and inflammatory complications. Clin Mol Allergy 2011; 9:10. [PMID: 21624140 PMCID: PMC3128843 DOI: 10.1186/1476-7961-9-10] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 05/31/2011] [Indexed: 01/18/2023] Open
Abstract
Chronic Granulomatous Disease is the most commonly encountered immunodeficiency involving the phagocyte, and is characterized by repeated infections with bacterial and fungal pathogens, as well as the formation of granulomas in tissue. The disease is the result of a disorder of the NADPH oxidase system, culminating in an inability of the phagocyte to generate superoxide, leading to the defective killing of pathogenic organisms. This can lead to infections with Staphylococcus aureus, Psedomonas species, Nocardia species, and fungi (such as Aspergillus species and Candida albicans). Involvement of vital or large organs can contribute to morbidity and/or mortality in the affected patients. Major advances have occurred in the diagnosis and treatment of this disease, with the potential for gene therapy or stem cell transplantation looming on the horizon.
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Affiliation(s)
- Eunkyung Song
- Department of Pediatrics, Division of Allergy and Clinical Immunology, Quillen College of Medicine, East Tennessee State University, USA.
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Mandeel Q, Nardoni S, Mancianti F. Keratinophilic fungi on feathers of common clinically healthy birds in Bahrain. Mycoses 2010; 54:71-7. [DOI: 10.1111/j.1439-0507.2009.01755.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Deshmukh SK, Verekar SA. Incidence of keratinophilic fungi from the soils of Vedanthangal Water Bird Sanctuary (India). Mycoses 2010; 54:487-90. [DOI: 10.1111/j.1439-0507.2010.01882.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rabérin H, Bellete B, Jospé R, Flori P, Hafid J, Sung R. Pneumopathie à Chrysosporium tropicum. J Mycol Med 2007. [DOI: 10.1016/j.mycmed.2007.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Martire B, Rondelli R, Soresina A, Pignata C, Broccoletti T, Finocchi A, Rossi P, Gattorno M, Rabusin M, Azzari C, Dellepiane RM, Pietrogrande MC, Trizzino A, Di Bartolomeo P, Martino S, Carpino L, Cossu F, Locatelli F, Maccario R, Pierani P, Putti MC, Stabile A, Notarangelo LD, Ugazio AG, Plebani A, De Mattia D. Clinical features, long-term follow-up and outcome of a large cohort of patients with Chronic Granulomatous Disease: an Italian multicenter study. Clin Immunol 2007; 126:155-64. [PMID: 18037347 DOI: 10.1016/j.clim.2007.09.008] [Citation(s) in RCA: 233] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2007] [Revised: 09/19/2007] [Accepted: 09/27/2007] [Indexed: 12/30/2022]
Abstract
A retrospective clinical and immunological survey was conducted in 60 patients with Chronic Granulomatous Disease. A prospective controlled non-randomized study of the efficacy of long-term IFNgamma treatment was carried out. The mean age at the time of diagnosis was 4.4 years; mean duration of follow-up was 10.4 years. Lung and skin infections were the most frequent manifestations both prior to diagnosis and during follow-up. Aspergillus species was the first cause of infection and of death in our cohort. The mortality rate was 13%. Long term prophylaxis with IFNgamma did not significantly change the rate of total infection per patient-year compared to controls (p=0.07). Our data provide clear evidence that protocols of continuing intensive surveillance and monitoring of compliance with anti-infective regimens may significantly improve the quality of life and long-term survival in patients with CGD. No evidence justifying long-term prophylaxis with IFNgamma was obtained.
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Antachopoulos C, Walsh TJ, Roilides E. Fungal infections in primary immunodeficiencies. Eur J Pediatr 2007; 166:1099-117. [PMID: 17551753 DOI: 10.1007/s00431-007-0527-7] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2007] [Revised: 05/11/2007] [Accepted: 05/19/2007] [Indexed: 12/17/2022]
Abstract
Patients with phagocytic, cellular, combined and other primary immunodeficiencies exhibit immune deficits that confer increased susceptibility to fungal infections. A number of yeasts and moulds, most commonly Candida and Aspergillus but also Cryptococcus, Histoplasma, Paecilomyces, Scedosporium, Trichosporon, Penicillium and other, rarely isolated, fungal organisms, have been variably implicated in causing disease in patients with chronic granulomatous disease, severe combined immunodeficiency, chronic mucocutaneous candidiasis, hyper-IgE syndrome, myeloperoxidase deficiency, leukocyte adhesion deficiency, defects in the interferon-gamma/interleukin-12 axis, DiGeorge syndrome, X-linked hyper-IgM syndrome, Wiskott-Aldrich syndrome and common variable immunodeficiency. Differences in the spectrum of fungal pathogens as well as in the incidence and clinical presentation of the infections may be observed among patients, depending upon different immune disorders. Fungal infections in these individuals may occasionally be the presenting clinical manifestation of a primary immunodeficiency and can cause significant morbidity and potentially fatal outcome if misdiagnosed or mistreated. A high degree of suspicion is needed and establishment of diagnosis should actively be pursued using appropriate imaging, mycological and histological studies. A number of antifungal agents introduced over the last fifteen years, such as the lipid formulations of amphotericin B, the second-generation triazoles, and the echinocandins, increase the options for medical management of these infections. Surgery may also be needed in some cases, while the role of adjunctive immunotherapy has not been systematically evaluated. The low incidence of primary immunodeficiencies in the general population complicates single-center prospective or retrospective clinical studies aiming to address diagnostic or therapeutic issues pertaining to fungal infections in these patients.
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Affiliation(s)
- Charalampos Antachopoulos
- Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USA
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Deshmukh SK, Mandeel QA, Verekar SA. Keratinophilic fungi from selected soils of Bahrain. Mycopathologia 2007; 165:143-7. [PMID: 17932786 DOI: 10.1007/s11046-007-9067-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2007] [Accepted: 09/18/2007] [Indexed: 11/29/2022]
Abstract
Eighty soil samples were collected from various sites of Bahrain and screened for presence of keratinophilic fungi using hair baiting techniques for isolation. Thirty-six isolates were recovered and identified. The cultures were identified using macro- and micromorphological features. Their identification was also confirmed by the BLAST search of sequences of ITS1-5.8S-ITS2 rDNA region against the NCBI/Gene bank data and compared with deposited sequences for confirmation. Eight species of five genera were isolated viz. Aphanoascus fulvuscence (8.75%), Aphanoascus punsolae (20.00%), Chrysosporium indicum (2.50%), Chrysosporium tropicum (2.50%), Chrysosporium zonatum (3.75%), Spiromastix warcupii (1.25%), Microsporum gypseum (3.75%), and Trichophyton mentagrophytes (2.50%). In conclusion, our study indicates that keratinophilic fungi do occur in the various soils of Bahrain. Moreover, the narrow diversity and low density of keratinophilic fungi in the investigated soils is expected and is emblematic to other hot arid environments.
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Affiliation(s)
- S K Deshmukh
- Department of Natural Products, Nicholas Piramal Research Centre, 1, Nirlon Complex, Off Western Express Highway, Near NSE Complex, Goregaon (East), Mumbai, 400 063, India
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Davis CM, Noroski LM, Dishop MK, Sutton DA, Braverman RM, Paul ME, Rosenblatt HM. Basidiomycetous fungal Inonotus tropicalis sacral osteomyelitis in X-linked chronic granulomatous disease. Pediatr Infect Dis J 2007; 26:655-6. [PMID: 17596815 DOI: 10.1097/inf.0b013e3180616cd0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Osteomyelitis is a common clinical manifestation of chronic granulomatous disease, a disorder of phagocytic function. Fungal organisms account for a significant proportion of these infections. We describe the clinical presentation and subsequent destructive sacral osteomyelitis with a basidiomycetous mold, Inonotus tropicalis, in a patient with an X-linked chronic granulomatous disease.
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Affiliation(s)
- Carla M Davis
- Division of Allergy and Immunology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA.
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39
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Invasive Sinusal Mycosis due to Chrysosporium tropicum. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2007. [DOI: 10.1016/s2173-5735(07)70325-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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40
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Zaki SM, Mikami Y, El-Din AAK, Youssef YA. Keratinophilic fungi recovered from muddy soil in Cairo vicinities, Egypt. Mycopathologia 2006; 160:245-51. [PMID: 16205974 DOI: 10.1007/s11046-005-0143-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2005] [Accepted: 07/14/2005] [Indexed: 11/25/2022]
Abstract
One hundred samples of muddy soil were collected from seven areas in the vicinity of Cairo and screened for the presence of keratinophilic fungi by using hair baiting isolation technique. Forty isolates of keratinophilic fungi were recovered and identified by recognition of their cultures, macro- and micromorphological features. Their physiological and molecular characteristics were studied by determination of their ubiquinone (Coenzyme Q) composition and DNA sequences of (ITS1-5.8S-ITS2) and 18S rRNA region sequences. The Keratinophilic isolates were identified as Chrysosporium carmichaelii, C. queenslandicum, C. zonatum, C. indicum, Aphanoascus mephitalis, and Uncinocarpus reesii. Chrysosporium zonatum was the most prevalent species and represented 42.5% of the total number of isolates. Each of C. carmichaelii and C. queenslandicum were equal in their prevalence and represented 15%. C. indicum comes next constituting 12.5%; followed by Uncinocarpus reesii which represented 10%. The least prevalent species in our study was Aphanoascus mephitalis, which was represented only 5% of the total keratinophilic isolates.
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Affiliation(s)
- S M Zaki
- Microbiology Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
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41
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Les champignons des genres Acremonium, Beauveria, Chrysosporium, Fusarium, Onychocola, Paecilomyces, Penicillium, Scedosporium et Scopulariopsis responsables de hyalohyphomycoses. J Mycol Med 2005. [DOI: 10.1016/j.mycmed.2005.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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42
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Sutton DA, Thompson EH, Rinaldi MG, Iwen PC, Nakasone KK, Jung HS, Rosenblatt HM, Paul ME. Identification and first report of Inonotus (Phellinus) tropicalis as an etiologic agent in a patient with chronic granulomatous disease. J Clin Microbiol 2005; 43:982-7. [PMID: 15695724 PMCID: PMC548074 DOI: 10.1128/jcm.43.2.982-987.2005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Although isolates of filamentous basidiomycetes can usually be recognized in a clinical laboratory setting, identification is problematic, as they seldom exhibit diagnostic morphological features formed in nature. This paper is the first report of Inonotus (Phellinus) tropicalis inciting human disease and describes the methods used to support the identification.
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Affiliation(s)
- D A Sutton
- Department of Pathology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA.
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Steininger C, van Lunzen J, Tintelnot K, Sobottka I, Rohde H, Horstkotte MA, Stellbrink HJ. Mycotic brain abscess caused by opportunistic reptile pathogen. Emerg Infect Dis 2005; 11:349-50. [PMID: 15759342 PMCID: PMC3320450 DOI: 10.3201/eid1102.040915] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Stebbins WG, Krishtul A, Bottone EJ, Phelps R, Cohen S. Cutaneous adiaspiromycosis: A distinct dermatologic entity associated with Chrysosporium species. J Am Acad Dermatol 2004; 51:S185-9. [PMID: 15577766 DOI: 10.1016/j.jaad.2004.04.036] [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: 11/20/2022]
Abstract
Primary cutaneous infection with Chrysosporium, a saprophytic fungus commonly found in soil, is believed to be very rare, with only two previously reported cases. We present a case of localized cutaneous Chrysosporium in an immunocompromised heart transplant patient. Considering that the histology of the skin in this case is superimposable on that seen in pulmonary Chrysosporium known as adiaspiromycosis, we regard the cutaneous variant in the absence of pulmonary disease as a distinct dermatologic entity. The low frequency of reports of primary cutaneous Chrysosporium infection suggests either underreporting of this diagnosis in the literature, or misidentification of this fungus as another more common mycotic species sharing morphologic similarities. By amplifying our understanding of Chrysosporium infection in the skin, this disorder will be easier to identify and treat.
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Affiliation(s)
- William G Stebbins
- Department of Dermatology, Mount Sinai Hospital and School of Medicine, New York, New York 10029, USA
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Deshmukh SK, Agrawal SC. Isolation of dermatophytes and other keratinophilic fungi from soils of Jammu, India. Mycoses 2003; 46:226-8. [PMID: 12801368 DOI: 10.1046/j.1439-0507.2003.00882.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A total of 112 soil samples collected from various areas of Jammu, India, were screened for the prevalence of keratinophilic fungi and related dermatophytes. From 65 positive samples (58.1%), a total of six genera with 13 species were isolated.
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Affiliation(s)
- S K Deshmukh
- Department of Natural Products, Quest Institute of Life Sciences, Nicholas Piramal India Limited, L. B. S. Marg, Mulund (W), Mumbai, India.
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46
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Moylett EH, Chinen J, Shearer WT. Trichosporon pullulans infection in 2 patients with chronic granulomatous disease: an emerging pathogen and review of the literature. J Allergy Clin Immunol 2003; 111:1370-4. [PMID: 12789241 DOI: 10.1067/mai.2003.1522] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Chronic granulomatous disease is a genetically determined primary immunodeficiency disease in which phagocytic cells are unable to kill certain bacteria and fungi after ingestion. Manifestations include recurrent pyogenic infections caused by catalase-positive microbes. Trichosporon species are emerging as opportunistic agents that cause systemic disease in immunocompromised patients. Typically disease has been described in association with T beigelii in patients with secondary immunodeficiency, such as underlying malignancy. OBJECTIVE The objective was to report the first 2 cases of T pullulans infection in 2 male children with chronic granulomatous disease. METHODS The records of the 2 patients were reviewed. In addition, all cases of T pullulans infection reported in the English language literature are presented. RESULTS This report brings to 7 the total number of cases of T pullulans reported and the first in patients with chronic granulomatous disease, one with invasive pneumonia and the other with an infected paronychium and localized cellulitis. In the 5 additional cases malignancy was the principal risk factor. CONCLUSION T pullulans has rarely been reported as a fungal pathogen. The most prominent risk factor for the development of trichosporonosis is immunocompromise, most notably with neutropenia. Abnormally functioning neutrophils, such as with chronic granulomatous disease, may also predispose individuals to this opportunistic pathogen.
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Affiliation(s)
- Edina H Moylett
- Section of Allergy and Immunology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, 6621 Fannin Street, MC:FC330.01, Houston, TX 77030, USA
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Vandenberg O, Klein A, Souayah H, Devaster JM, Levy J, Butzler JP. Possible Campylobacter jejuni osteomyelitis in a 14-month-old child. Int J Infect Dis 2003; 7:164-5. [PMID: 12839722 DOI: 10.1016/s1201-9712(03)90016-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Roilides E, Lamaignere CG, Farmaki E. Cytokines in immunodeficient patients with invasive fungal infections: an emerging therapy. Int J Infect Dis 2002; 6:154-63. [PMID: 12718828 DOI: 10.1016/s1201-9712(02)90104-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Immune response is the major contributor to host defense against opportunistic fungal infections such as candidiasis, aspergillosis and other rare infections. A number of cytokines have been developed and studied in vitro for activity against fungal pathogens. The most studied among them in relation to fungal infections are granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage colony-stimulating factor (M-CSF) and interferon-gamma (IFN-gamma). The fields where these cytokines have been predominantly studied or where they may need more study are primary immunodeficiencies of the phagocytic cells, neonatal age, human immunodeficiency virus infection and cancer-related conditions such as neutropenia and hemopoietic cell transplantation. In this review, the in vitro, experimental animal and clinical data of cytokines are summarized in relation to invasive candidiasis, aspergillosis and emerging fungal infections. Cytokine administration to patients together with antifungal agents, as well as transfusion of cytokine-upgraded phagocytes, are promising immunotherapeutic modalities for further research.
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Affiliation(s)
- Emmanuel Roilides
- 3rd Department of Pediatrics, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
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49
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Abstract
Chronic granulomatous disease is a rare inherited disorder of phagocytic cells which results in a susceptibility to infections of catalase-positive bacteria and fungi (especially Aspergillus species), as well as granuloma formation. The mainstay of therapy is antibacterial and antifungal prophylaxis. Trimethoprim sulfamethoxazole is the drug of choice for the prevention of bacterial infection, while itraconazole is most widely used for the prevention of fungal infection. Immunomodulatory agents, such as IFN-phi, have a role in the prevention and treatment of intractable infection. New antifungal agents provide the promise of improved cure rates for invasive Aspergillus, while bone marrow transplants and gene therapy may offer the promise of complete cure.
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Affiliation(s)
- David Goldblatt
- Immunology Department, Great Ormond Street Children's Hospital NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.
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50
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Hayashi S, Naitoh K, Matsubara S, Nakahara Y, Nagasawa Z, Tanabe I, Kusaba K, Tadano J, Nishimura K, Sigler L. Pulmonary colonization by Chrysosporium zonatum associated with allergic inflammation in an immunocompetent subject. J Clin Microbiol 2002; 40:1113-5. [PMID: 11880456 PMCID: PMC120249 DOI: 10.1128/jcm.40.3.1113-1115.2002] [Citation(s) in RCA: 12] [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
We report a case of noninvasive pulmonary disease due to Chrysosporium zonatum in an immunocompetent male. The fungus colonized an existing tuberculous cavity and was isolated from transbronchial lavage fluid and from a percutaneous aspiration specimen. The disease was accompanied by the unusual feature of an allergic reaction. The fungus ball was successfully treated by intracavitary administration of amphotericin B. C. zonatum is the anamorph of the heterothallic ascomycete Uncinocarpus orissi, and the identity of the case isolate was verified by formation of ascospores in mating tests with reference isolates.
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Affiliation(s)
- Shinichiro Hayashi
- Division of Pulmonary Diseases, Department of Internal Medicine, Microbiology Branch, Saga Medical School, Saga, Japan.
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