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Gunaseelan S, Kezo K, Karunarathna SC, Yang E, Zhao C, Elgorban AM, Tibpromma S, Kaliyaperumal M. New species of Tropicoporus (Basidiomycota, Hymenochaetales, Hymenochaetaceae) from India, with a key to Afro-Asian Tropicoporus species. MycoKeys 2024; 102:29-54. [PMID: 38356850 PMCID: PMC10862346 DOI: 10.3897/mycokeys.102.117067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/21/2024] [Indexed: 02/16/2024] Open
Abstract
The Inonotuslinteus complex, predominantly reported from East Asia, Mesoamerica and Caribbean countries, was circumscribed into Tropicoporus as one of the new genera, based on morphological and phylogenetic data. The present paper describes four new species of Tropicoporus from India. Morphological characteristics and phylogenetic analyses, based on ITS and nLSU data, delimited the new species, which are named T.cleistanthicola, T.indicus, T.pseudoindicus and T.tamilnaduensis. The pairwise homoplasy index (PHI) test was done to confirm the distinctive nature of the new species. The traits of Indian species remain distinct from one another, except for the pileate basidiome with the mono-dimitic hyphal system, cystidioles and broadly ellipsoid basidiospores. Descriptions, illustrations, PHI test results and a phylogenetic tree to show the position of the new species are provided. In addition, an identification key to Tropicoporus in Asia and an African species is given.
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Affiliation(s)
- Sugantha Gunaseelan
- Centre for Advanced Studies in Botany, University of Madras, Guindy Campus, Chennai 600025, Tamil Nadu, IndiaUniversity of MadrasChennaiIndia
| | - Kezhocuyi Kezo
- Centre for Advanced Studies in Botany, University of Madras, Guindy Campus, Chennai 600025, Tamil Nadu, IndiaUniversity of MadrasChennaiIndia
| | - Samantha C. Karunarathna
- Center for Yunnan Plateau Biological Resources Protection and Utilization, College of Biological Resource and Food Engineering, Qujing Normal University, Qujing, Yunnan 655011, ChinaQujing Normal UniversityYunnanChina
- National Institute of Fundamental Studies (NIFS), Kandy, Sri LankaNational Institute of Fundamental Studies (NIFS)KandySri Lanka
| | - Erfu Yang
- Center for Yunnan Plateau Biological Resources Protection and Utilization, College of Biological Resource and Food Engineering, Qujing Normal University, Qujing, Yunnan 655011, ChinaQujing Normal UniversityYunnanChina
- Department of Biology, Faculty of Science, Chiang Mai University, Chiang Mai 50200, ThailandChiang Mai UniversityChiang MaiThailand
| | - Changlin Zhao
- College of Biodiversity Conservation, Southwest Forestry University, Kunming 650224, ChinaSouthwest Forestry UniversityKunmingChina
| | - Abdallah M. Elgorban
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi ArabiaKing Saud UniversityRiyadhSaudi Arabia
| | - Saowaluck Tibpromma
- Center for Yunnan Plateau Biological Resources Protection and Utilization, College of Biological Resource and Food Engineering, Qujing Normal University, Qujing, Yunnan 655011, ChinaQujing Normal UniversityYunnanChina
| | - Malarvizhi Kaliyaperumal
- Centre for Advanced Studies in Botany, University of Madras, Guindy Campus, Chennai 600025, Tamil Nadu, IndiaUniversity of MadrasChennaiIndia
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Gupta P, Kaur H, Dwivedi S, Agnihotri S, Rudramurthy SM. First case of Tropicoporus tropicalis keratitis in an immunocompetent host from India and review of the literature. J Mycol Med 2021; 32:101205. [PMID: 34598109 DOI: 10.1016/j.mycmed.2021.101205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/24/2022]
Abstract
Tropicoporus tropicalis is an environmental basidiomycete that has been implicated in nine cases of cutaneous (n = 7) and pulmonary (n = 2) human infections predominantly in chronic granulomatous disease patients. We report here the first case of keratitis caused by Tropicoporus tropicalis in a 40-year-old immunocompetent patient, who presented with sudden diminution of vision in right eye. Corneal scrapings revealed hyaline, septate hyphae in microscopy and culture showed growth of white non-sporulating mycelial growth which was confirmed as Tropicoporus tropicalis by sequencing of ITS region of 28S rDNA. The patient was initiated on topical voriconazole along with natamycin, gatifloxacin and atropine drops. However, despite treatment, corneal ulcer perforated, for which penetrating keratoplasty was performed. Thereafter, he was prescribed amphotericin B (AMB) drops sixteen times a day and ketoconazole 200 mg twice a day with no recurrence reported over one year of follow up. The case represents the first case of infection by this fungus from India and also is the first case to be reported in an immunocompetent host.
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Affiliation(s)
- Parakriti Gupta
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India 160012
| | - Harsimran Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India 160012
| | - Sujata Dwivedi
- Chandigarh Cornea Clinic, Bharat Vikas Parishad Medical Centre, Chandigarh, India 160023.
| | - Sourav Agnihotri
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India 160012
| | - Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India 160012
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Furusawa Y, Takahashi M, Iwanaga T, Yabuki A, Kano R, Hatai H, Sueno W, Endo Y, Momoi Y. Systemic Inonotus sp. Infection in a dog. J Vet Med Sci 2020; 82:779-783. [PMID: 32378518 PMCID: PMC7324816 DOI: 10.1292/jvms.19-0455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 3-years-old male golden retriever was presented for decreased activity (lethargy), anorexia, and titubation. Superficial lymph nodes were enlarged, and arrhythmia and tachycardia were auscultated. Fungal hyphae-like structures were detected in the biopsy samples from an enlarged lymph node and spleen. Nucleotide sequence of the internal transcribed spacer region of the fungi amplified by PCR was highly homologous to that of Inonotus pachyphloeus. The dog was treated with antifungal agents such as itraconazole, fluconazole, and voriconazole. Clinical signs resolved for 325 days but the dog died suddenly, possibly because of arrhythmia. Postmortem examination revealed the presence of a disseminated fungal infection. This report describes the case of canine systemic Inonotus sp. infection treated by an antifungal agent.
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Affiliation(s)
- Yu Furusawa
- Kagoshima University Veterinary Teaching Hospital, 1-21-24 Korimoto, Kagoshima 890-0065, Japan
| | - Masashi Takahashi
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan
| | - Tomoko Iwanaga
- Kagoshima University Veterinary Teaching Hospital, 1-21-24 Korimoto, Kagoshima 890-0065, Japan
| | - Akira Yabuki
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan
| | - Rui Kano
- Department of Veterinary Pathobiology, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Hitoshi Hatai
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan
| | - Wako Sueno
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan
| | - Yasuyuki Endo
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan
| | - Yasuyuki Momoi
- Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan
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Hevia A, Iachini R, Fernández J, Lazzari J, Suárez-Alvarez R, Abrantes R, Toranzo A, Refojo N, Canteros C. Mycosis Due to Tropicoporus tropicalis (= Inonotus tropicalis) in a Domestic Dog. Mycopathologia 2019; 184:701-6. [PMID: 31376041 DOI: 10.1007/s11046-019-00368-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/22/2019] [Indexed: 12/28/2022]
Abstract
Mycelial basidiomycetes rarely produce mycoses in animals including humans. We report a case of a 9-year-old female mongrel dog with lesions in the prescapular lymph nodes. The histopathology of a lymph node sample showed flexuous septate hyphae, and a sterile mold grew in culture from that specimen. DNA sequencing of the ITS region allowed us to identify the fungus as Tropicoporus tropicalis. The dog was treated with itraconazole, but it was euthanized six months later due to an unfavorable clinical outcome. Tropicoporus tropicalis is an infrequent pathogen of pets, and the use of molecular tools is needed for its identification. Animal infections due to T. tropicalis were not previously been reported in Argentina.
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Guery R, Pilmis B, Dunogue B, Blanche S, Lortholary O, Lanternier F. Non-Aspergillus Fungal Infections in Chronic Granulomatous Disease. Curr Fungal Infect Rep 2019. [DOI: 10.1007/s12281-019-00339-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Fernández-Cruz A, Kwon M, Guinea J, Escribano P, Jiménez MDCM, Pulido A, Parra V, Serrano D, Gayoso J, Martín JLD, Bouza E. Inonotosis in Patient with Hematologic Malignancy. Emerg Infect Dis 2018; 24:180-182. [PMID: 29260664 PMCID: PMC5749471 DOI: 10.3201/eid2401.171265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a lung-invasive fungal disease with possible cutaneous needle tract seeding in a patient with a febrile neutropenia caused by the Basidiomycetes mold Inonotus spp. Although rare, Inonotus spp. should be added to the list of microorganisms causing invasive fungal disease in neutropenic patients with hematologic malignancies.
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Haidar G, Zerbe CS, Cheng M, Zelazny AM, Holland SM, Sheridan KR. Phellinus species: An emerging cause of refractory fungal infections in patients with X-linked chronic granulomatous disease. Mycoses 2016; 60:155-160. [PMID: 27781311 DOI: 10.1111/myc.12573] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/01/2016] [Accepted: 09/09/2016] [Indexed: 12/12/2022]
Abstract
Aspergillus spp. are a leading cause of mortality in chronic granulomatous disease (CGD), but other fungi have emerged in the era of mould prophylaxis. Of these, Phellinus spp. are an under-recognised cause of invasive fungal infections (IFIs) in CGD, and data on their presentation and management are scarce. We present a patient with CGD who developed disseminated IFI involving the lungs and brain. Surgical specimens grew a basidiomycete which was disregarded as a contaminant. After three months of progressive disease despite antifungals, he was diagnosed with Phellinus tropicalis by internal transcribed spacer (ITS) sequencing. He improved with amphotericin B and isavuconazole but required haematopoietic stem cell transplantation (HSCT). We review the literature on Phellinus infections in CGD and conclude that: (i) these infections emerge on mould-active prophylaxis and are indolent; (ii) they typically cause locally destructive disease but can disseminate; (iii) diagnosis is delayed and requires molecular methods; (iv) amphotericin B is most active in vitro; and (v) treatment is protracted and requires surgery and possibly HSCT. In conclusion, Phellinus spp. are emerging pathogens in CGD. Every effort should be made to establish the diagnosis of non-Aspergillus IFIs in patients with CGD by sending tissue specimens for molecular diagnostics.
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Affiliation(s)
- Ghady Haidar
- Department of Medicine, Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Christa S Zerbe
- Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Michelle Cheng
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Adrian M Zelazny
- Department of Laboratory Medicine, Microbiology Service, National Institutes of Health, Bethesda, MD, USA
| | - Steven M Holland
- Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kathleen R Sheridan
- Department of Medicine, Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Ribas T, Pipe-Martin H, Kim KS, Leissinger MK, Bauer RW, Grasperge BJ, Grooters AM, Sutton DA, Pariaut R. Fungal myocarditis and pericardial effusion secondary to Inonotus tropicalis (phylum Basidiomycota) in a dog. J Vet Cardiol 2015; 17:142-8. [PMID: 26003903 DOI: 10.1016/j.jvc.2015.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 12/18/2014] [Accepted: 01/12/2015] [Indexed: 01/20/2023]
Abstract
Fungal disease is a rare cause of pericardial effusion in dogs. This report describes the first case of fungal pericardial effusion and myocarditis secondary to the fungal organism Inonotus tropicalis. A 9-year-old female spayed French bulldog with a multi-year history of treatment with glucocorticoids for management of atopy was presented for exercise intolerance, ascites and weight loss. Physical examination and thoracic imaging revealed enlarged peripheral and cranial mediastinal lymph nodes, left ventricular thickening and cardiac tamponade secondary to pericardial effusion. Fine needle aspiration of the cranial mediastinal lymph node showed pyogranulomatous inflammation with short, thin and poorly septated hyphae. Culture of the aspirate yielded a fungal isolate identified as Inonotus tropicalis based on morphologic features and rRNA gene sequencing. Postmortem examination showed myocardial thickening with multifocal to coalescing, firm, white, ill-defined nodules. Histology confirmed the presence of disseminated fungal infection with extensive myocardial involvement. Inonotus tropicalis is an opportunistic poroid wood-decaying basidiomycete. Infection in this dog was likely the result of chronic immunosuppressive therapy.
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Shigemura T, Nakazawa Y, Amano Y, Sudo A, Watanabe M, Kobayashi M, Kobayashi N, Koike K, Agematsu K, Nishimura K. Subcutaneous abscess due to the basidiomycete Phellinus mori in a patient with chronic granulomatous disease. Infection 2015; 43:371-5. [DOI: 10.1007/s15010-015-0724-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 01/07/2015] [Indexed: 11/27/2022]
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Abstract
Filamentous basidiomycetes (BM) are common environmental fungi that have recently emerged as important human pathogens, inciting a wide array of clinical manifestations that include allergic and invasive diseases. We reviewed 218 reported global cases of BM fungi. The most common etiologic agent was Schizophyllum commune in 52.3% (114/218) of the cases followed by Hormographiella aspergillata (n = 13; 5.9%), Ceriporia lacerata (n = 11; 5%), and, rarely, Volvariella volvacea, Inonotus tropicalis, Irpex lacteus, Phellinus undulates, Perenniporia species, Bjerkandera adusta, Sporotrichum pruinosum, Phanerochaete steroids, and Cyclomyces tabacinus. These fungi are present in the environment as gilled mushrooms, shelf fungi, and bracket fungi. However, in clinical settings, they usually present as nonsporulating white moulds that are difficult to identify. Moreover, the GenBank database of these fungi is limited. Regarding the country-wise distribution of cases, Japan topped the list with about 43% (n = 94) of globally reported cases, followed by India (57; 26%), the United States (4%), Austria (3.2%), Iran (3.2%), France (2.8%), and the remaining one-third from 16 other countries. The respiratory tract was the most commonly afflicted site (n = 71), with the majority of the cases (42; 59.1%) being allergic in etiology and comprising 34 cases of allergic bronchopulmonary mycosis. Also, B. adusta has been implicated in a recently described clinical entity, that is, fungus associated chronic cough, reported exclusively from Japan. BM fungi-incited diseases are currently underdiagnosed due to lack of awareness and expertise, warranting comprehensive epidemiological and susceptibility studies to determine their prevalence and to predict a more appropriate therapy.
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Affiliation(s)
| | - Shallu Kathuria
- Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Kshitij Agarwal
- Rajan Babu Institute of Pulmonary Medicine and Tuberculosis, Delhi, India
| | - Jacques F Meis
- Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Romanelli AM, Fu J, Herrera ML, Wickes BL. A universal DNA extraction and PCR amplification method for fungal rDNA sequence-based identification. Mycoses 2014; 57:612-22. [PMID: 24865530 DOI: 10.1111/myc.12208] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/01/2014] [Accepted: 05/03/2014] [Indexed: 11/28/2022]
Abstract
Accurate identification of fungal pathogens using a sequence-based approach requires an extraction method that yields template DNA pure enough for polymerase chain reaction (PCR) or other types of amplification. Therefore, the objective of this study was to develop and standardise a rapid, inexpensive DNA extraction protocol applicable to the major fungal phyla, which would yield sufficient template DNA pure enough for PCR and sequencing. A total of 519 clinical and culture collection strains, comprised of both yeast and filamentous fungi, were prepared using our extraction method to determine its applicability for PCR, which targeted the ITS and D1/D2 regions in a single PCR amplicon. All templates were successfully amplified and found to yield the correct strain identification when sequenced. This protocol could be completed in approximately 30 min and utilised a combination of physical and chemical extraction methods but did not require organic solvents nor ethanol precipitation. The method reduces the number of tube manipulations and yielded suitable template DNA for PCR amplification from all phyla that were tested.
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Affiliation(s)
- A M Romanelli
- Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA, USA
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De Ravin SS, Parta M, Sutton DA, Wickes BL, Thompson EH, Wiederhold NP, Nakasone KK, Alimchandani M, OConnell A, Notarangelo L, Kang E, Malech HL, Zelazny AM. Paravertebral mushroom: identification of a novel species of Phellinus as a human pathogen in chronic granulomatous disease. J Clin Microbiol 2014; 52:2726-9. [PMID: 24829241 DOI: 10.1128/JCM.00667-14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe a case of paravertebral abscess caused by a Phellinus sp. in a boy with chronic granulomatous disease. Sequence-based identification of this mold, a new agent of disease, suggests a close relation to Phellinus umbrinellus.
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Ramesh M, Resnick E, Hui Y, Maglione PJ, Mehta H, Kattan J, Bouvier NM, LaBombardi V, Victor TR, Chaturvedi S, Cunningham-Rundles C. Phellinus tropicalis abscesses in a patient with chronic granulomatous disease. J Clin Immunol 2013; 34:130-3. [PMID: 24310980 DOI: 10.1007/s10875-013-9967-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 11/04/2013] [Indexed: 11/24/2022]
Abstract
Chronic Granulomatous Disease (CGD), caused by genetic defects in components of the phagocyte NADPH oxidase pathway, leads to recurrent life-threatening bacterial and invasive fungal infections. While a number of unique pathogens have been associated with this disease, the causative organisms may be difficult to identify. Here, we present a 24 year old male with known X-linked CGD who concurrently developed a cervical abscess and an abscess in the subcutaneous tissues of the right hip, both of which were surgically drained. Cultures failed to identify any organisms. He was treated empirically with ertapenem but the hip abscess recurred at the original site and in contiguous dependent areas in the posterior thigh and knee. A filamentous organism was observed microscopically, initially considered a contaminant, but on culture yielded a mold growth, identified as Phellinus tropicalis (synonym: Inonotus tropicalis) based on phenotypic and molecular methods. This is the third case report of human infection with P. tropicalis, all in subjects with CGD. The patient was treated with voriconazole with resolution of his symptoms.
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Affiliation(s)
- Manish Ramesh
- Departments of Medicine and Pediatrics, The Immunology Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1089, New York, NY, 10029, USA
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Sheppard BJ, McGrath E, Giuffrida M, Craft SLM, Kung CY, Smith ME. Report of wood decay fungus Inonotus tropicalis (phylum Basidiomycota) from a dog with a granulomatous mediastinal mass. J Vet Diagn Invest 2013; 25:566-72. [PMID: 23929678 DOI: 10.1177/1040638713499341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 75.9-kg, 3.5-year-old male Irish Wolfhound dog with a 2-3-week history of gagging and eating difficulties was referred to the University of Florida Veterinary Medical Hospital (Gainesville, Florida) for evaluation of a large cranial mediastinal mass suspected to be a thymoma or lymphosarcoma. The patient had 4 months of nearly 10 kg progressive weight loss with severe flank sensitivity and radiographically apparent lumbar vertebral changes interpreted as discospondylitis. Lab work revealed hyperglobulinemia, mild proteinuria, normal T4, negative Brucella canis titer, and negative blood and urine bacterial cultures. A thoracotomy revealed a nonresectable, destructive, space-occupying mediastinal mass resulting in euthanasia without surgical recovery. Biopsies from the mass were collected during surgery for histology. Microscopic examination revealed extensive granulomatous cellulitis and lymphadenitis characterized by central cavitated necrotic areas containing debris and degenerate neutrophils, intermediate zones of fibrovascular proliferation with marked mixed inflammation, peripheral fibrosis, frequent multinucleated macrophages, and scattered mineralization. The necrotic material contained dense mats of 2 µm wide by 8-15 µm long fungal hyphae with parallel walls, acute angle branching, frequent septae, and occasional bulb-like dilations. DNA sequencing and phylogenetic analysis of the internal transcribed spacer region confirmed the presence of a fungus in the Inonotus tropicalis group. Inonotus tropicalis is primarily a wood decay fungus that is found on dead wood from angiosperms in tropical and subtropical habitats. Isolates of the I. tropicalis group have been detected a few times from immunosuppressed human beings with X-linked granulomatous disease.
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Affiliation(s)
- Barbara J Sheppard
- 1Barbara J. Sheppard, Department of Infectious Diseases and Pathology, University of Florida, Gainesville, FL 32611.
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Abstract
Filamentous basidiomycetes are difficult to identify in the clinical laboratory, mostly due to lack of sporulation, and their role as agents of fungal infection can be difficult to assess. More cases of infection with these agents are being reported as more laboratories gain proficiency with the recognition of their subtle morphologic features and the use of DNA-based methods for identification. Most infections occur in the respiratory tract and sinuses, although brain infection has been reported. Susceptibility testing suggests that these agents will respond well to azole drugs other than fluconazole.
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Falcone EL, Holland SM. Invasive fungal infection in chronic granulomatous disease: insights into pathogenesis and management. Curr Opin Infect Dis 2012; 25:658-69. [PMID: 22964947 DOI: 10.1097/QCO.0b013e328358b0a4] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [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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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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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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Chowdhary A, Agarwal K, Kathuria S, Singh PK, Roy P, Gaur SN, de Hoog GS, Meis JF. Clinical significance of filamentous basidiomycetes illustrated by isolates of the novel opportunist Ceriporia lacerata from the human respiratory tract. J Clin Microbiol 2013; 51:585-90. [PMID: 23241374 DOI: 10.1128/JCM.02943-12] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The filamentous basidiomycete Ceriporia lacerata, an agent of white rot on wood, has never been reported in human disease and its clinical significance is not yet known. We describe 4 patients with respiratory diseases where C. lacerata was implicated in a wide spectrum of clinical manifestations ranging from saprobic colonization to fungal pneumonia. The isolates did not show the morphological characteristics that facilitate recognition of filamentous basidiomycetes, such as the presence of clamp connections, spicules along hyphae, or fruiting bodies. The identity of the mold was confirmed by sequencing the internal transcribed spacer 1 and 4 (ITS-1 and ITS-4) and D1/D2 regions of the rRNA gene. All of the isolates exhibited the lowest MICs of posaconazole and isavuconazole (MIC range, 0.06 to 0.125 μg/ml), followed by itraconazole (MIC range, 0.06 to 0.5 μg/ml), voriconazole (MIC range, 0.125 to 0.5 μg/ml), and amphotericin B (MIC range, 0.25 to 1 μg/ml). The infections reported here occurred in patients with preexisting lung damage induced by tuberculosis or chronic obstructive pulmonary disease. Chronic, sometimes fatal infections by the ascomycete Aspergillus fumigatus and the basidiomycete Schizophyllum commune are well established in the presence of an anatomical pulmonary defect or in the background of immunodeficiency. It is postulated that C. lacerata, a novel opportunist basidiomycete, may be involved in similar pathological processes.
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Chowdhary A, Agarwal K, Kathuria S, Singh PK, Roy P, Gaur SN, Rodrigues AM, de Hoog GS, Meis JF. First human case of pulmonary fungal ball due to a Perenniporia species (a basidiomycete). J Clin Microbiol 2012; 50:3786-91. [PMID: 22895039 DOI: 10.1128/JCM.01863-12] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Perenniporia species are basidiomycetes, resupinate shelf fungi responsible for white rot decay of wood. Here, we report for the first time an intracavitary pulmonary fungal ball due to a species of Perenniporia that has not been recognized so far as a human pathogen. The fungus was identified by sequencing of the partial ribosomal operon of a culture from a clinical specimen.
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Williamson D, Pandey S, Taylor S, Rogers K, Storey L, Marshall MR, Holland D. A case of infection caused by the basidiomycete Phellinus undulatus. J Med Microbiol 2011; 60:256-258. [DOI: 10.1099/jmm.0.025569-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We present a case of soft tissue infection caused by the basidiomycete Phellinus undulatus. To our knowledge, this is the first reported case of human infection caused by this fungus. Definitive identification was only possible through molecular analysis as the isolate failed to produce any distinct morphological features in vitro.
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Affiliation(s)
- Deborah Williamson
- Department of Microbiology, LabPlus, Auckland City Hospital, Auckland, New Zealand
| | - Sushil Pandey
- Department of Microbiology, LabPlus, Auckland City Hospital, Auckland, New Zealand
| | - Susan Taylor
- Department of Microbiology, Middlemore Hospital, Auckland, New Zealand
- Department of Infectious Diseases, Middlemore Hospital, Auckland, New Zealand
| | - Karen Rogers
- Department of Microbiology, LabPlus, Auckland City Hospital, Auckland, New Zealand
| | - Louanne Storey
- Department of Microbiology, Middlemore Hospital, Auckland, New Zealand
- Department of Infectious Diseases, Middlemore Hospital, Auckland, New Zealand
| | - Mark R. Marshall
- Department of Renal Medicine, Middlemore Hospital, Auckland, New Zealand
| | - David Holland
- Department of Microbiology, Middlemore Hospital, Auckland, New Zealand
- Department of Infectious Diseases, Middlemore Hospital, Auckland, New Zealand
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Abstract
The filamentous basidiomycetous fungus, Oxyporus corticola, has not previously been reported in the human or veterinary medical literature. Identification of this organism as the etiologic agent of fungal osteomyelitis and multiorgan dissemination in a German shepherd dog was confirmed by comparison of ITS and D1/D2 sequences with known isolates.
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Affiliation(s)
- C W Brockus
- Charles River Laboratories, Preclinical Services, Reno, Nevada 89511, USA.
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23
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Salit RB, Shea YR, Gea-Banacloche J, Fahle GA, Abu-Asab M, Sugui JA, Carpenter AE, Quezado MM, Bishop MR, Kwon-Chung KJ. Death by edible mushroom: first report of Volvariella volvacea as an etiologic agent of invasive disease in a patient following double umbilical cord blood transplantation. J Clin Microbiol 2010; 48:4329-32. [PMID: 20826647 DOI: 10.1128/JCM.01222-10] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe a case of invasive fungal infection caused by Volvariella volvacea following double umbilical cord blood transplantation (UCBT). Although infections caused by several mushroom species have been documented, we believe this to be the first published report of invasive infection with Volvariella volvacea, an edible mushroom belonging to Agaricales.
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Romanelli AM, Sutton DA, Thompson EH, Rinaldi MG, Wickes BL. Sequence-based identification of filamentous basidiomycetous fungi from clinical specimens: a cautionary note. J Clin Microbiol 2010; 48:741-52. [PMID: 20042628 DOI: 10.1128/JCM.01948-09] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The species-level identification of sterile and/or arthroconidium-forming filamentous fungi presumed to be basidiomycetes based upon morphological or physiological features alone is usually not possible due to the limited amount of hyphal differentiation. Therefore, a reliable molecular approach capable of the unambiguous identification of clinical isolates is needed. One hundred sixty-eight presumptive basidiomycetes were screened by sequence analysis of the internal transcribed spacer (ITS) and D1/D2 ribosomal DNA regions in an effort to obtain a species identification. Through the use of this approach, identification of a basidiomycetous fungus to the species level was obtained for 167/168 of the isolates. However, comparison of the BLAST results for each isolate for both regions revealed that only 28.6% (48/168) of the isolates had the same species identification by use of both the ITS and the D1/D2 regions, regardless of the percent identity. At the less stringent genus-only level, the identities for only 48.8% (82/168) of the isolates agreed for both regions. Investigation of the causes for this low level of agreement revealed that 14% of the species lacked an ITS region deposit and 16% lacked a D1/D2 region deposit. Few GenBank deposits were found to be complete for either region, with only 8% of the isolates having a complete ITS region and 10% having a complete D1/D2 region. This study demonstrates that while sequence-based identification is a powerful tool for many fungi, sequence data derived from filamentous basidiomycetes should be interpreted carefully, particularly in the context of missing or incomplete GenBank data, and, whenever possible, should be evaluated in light of compatible morphological features.
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Song Y, Hui J, Kou W, Xin R, Jia F, Wang N, Hu F, Zhang H, Liu H. Identification of Inonotus obliquus and Analysis of Antioxidation and Antitumor Activities of Polysaccharides. Curr Microbiol 2008; 57:454-62. [DOI: 10.1007/s00284-008-9233-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Revised: 07/27/2008] [Accepted: 07/28/2008] [Indexed: 11/25/2022]
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Lee YS, Kang YH, Jung JY, Kang IJ, Han SN, Chung JS, Shin HK, Lim SS. Inhibitory constituents of aldose reductase in the fruiting body of Phellinus linteus. Biol Pharm Bull 2008; 31:765-8. [PMID: 18379080 DOI: 10.1248/bpb.31.765] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In an effort to characterize active principles for diabetic complication from medicinal mushroom, aldose reductase inhibitors were isolated from the fruiting body of Phellinus linteus and identified as hispidin (5), phelligridimer A (6), davallialactone (7), methyldavallialactone (8), hypholomine B (9), interfungins A (10), and inoscavin A (11), together with protocatechuic acid (1), protocatechualdehyde (2), caffeic acid (3), and ellagic acid (4). Their structures were elucidated by spectroscopic analyses. Among them, davallialactone (7), hypholomine B (9), and ellagic acid (4) exhibited potent rat lens aldose reductase and human recombinant aldose reductase inhibitory activity with IC50 values of 0.33, 0.82, 0.63 microM and 0.56, 1.28, 1.37 microM, respectively.
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Affiliation(s)
- Yeon Sil Lee
- Department of Food Science and Nutrition, Hallym University, Chuncheon 200-702, Korea
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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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Lee IK, Yun BS. Highly oxygenated and unsaturated metabolites providing a diversity of hispidin class antioxidants in the medicinal mushrooms Inonotus and Phellinus. Bioorg Med Chem 2007; 15:3309-14. [PMID: 17387019 DOI: 10.1016/j.bmc.2007.03.039] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 03/11/2007] [Accepted: 03/12/2007] [Indexed: 10/23/2022]
Abstract
Three new highly oxygenated and unsaturated metabolites named interfungins A (1), B (2), and C (3), which provide a diversity of hispidin class compounds in the fungi Inonotus and Phellinus, were isolated from the methanolic extract of the fruiting body of the fungus Inonotus xeranticus (Hymenochaetaceae). Their structures were established by spectroscopic methods. The existence of these functionalized metabolites implies that inoscavin A, davallialactone, and phelligridin F, which were previously isolated from the fungi Inonotus and Phellinus spp., are derived from 1. Compound 1 is derived from the condensation of hispidin and hispolon. Inoscavins B and C previously isolated from the fungus I. xeranticus are most probably derived from 2 which stemmed from the oxidative coupling of 3,4-dihydroxybenzalacetone and hispidin. This class of compounds exhibited significant free radical scavenging activity against the superoxide radical cation, ABTS radical anion, and DPPH radical.
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Affiliation(s)
- In-Kyoung Lee
- Functional Metabolomics Research Center, KRIBB, Yuseong, Daejeon 305-806, Republic of Korea
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