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Jiang C, Zhen X, Zhang X, Guo L, Han J, Cui Z, Zhou X. The nonlinear association between albumin levels and risk of noninvasive fungal rhinosinusitis. Eur Arch Otorhinolaryngol 2022; 279:4977-4983. [PMID: 35333963 DOI: 10.1007/s00405-022-07325-7] [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: 01/10/2022] [Accepted: 02/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The preoperative diagnosis of noninvasive fungal rhinosinusitis (NIFRS) is inaccurate, and biomarkers to assist the diagnosis are urgently needed. We aimed to evaluate the relationship between albumin levels and NIFRS to assist in early diagnosis. METHODS Patients with NIFRS and chronic sinusitis were enrolled in this study. Appropriate statistical methods were used to determine whether there was a statistical difference between the groups. Subgroup analysis was performed to investigate the relationship between albumin levels and NIFRS, and a generalised additive model (GAM) was used to perform nonlinear relationships. RESULTS A total of 620 patients were included, including 240 patients with NIFRS. A close relationship was found between albumin levels and NIFRS (P < 0.0001), and the low albumin group was associated with a higher incidence of NIFRS, which was reduced by 60 and 70% in the middle and high albumin groups, respectively. The subgroup analysis also demonstrated an association between albumin levels and NIFRS, except in patients with an alcohol history (P = 0.0665). Interestingly, a nonlinear relationship is observed according to the adjusted GAM. The inflection point was set at 37.0 g/L. A negative correlation was observed among patients with albumin > 37.0 g/L. When the albumin count was <37.0 g/L, the Y value obviously increased and was saturated at 70%, with no further significant increase. CONCLUSION Albumin levels were significantly negatively correlated with the incidence of NIFRS, and the incidence increased markedly among patients with albumin < 37.0 g/L.
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Affiliation(s)
- Chao Jiang
- Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Xiaoyue Zhen
- Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Xin Zhang
- Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Ling Guo
- Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Jie Han
- Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Zhaoyang Cui
- Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
| | - Xuanchen Zhou
- Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
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Tian L, Mu Y, Zhang H, Su X, Yang C, Shu X, Qing D. First report on cutaneous infectious granuloma caused by Schizophyllum commune. BMC Infect Dis 2018; 18:286. [PMID: 29940940 PMCID: PMC6019233 DOI: 10.1186/s12879-018-3187-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background Schizophyllum commune, a basidiomycetous fungus, is a common invader of rotten wood. This fungus rarely causes mycotic disease in humans, especially cutaneous infection. In this paper, we describe the first case of cutaneous granuloma caused by S. commune in a Chinese woman. Case presentation A 25-year-old female with a two-year history of erythema, papules, nodules, and scales on her sole of left foot was presented to our outpatient center. Samples were obtained by the scraping of lesion and for light microscopy. Hyphae were observed by microscopic examination. We carried out a skin tissue biopsy, which showed multiple granulomatous nodules. Biopsy specimens were also inoculated onto media. After being cultured on SDA at 27 °C for 7 days, spreading-woolly-white colonies grew on the inoculation sites of media containing chloramphenicol only and there,s no other colonies grew. S. commune was identified by morphology methods, biochemical tests, and PCR sequencing. Pathological findings also aided in diagnosing cutaneous fungal granuloma. Oral itraconazole was applied. After 1 month of therapy, rashes on her left foot and pain were improved. Conclusion We describe the first case of cutaneous granuloma caused by Schizophyllum commune, which illustrates the importance of recognizing uncommon pathogenic fungal infections.
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Affiliation(s)
- Lidi Tian
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yunzhu Mu
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Hao Zhang
- Department of Dermatology, Shenzhen Baoan Central Hospital and the 5th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.
| | - Xiaocui Su
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Chuan Yang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xianzhu Shu
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Defu Qing
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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Michel J, Maubon D, Varoquaux DA, Boulze C, Normand AC, Righini CA, Piarroux R, Dessi P, Ranque S. Schizophyllum commune: an emergent or misdiagnosed fungal pathogen in rhinology? Med Mycol 2015; 54:301-9. [PMID: 26613704 DOI: 10.1093/mmy/myv084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 08/10/2015] [Indexed: 11/14/2022] Open
Abstract
Schizophyllum commune is a common basidiomycete fungus that is rarely involved in human disease. The medical records of patients operated on for fungal rhinosinusitis (FRS) in two University Hospitals between 2012 and 2014 were reviewed. Within the two-year survey, six female, and notably no male, patients were diagnosed with S. commune rhinosinusitis. Mean age was 44.6 years at diagnosis (30 to 68 years). Mean time between onset of symptoms and diagnosis was 8.5 months (2 to 12 months). All six patients were immunocompetent and had no particular host factor for FRS. S. commune was identified using MALDI-TOF mass spectrometry and identifications were confirmed via DNA sequence analysis. Chronic invasive fungal rhinosinusitis was diagnosed in three of our six patients. Based on histological findings, antifungal treatment was delivered in association with surgery. The basidiomycete fungus S. commune is an emerging cause of rhinosinusitis probably as a direct consequence of the recent technological progress in fungal identification methods (DNA sequencing and MALDI-TOF mass spectrometry).
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Affiliation(s)
- Justin Michel
- Department of Otorhinolaryngology, Head and Neck Surgery, APHM CHU Timone, and Aix-Marseille University, 13385 Marseille Cedex 5, France
| | - Danièle Maubon
- Parasitologie-Mycologie, Département des Agents Infectieux, CHU Grenoble and Université Grenoble Alpes, Grenoble, France
| | | | - Carole Boulze
- Department of Otorhinolaryngology, Head and Neck Surgery, APHM CHU Timone, and Aix-Marseille University, 13385 Marseille Cedex 5, France
| | - Anne Cécile Normand
- Parasitologie-Mycologie, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Adultes, Marseilles, France
| | - Christian Adrien Righini
- Department of Otorhinolaryngology, Head and Neck Surgery CHU Grenoble and Université Grenoble Alpes, Grenoble, France
| | - Renaud Piarroux
- Parasitologie-Mycologie, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Adultes, Marseilles, France Aix-Marseille University, IP-TPT UMR MD3, 13885 Marseilles, France
| | - Patrick Dessi
- Department of Otorhinolaryngology, Head and Neck Surgery, APHM CHU Timone, and Aix-Marseille University, 13385 Marseille Cedex 5, France
| | - Stéphane Ranque
- Parasitologie-Mycologie, Assistance Publique-Hôpitaux de Marseille, CHU Timone-Adultes, Marseilles, France Aix-Marseille University, IP-TPT UMR MD3, 13885 Marseilles, France
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Frequency of fungal agents identified in sinus samples from patients with clinically suspected rhinosinusitis. Diagn Microbiol Infect Dis 2014; 81:208-12. [PMID: 25524158 DOI: 10.1016/j.diagmicrobio.2014.11.017] [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: 07/14/2014] [Revised: 11/14/2014] [Accepted: 11/25/2014] [Indexed: 11/22/2022]
Abstract
Fungal rhinosinusitis (FRS) is one of the most important rhinosinusoidal disorders, which involves a variety of etiological agents. We carried out a study to determine the frequency of fungal agents in sinus samples from patients with clinically suspected rhinosinusitis (RS). A total of 205 clinical samples were assessed from 174 patients with clinically suspected RS, of which 48 were positive for microscopic examination and culture, 47 were positive for direct examination but negative by culture, 4 were negative for direct examination but positive by culture, and 106 were negative for both methodologies. The main fungal agents isolated were Aspergillus spp. (32.7%), followed by Schizophyllum commune (28.8%). Sensitivity and specificity of the direct examination were 92.3% and 69.3%, respectively, and concordance between the direct examination and culture was 48.4%. This study indicated that both Aspergillus and S. commune appear to be the most important agents involved in the development of FRS.
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Schizophillum commune causing sinusitis with nasal polyposis in the sub-Himalayan region: first case report and review. Mycopathologia 2013; 177:103-10. [PMID: 24318775 DOI: 10.1007/s11046-013-9717-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 11/03/2013] [Indexed: 10/25/2022]
Abstract
Schizophillum commune is an environmental fungus rarely causing human infections of diverse nature. Sinusitis occurs in immunocompromised persons and seldom in healthy subjects. Though easily isolated, the lack of awareness of its virulence is a bottleneck in the diagnosis of this infection. We report the first case of S. commune sinusitis with nasal polyps in an immunocompetent male from the sub-Himalayan region. The computerized tomography scan findings established the clinical diagnosis, and causative agent was confirmed as S. commune. A white, woolly mold with septate, hyaline hyphae and characteristic spicules but unclamped connections suggested a monokaryotic isolate. Patient was treated successfully with fiberoptic endoscopic sinus surgery, and no antifungal therapy was instituted. There was no recurrence at review after 1 year.
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Toya T, Shinohara A, Tatsuno K, Seo S, Nannya Y, Ichikawa M, Makimura K, Moriya K, Kurokawa M. A case of Schizophyllum commune sinusitis following unrelated cord blood transplantation for acute lymphoblastic leukemia. Int J Hematol 2013; 98:261-3. [PMID: 23686329 DOI: 10.1007/s12185-013-1362-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 05/07/2013] [Accepted: 05/07/2013] [Indexed: 11/30/2022]
Abstract
Schizophyllum commune is a globally distributed basidiomycete fungus that is known as a rare cause of sinusitis, for which no prompt treatment has been established. We describe the first report of S. commune sinusitis following unrelated cord blood transplantation for acute lymphoblastic leukemia. Thirteen days after transplantation, a 23-year-old female developed maxillary and ethmoid sinusitis. The sinusitis was antimicrobial-resistant, and the sinus aspirate culture revealed white wooly mold, which was identified as S. commune by nucleotide sequencing. The patient was successfully treated with intravenous administration of liposomal amphotericin B for 2 months, followed by oral voriconazole. This report suggests the effectiveness of liposomal amphotericin B and voriconazole for S. commune infection in immunocompromised patients. Given the difficulty in distinguishing S. commune infection from aspergillosis by standard culture methods, the incidence of S. commune infection following allogeneic hematopoietic stem cell transplantation may be underestimated. Nucleotide sequencing may be useful in the diagnosis of S. commune infection.
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Affiliation(s)
- Takashi Toya
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Molecular characterization and in vitro antifungal susceptibility profile of Schizophyllum commune, an emerging basidiomycete in bronchopulmonary mycoses. Antimicrob Agents Chemother 2013; 57:2845-8. [PMID: 23507274 DOI: 10.1128/aac.02619-12] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Schizophyllum commune (n = 30) showed lowest geometric mean MICs of isavuconazole (0.19 μg/ml), itraconazole (0.2 μg/ml), voriconazole (0.24 μg/ml), and amphotericin B (0.29 μg/ml) and high geometric mean MICs of fluconazole (19.39 μg/ml) and flucytosine (17.28 μg/ml). Five cases (of 8) of allergic bronchopulmonary mycosis that were treated with itraconazole had no recrudescence after 6 to 24 months of follow-up. One case each of invasive pulmonary mycosis and fungal ball were treated successfully with voriconazole and itraconazole.
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Chowdhary A, Randhawa HS, Gaur SN, Agarwal K, Kathuria S, Roy P, Klaassen CH, Meis JF. Schizophyllum commune as an emerging fungal pathogen: a review and report of two cases. Mycoses 2012; 56:1-10. [PMID: 22524529 DOI: 10.1111/j.1439-0507.2012.02190.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We report Schizophyllum commune as the aetiological agent of one case each of allergic broncho-pulmonary mycosis (ABPM) and pulmonary fungal ball, and present a literature review. The fungus was characterised by clamp connections, hyphal spicules, and formation of basidiocarps with basidiospores. The phenotypic identification was confirmed by sequencing of the ITS region. To-date, ABPM and pulmonary fungal ball to S. commune have been reported exclusively from Japan and North America respectively. Of the 71 globally reported cases due to S. commune, 45 (63%) were bronchopulmonary, 22 (31%) sinusitis and 4 extrapulmonary. Taken together, cases of bronchopulmonary disease and sinusitis numbered 67 (94%), indicating the respiratory tract as the primary target of disease. Concerning the country-wise distribution, Japan topped the list with 33 cases (46%), followed by Iran - 7 cases (10%), U.S.A. - 6 cases (9%), and a lower prevalence of 1.4-6% for the remaining 12 countries. The preponderance of the disease in Japan may be attributed to its greater awareness vis-à-vis that in other countries rather than to any geographical/climatic factors. We believe that the burden of S. commune-incited disease is currently underestimated, warranting comprehensive prospective studies to determine its prevalence.
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Affiliation(s)
- A Chowdhary
- Departments of Medical Mycology Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
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Swain B, Panigrahy R, Panigrahi D. Schizophyllum commune sinusitis in an immunocompetent host. Indian J Med Microbiol 2012; 29:439-42. [PMID: 22120814 DOI: 10.4103/0255-0857.90194] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Schizophyllum commune is widely distributed in the nature, but it rarely causes human infection. We have isolated this mould in a 46-year-old immunocompetent, non-diabetic patient with chronic sinusitis, previously treated with multiple antibiotics and topical steroid nasal drops with no response. Materials obtained from the nasal sinus during the endoscopic surgery, on KOH mount and histopathological study revealed broad septed hyaline hyphae. Growth on the Sabouraud's dextrose agar and potato dextrose agar produced white moulds with microscopic and macroscopic characters of S. commune. Till date there are few reports of S. commune sinusitis in immunocompetent individuals Worldwide. This is the first reported case in India to the best of our knowledge.
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Affiliation(s)
- B Swain
- Department of Microbiology, Institute of Medical Sciences and SUM Hospital, SOA University, Kalinga Nagar, Bhubaneswar, Odisha, India.
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Perić A, Vojvodić D, Zolotarevski L, Perić A. Nasal polyposis and fungal Schizophyllum commune infection: a case report. ACTA MEDICA (HRADEC KRÁLOVÉ) 2011; 54:83-6. [PMID: 21842724 DOI: 10.14712/18059694.2016.25] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We present a rare case of eosinophilic fungal rhinosinusitis with nasal polyps in a 32-year-old woman caused by basidiomycete fungus Schizophyllum commune. Diagnosis was done by the endoscopic nasal examination, computed tomography (CT) of the paranasal sinuses, the histopathological examination of polyps, the presence of eosinophils and fungal hyphae in nasal mucus and by the detection of S. commune by culture. The patient was successfully treated by combination of oral itraconazole and topical corticosteroid therapy combined with surgery. The pathogenesis and diagnosis of allergic fungal rhinosinusitis are also discussed.
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Affiliation(s)
- Aleksandar Perić
- Clinic of Otorhinolaryngology, Department of Rhinology, Military Medical Academy, Belgrade, Serbia.
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