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Harris HS, Harris MD, Thompson GR, Engelthaler DM, Montfort PL, Leviner AL, Miller MA. Novel Presentation of Coccidioidomycosis with Myriad Free-Floating Proteinaceous Spheres in the Pericardial Sac of a Southern Sea Otter (Enhydra lutris nereis). J Wildl Dis 2024; 60:223-228. [PMID: 37756694 DOI: 10.7589/jwd-d-23-00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/26/2023] [Indexed: 09/29/2023]
Abstract
A southern sea otter (Enhydra lutris nereis) stranded dead in central California, USA, with a distended pericardial sac containing thousands of free-floating proteinaceous masses. Serology, fungal culture, PCR, and sequencing confirmed the etiology of this novel lesion as Coccidioides immitis. Range expansion of this zoonotic pathogen is predicted with climate change.
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Affiliation(s)
- Heather S Harris
- The Marine Mammal Center, 1385 Main Street, Morro Bay, California 93442, USA
- California Polytechnic State University, Animal Science Department, 1 Grand Avenue, San Luis Obispo, California 93407, USA
| | - Michael D Harris
- California Department of Fish and Wildlife, Marine Wildlife Veterinary Care and Research Center, 151 McAllister Way, Santa Cruz, California 95060, USA
| | - George R Thompson
- University of California Davis Medical Center, Department of Internal Medicine, Division of Infectious Diseases, 4150 V Street, Suite G500, Sacramento, California 95817, USA
| | - David M Engelthaler
- Translational Genomics Research Institute, Pathogen and Microbiome Division, 3051 W Shamrell Boulevard, Flagstaff, Arizona 86005, USA
| | - Parker L Montfort
- Translational Genomics Research Institute, Pathogen and Microbiome Division, 3051 W Shamrell Boulevard, Flagstaff, Arizona 86005, USA
| | - Alexis L Leviner
- California Polytechnic State University, Animal Science Department, 1 Grand Avenue, San Luis Obispo, California 93407, USA
| | - Melissa A Miller
- California Department of Fish and Wildlife, Marine Wildlife Veterinary Care and Research Center, 151 McAllister Way, Santa Cruz, California 95060, USA
- University of California Davis Wildlife Health Center, 1089 Veterinary Medicine Drive, Davis, California 95616, USA
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2
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McHardy IH, Barker B, Thompson GR. Review of Clinical and Laboratory Diagnostics for Coccidioidomycosis. J Clin Microbiol 2023; 61:e0158122. [PMID: 36883820 PMCID: PMC10204634 DOI: 10.1128/jcm.01581-22] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Coccidioidomycosis is a fungal disease associated with soil exposure that frequently goes undiagnosed due at least in part to its nonspecific presentation and the lack of clinical suspicion by health care providers. Currently available diagnostics for coccidioidomycosis offer qualitative results that can suffer from low specificity, while semiquantitative assays are labor-intensive and complex and can require multiple days to complete. Furthermore, significant confusion exists regarding the optimal diagnostic algorithms and appropriate usage of available diagnostic tests. This review aims to inform clinical laboratorians and treating clinicians about the current diagnostic landscape, appropriate diagnostic strategies, and future diagnostic directions for coccidioidomycosis, which is expected to become more prevalent due to increased migration into areas of endemicity and climate changes.
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Affiliation(s)
- Ian H. McHardy
- Scripps Medical Laboratory, Scripps Health, San Diego, California, USA
- University of California, Davis Center for Valley Fever, Sacramento, California, USA
| | - Bridget Barker
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - George R. Thompson
- Department of Internal Medicine, Division of Infectious Diseases, University of California, Davis Medical Center, Sacramento, California, USA
- University of California, Davis Center for Valley Fever, Sacramento, California, USA
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3
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Yang X, Song Y, Liang T, Wang Q, Li R, Liu W. Application of laser capture microdissection and PCR sequencing in the diagnosis of Coccidioides spp. infection: A case report and literature review in China. Emerg Microbes Infect 2021; 10:331-341. [PMID: 33576325 PMCID: PMC7919914 DOI: 10.1080/22221751.2021.1889931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/19/2021] [Accepted: 02/09/2021] [Indexed: 02/08/2023]
Abstract
Coccidioidomycosis is endemic to California, Arizona, and Mexico. In recent years, the reported cases of coccidioidomycosis have increased in nonendemic regions. Here, we reported a case of imported pulmonary coccidioidomycosis in a Chinese patient. A 63-year-old man presented with dry cough and fatigue for 6 months, and a computed tomography scan revealed a solitary nodule in the right lower lung and small nodules in both lungs. The diagnosis of coccidioidomycosis was initially confirmed by histopathologic examination. The pathogen Coccidioides spp. was identified by laser capture microdissection (LCM) combined with subsequent molecular techniques based on the positive histopathologic features. Additionally, we reviewed 47 reported cases of coccidioidomycosis in China. The number of reported cases is increasing, and the incidence of disseminated infection has exhibited a trend of shifting towards healthy young adults in China. Since clinical presentations and imaging findings lack specificity, a majority of domestic cases of coccidioidomycosis were initially misdiagnosed as tumours or tuberculosis. Moreover, the diagnosis of endemic mycoses may be challenging because of their rarity and the limited availability of diagnostic tests. The diagnosis was mainly confirmed by histopathological examination. The species involved were identified based on positive cultures in only 4 cases. To our knowledge, this is the first study to use LCM and molecular techniques to identify Coccidioides spp. in the histopathologically positive but uncultivable specimen. Comparing with previous reported studies, LCM combined with nucleic acid amplification techniques improve the ability of species identification for the timely diagnosis of coccidioidomycosis.
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Affiliation(s)
- Xinyu Yang
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - Yinggai Song
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - TianYu Liang
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - Qiqi Wang
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - Ruoyu Li
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
| | - Wei Liu
- Department of Dermatology and Venereology, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University First Hospital, Beijing, People’s Republic of China
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4
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Chaturvedi S, Victor TR, Marathe A, Sidamonidze K, Crucillo KL, Chaturvedi V. Real-time PCR assay for detection and differentiation of Coccidioides immitis and Coccidioides posadasii from culture and clinical specimens. PLoS Negl Trop Dis 2021; 15:e0009765. [PMID: 34529679 PMCID: PMC8486383 DOI: 10.1371/journal.pntd.0009765] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/01/2021] [Accepted: 08/25/2021] [Indexed: 11/19/2022] Open
Abstract
Coccidioidomycosis (Valley fever) is a pulmonary and systemic fungal disease with increasing incidence and expanding endemic areas. The differentiation of etiologic agents Coccidioides immitis and C. posadasii remains problematic in the clinical laboratories as conventional PCR and satellite typing schemes are not facile. Therefore, we developed Cy5- and FAM-labeled TaqMan-probes for duplex real-time PCR assay for rapid differentiation of C. immitis and C. posadasii from culture and clinical specimens. The RRA2 gene encoding proline-rich antigen 2, specific for Coccidioides genus, was the source for the first set of primers and probe. Coccidioides immitis contig 2.2 (GenBank: AAEC02000002.1) was used to design the second set of primers and probe. The second primers/probe did not amplify the corresponding C. posadasii DNA, because of an 86-bp deletion in the contig. The assay was highly sensitive with limit of detection of 0.1 pg gDNA/PCR reaction, which was equivalent to approximately ten genome copies of C. immitis or C. posadasii. The assay was highly specific with no cross-reactivity to the wide range of fungal and bacterial pathogens. Retrospective analysis of fungal isolates and primary specimens submitted from 1995 to 2020 confirmed 168 isolates and four primary specimens as C. posadasii and 30 isolates as C. immitis from human coccidioidomycosis cases, while all eight primary samples from two animals (rhesus monkey and rhinoceros) were confirmed as C. posadasii. A preliminary analysis of cerebrospinal fluid (CSF) and pleural fluid samples showed positive correlation between serology tests and real-time PCR for two of the 15 samples. The Coccidioides spp. duplex real-time PCR will allow rapid differentiation of C. immitis and C. posadasii from clinical specimens and further augment the treatment and surveillance of coccidioidomycosis.
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Affiliation(s)
- Sudha Chaturvedi
- Mycology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
- Department of Biomedical Sciences, University at Albany, Albany, New York, United States of America
- * E-mail: (SC); (VC)
| | - Tanya R. Victor
- Mycology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Anuradha Marathe
- Mycology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Ketevan Sidamonidze
- Mycology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
| | - Kelly L. Crucillo
- Coccidioidomycosis Serology Laboratory, Department of Medical Microbiology and Immunology, University of California School of Medicine, Davis, California, United States of America
| | - Vishnu Chaturvedi
- Mycology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, United States of America
- * E-mail: (SC); (VC)
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5
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Gorris ME, Caballero Van Dyke MC, Carey A, Hamm PS, Mead HL, Uehling JK. A Review of Coccidioides Research, Outstanding Questions in the Field, and Contributions by Women Scientists. CURRENT CLINICAL MICROBIOLOGY REPORTS 2021; 8:114-128. [PMID: 34367880 PMCID: PMC8327307 DOI: 10.1007/s40588-021-00173-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 12/19/2022]
Abstract
Purpose of Review Coccidioidomycosis is an infectious disease that gained clinical significance in the early 20th century. Many of the foundational contributions to coccidioidomycosis research, including the discovery of the fungal disease agent, Coccidioides spp., were made by women. We review recent progress in Coccidioides research and big questions remaining in the field, while highlighting some of the contributions from women. Recent Findings New molecular-based techniques provide a promising method for detecting Coccidioides, which can help determine the dominate reservoir host and ideal environmental conditions for growth. Genetic and genomic analyses have allowed an understanding of population structure, species level diversity, and evolutionary histories. We present a current, comprehensive genome list, where women contributed many of these entries. Several efforts to develop a coccidioidomycosis vaccine are underway. Summary Women continue to pioneer research on Coccidioides, including the relationships between the fungi and the environment, genetics, and clinical observations. Significant questions remain in the field of Coccidioides, including the main host reservoir, the relationships between genotypic and phenotypic variation, and the underlying cause for chronic clinical coccidioidomycosis cases.
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Affiliation(s)
- Morgan E Gorris
- Los Alamos National Laboratory, Information Systems and Modeling & Center for Nonlinear Studies, Los Alamos, NM USA
| | | | - Adrienne Carey
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Paris S Hamm
- Department of Biology, University of New Mexico, Albuquerque, NM USA
| | - Heather L Mead
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ USA
| | - Jessie K Uehling
- Department of Botany and Plant Pathology, Oregon State University, Corvallis, OR USA
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6
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Havis BM, Walker KE, Adkins PRF, Shen Z, Middleton JR, Gull T, Nagy D, Kim DY. Systemic coccidioidomycosis in a llama cria native to Missouri. J Vet Diagn Invest 2021; 33:587-590. [PMID: 33583365 DOI: 10.1177/1040638721994615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 3-mo-old male llama was examined because of a 4-wk history of lethargy and ill thrift. Clinical examination revealed subcutaneous masses in the left prescapular and right inguinal regions, mild ataxia, a slight head tilt to the right, and right ear droop. The cria died before clinical workup was complete. At autopsy, there was generalized lymphadenomegaly, a hepatic nodule, a midbrain mass causing rostral compression of the cerebellum, and internal hydrocephalus. Microscopic findings included pyogranulomatous lymphadenitis, meningoencephalitis, hepatitis, and bronchopneumonia. Intralesional fungal spherules, most consistent with Coccidioides spp., were identified in the lymph nodes, lung, and brain. Fungal culture, single-nucleotide variation genotyping real-time PCR, and DNA sequencing confirmed Coccidioides posadasii. The dam of the cria was native to Arizona and had been moved to Missouri ~2.5 y previously. Agar gel immunodiffusion assay of the herd revealed that only the dam was positive for Coccidioides spp.; 6 herdmates were negative. Computed tomography of the dam revealed multiple nodules within the lungs and liver, which were presumed to be an active coccidioidomycosis infection. This case of systemic coccidioidomycosis in a llama native to Missouri was presumably acquired by vertical transmission from the dam.
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Affiliation(s)
- Brett M Havis
- Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - Kelsey E Walker
- Veterinary Health Center, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - Pamela R F Adkins
- Veterinary Health Center, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - Zhenyu Shen
- Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - John R Middleton
- Veterinary Health Center, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - Tamara Gull
- Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - Dusty Nagy
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX
| | - Dae Young Kim
- Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, MO
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7
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Gade L, McCotter OZ, Bowers JR, Waddell V, Brady S, Carvajal JA, Sunenshine R, Komatsu KK, Engelthaler DM, Chiller T, Litvintseva AP. The detection of Coccidioides from ambient air in Phoenix, Arizona: Evidence of uneven distribution and seasonality. Med Mycol 2021; 58:552-559. [PMID: 31506673 DOI: 10.1093/mmy/myz093] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/15/2019] [Accepted: 08/23/2019] [Indexed: 11/12/2022] Open
Abstract
Coccidioidomycosis is a debilitating fungal disease caused by inhalation of arthroconidia. We developed a novel approach for detection of airborne Coccidioides and used it to investigate the distribution of arthroconidia across the Phoenix, Arizona, metropolitan area. Air filters were collected daily from 21 stationary air-sampling units across the area: the first set collected before, during and after a large dust storm on August 25, 2015, and the second over the 45-day period September 25-November 8, 2016. Analysis of DNA extracted from the filters demonstrated that the day of the dust storm was not associated with increase of Coccidioides in air samples, although evidence of the low-level polymerase chain reaction (PCR) inhibition was observed in DNA extracted from samples collected on the day of the dust storm. Testing over 45 days identified uneven geographic distribution suggesting Coccidioides hot spots. In 2016, highest daily concentration of arthroconidia was observed between September 25-October 20, and only sporadic low levels were detected after that. These results provide evidence of seasonality and uneven spatial distribution of Coccidioides in the air. Our results demonstrate that routine air monitoring for arthroconidia is possible and provides an important tool for Coccidioides surveillance, which can address important questions about environmental exposure and human infection.
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Affiliation(s)
- Lalitha Gade
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Orion Z McCotter
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jolene R Bowers
- Pathogen and Microbiome Division, Translational Genomics Research Institute (TGen-North), Flagstaff, Arizona, USA
| | - Victor Waddell
- Arizona Department of Health Services, Phoenix, Arizona, USA
| | - Shane Brady
- Arizona Department of Health Services, Phoenix, Arizona, USA
| | | | - Rebecca Sunenshine
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Maricopa County Department of Public Health, Phoenix, Arizona, USA
| | | | - David M Engelthaler
- Pathogen and Microbiome Division, Translational Genomics Research Institute (TGen-North), Flagstaff, Arizona, USA
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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8
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Mead HL, Hamm PS, Shaffer IN, Teixeira MDM, Wendel CS, Wiederhold NP, Thompson GR, Muñiz-Salazar R, Castañón-Olivares LR, Keim P, Plude C, Terriquez J, Galgiani JN, Orbach MJ, Barker BM. Differential Thermotolerance Adaptation between Species of Coccidioides. J Fungi (Basel) 2020; 6:E366. [PMID: 33327629 PMCID: PMC7765126 DOI: 10.3390/jof6040366] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/24/2020] [Accepted: 12/05/2020] [Indexed: 12/18/2022] Open
Abstract
Coccidioidomycosis, or Valley fever, is caused by two species of dimorphic fungi. Based on molecular phylogenetic evidence, the genus Coccidioides contains two reciprocally monophyletic species: C. immitis and C. posadasii. However, phenotypic variation between species has not been deeply investigated. We therefore explored differences in growth rate under various conditions. A collection of 39 C. posadasii and 46 C. immitis isolates, representing the full geographical range of the two species, was screened for mycelial growth rate at 37 °C and 28 °C on solid media. The radial growth rate was measured for 16 days on yeast extract agar. A linear mixed effect model was used to compare the growth rate of C. posadasii and C. immitis at 37 °C and 28 °C, respectively. C. posadasii grew significantly faster at 37 °C, when compared to C. immitis; whereas both species had similar growth rates at 28 °C. These results indicate thermotolerance differs between these two species. As the ecological niche has not been well-described for Coccidioides spp., and disease variability between species has not been shown, the evolutionary pressure underlying the adaptation is unclear. However, this research reveals the first significant phenotypic difference between the two species that directly applies to ecological research.
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Affiliation(s)
- Heather L. Mead
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ 86011, USA; (H.L.M.); (P.K.)
| | - Paris S. Hamm
- Department of Biology, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Isaac N. Shaffer
- School of Informatics, Computers, and Cyber Systems, Northern Arizona University, Flagstaff, AZ 86011, USA;
| | | | | | - Nathan P. Wiederhold
- Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 77030, USA;
| | - George R. Thompson
- Departments of Internal Medicine Division of Infectious Diseases, and Medical Microbiology and Immunology, University of California-Davis, Sacramento, CA 95616, USA;
| | - Raquel Muñiz-Salazar
- Laboratorio de Epidemiología y Ecología Molecular, Escuela Ciencias de la Salud, Universidad Autónoma de Baja California, Unidad Valle Dorado, Ensenada 22890, Mexico;
| | - Laura Rosio Castañón-Olivares
- Department of Microbiology and Parasitology, Universidad Nacional Autónoma de Mexico, Ciudad de México 04510, Mexico;
| | - Paul Keim
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ 86011, USA; (H.L.M.); (P.K.)
| | - Carmel Plude
- Northern Arizona Healthcare, Flagstaff, AZ 86001, USA; (C.P.); (J.T.)
| | - Joel Terriquez
- Northern Arizona Healthcare, Flagstaff, AZ 86001, USA; (C.P.); (J.T.)
| | - John N. Galgiani
- Valley Fever Center for Excellence, University of Arizona, Tucson, AZ 85721, USA; (J.N.G.); (M.J.O.)
| | - Marc J. Orbach
- Valley Fever Center for Excellence, University of Arizona, Tucson, AZ 85721, USA; (J.N.G.); (M.J.O.)
- School of Plant Sciences, University of Arizona, Tucson, AZ 85721, USA
| | - Bridget M. Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ 86011, USA; (H.L.M.); (P.K.)
- Valley Fever Center for Excellence, University of Arizona, Tucson, AZ 85721, USA; (J.N.G.); (M.J.O.)
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9
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Gunstra A, Steurer JA, Seibert RL, Dixon BC, Russell DS. Sensitivity of Serologic Testing for Dogs Diagnosed with Coccidioidomycosis on Histology: 52 Cases (2012-2013). J Am Anim Hosp Assoc 2020; 55:238-242. [PMID: 31433229 DOI: 10.5326/jaaha-ms-6772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Coccidioidomycosis, or Valley Fever, is a fungal infection caused by Coccidioides spp., soil-living fungi endemic to the southwest region of the United States. The infection can cause various diseases including respiratory, neurologic, cardiac, dermatologic, and ocular disease as well as osteomyelitis in dogs and many other mammals. Obtaining a definitive diagnosis can be challenging. Serology is commonly used as a screening diagnostic test for disease, but both false-negative and false-positive results have been reported. Fifty-two cases of coccidioidomycosis diagnosed via histopathology were retrospectively evaluated. The sensitivity of serology in the study population was determined to be 87% for immunoglobulin G and 46% for immunoglobulin M. The cases were evaluated for an association between negative serology results and anatomic location of disease, but these variables were found to be independent. This study reports the sensitivity of serology for canine coccidioidomycosis and highlights the importance of using multiple diagnostic tests for definitive diagnosis of infection.
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Affiliation(s)
- Amber Gunstra
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
| | - Jeffrey A Steurer
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
| | - Rachel L Seibert
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
| | - Bradford C Dixon
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
| | - Duncan S Russell
- From Southwest Veterinary Surgical Service, P.C., Gilbert, Arizona (A.G., J.A.S., R.L.S., B.C.D.); and the Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon (D.S.R.)
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10
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Abstract
PURPOSE OF REVIEW The purpose of the review is an update of diagnosis and treatment of coccidioidomycosis infection in solid organ transplant (SOT) patients. Endemic fungal infections continue to be a cause of serious morbidity and mortality in transplant recipients. RECENT FINDINGS In transplant patients there are recommendations regarding screening in areas that are endemic for coccidioidomycosis. This screening involves serologic testing and chest imaging. In endemic areas pretransplant seropositivity varies from 1.4 to 5.6%. In immunocompromised patients with elevated complement fixation titers, evaluation of cerebrospinal fluid is recommended even in the absence of symptoms. Although coccidioidomycosis can be a self-limited disease in immunocompotent patients, all SOT patients should be treated regardless of severity. This may include intravenous amphotericin B in severe cases and fluconazole therapy in milder episodes. In those SOT recipients with evidence of prior coccidioidomycosis, lifelong secondary prophylaxis with fluconazole given risk of recurrent disease. SUMMARY Coccidioidomycosis continues to be a cause of serious morbidity and mortality in transplant recipients but with proper screening and treatment can be successfully managed.
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11
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Barker BM, Litvintseva AP, Riquelme M, Vargas-Gastélum L. Coccidioides ecology and genomics. Med Mycol 2019; 57:S21-S29. [PMID: 30690605 DOI: 10.1093/mmy/myy051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Indexed: 11/13/2022] Open
Abstract
Although the natural history and ecology of Coccidioides spp. have been studied for over 100 years, many fundamental questions about this fungus remain unanswered. Two of the most challenging aspects of the study of Coccidioides have been the undefined ecological niche and the outdated geographic distribution maps dating from midcentury. This review details the history of Coccidioides ecological research, and discusses current strategies and advances in understanding Coccidioides genetics and ecology.
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Affiliation(s)
- Bridget M Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, USA
| | | | - Meritxell Riquelme
- Department of Microbiology, Centro de Investigación Científica y Educación Superior de Ensenada (CICESE), Ctra. Ensenada-Tijuana No. 3918, Ensenada, Baja California, 22860, Mexico
| | - Lluvia Vargas-Gastélum
- Department of Microbiology, Centro de Investigación Científica y Educación Superior de Ensenada (CICESE), Ctra. Ensenada-Tijuana No. 3918, Ensenada, Baja California, 22860, Mexico
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12
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Li Z, Chaturvedi V. The Powers and Perils of PCR in the Search for the Natural Reservoirs of Coccidioides Species. Mycopathologia 2019; 182:435-438. [PMID: 28466242 DOI: 10.1007/s11046-017-0136-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Zhirong Li
- Howard Hughes Medical Institute, University of California Berkeley, Berkeley, CA, USA
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Fernandez JA, Hidalgo MN, Hodzic E, Diab SS, Uzal FA. Pathology of coccidioidomycosis in llamas and alpacas. J Vet Diagn Invest 2018; 30:560-564. [PMID: 29790449 DOI: 10.1177/1040638718777282] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Coccidioidomycosis is a fungal disease caused by either Coccidioides immitis or Coccidioides posadasii. Anecdotal evidence suggests that camelids are particularly susceptible to this disease and that a relatively large percentage of pneumonias in these animals are caused by Coccidioides spp. In a search of 21 y (1992-2013) of records from the California Animal Health and Food Safety Laboratory, we found 79 cases of coccidioidomycosis diagnosed in camelids; 66 (84%) had pneumonia and 13 (16%) had lesions only in organs other than the lungs. The organs most frequently affected were lung (84%) and liver (78%). Coccidioides spp. were the cause of pneumonia in 66 of 362 (18%) camelid cases during the study period. The lesions in affected organs were multifocal-to-coalescing pyogranulomas, which in most cases were visible grossly. Ten of the 12 formalin-fixed, paraffin-embedded lung samples tested by a universal Coccidioides spp. PCR assay were positive (4 C. immitis, 2 C. posadasii); the species could not be determined in 4 of the 10 cases positive by PCR. Coccidioidomycosis is an important cause of pneumonia in camelids in California, and can be caused by either C. immitis or C. posadasii.
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Affiliation(s)
- Julian A Fernandez
- Basic and Agricultural Studies Department, Veterinary School, National University of Rio Cuarto, Rio Cuarto, Argentina (Fernandez).,Pathology Department, Veterinary School, Autonomous University of Barcelona, Barcelona, Spain (Hidalgo).,Real-time PCR Research and Diagnostics Core Facility (Hodzic), School of Veterinary Medicine, University of California, Davis, CA.,California Animal Health and Food Safety Laboratory, Davis (Diab), School of Veterinary Medicine, University of California, Davis, CA.,San Bernardino (Uzal) branches, School of Veterinary Medicine, University of California, Davis, CA
| | - Mireia N Hidalgo
- Basic and Agricultural Studies Department, Veterinary School, National University of Rio Cuarto, Rio Cuarto, Argentina (Fernandez).,Pathology Department, Veterinary School, Autonomous University of Barcelona, Barcelona, Spain (Hidalgo).,Real-time PCR Research and Diagnostics Core Facility (Hodzic), School of Veterinary Medicine, University of California, Davis, CA.,California Animal Health and Food Safety Laboratory, Davis (Diab), School of Veterinary Medicine, University of California, Davis, CA.,San Bernardino (Uzal) branches, School of Veterinary Medicine, University of California, Davis, CA
| | - Emir Hodzic
- Basic and Agricultural Studies Department, Veterinary School, National University of Rio Cuarto, Rio Cuarto, Argentina (Fernandez).,Pathology Department, Veterinary School, Autonomous University of Barcelona, Barcelona, Spain (Hidalgo).,Real-time PCR Research and Diagnostics Core Facility (Hodzic), School of Veterinary Medicine, University of California, Davis, CA.,California Animal Health and Food Safety Laboratory, Davis (Diab), School of Veterinary Medicine, University of California, Davis, CA.,San Bernardino (Uzal) branches, School of Veterinary Medicine, University of California, Davis, CA
| | - Santiago S Diab
- Basic and Agricultural Studies Department, Veterinary School, National University of Rio Cuarto, Rio Cuarto, Argentina (Fernandez).,Pathology Department, Veterinary School, Autonomous University of Barcelona, Barcelona, Spain (Hidalgo).,Real-time PCR Research and Diagnostics Core Facility (Hodzic), School of Veterinary Medicine, University of California, Davis, CA.,California Animal Health and Food Safety Laboratory, Davis (Diab), School of Veterinary Medicine, University of California, Davis, CA.,San Bernardino (Uzal) branches, School of Veterinary Medicine, University of California, Davis, CA
| | - Francisco A Uzal
- Basic and Agricultural Studies Department, Veterinary School, National University of Rio Cuarto, Rio Cuarto, Argentina (Fernandez).,Pathology Department, Veterinary School, Autonomous University of Barcelona, Barcelona, Spain (Hidalgo).,Real-time PCR Research and Diagnostics Core Facility (Hodzic), School of Veterinary Medicine, University of California, Davis, CA.,California Animal Health and Food Safety Laboratory, Davis (Diab), School of Veterinary Medicine, University of California, Davis, CA.,San Bernardino (Uzal) branches, School of Veterinary Medicine, University of California, Davis, CA
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Colson AJ, Vredenburgh L, Guevara RE, Rangel NP, Kloock CT, Lauer A. Large-Scale Land Development, Fugitive Dust, and Increased Coccidioidomycosis Incidence in the Antelope Valley of California, 1999-2014. Mycopathologia 2017; 182:439-458. [PMID: 28084574 DOI: 10.1007/s11046-016-0105-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 12/16/2016] [Indexed: 11/26/2022]
Abstract
Ongoing large-scale land development for renewable energy projects in the Antelope Valley, located in the Western Mojave Desert, has been blamed for increased fugitive dust emissions and coccidioidomycosis incidence among the general public in recent years. Soil samples were collected at six sites that were destined for solar farm construction and were analyzed for the presence of the soil-borne fungal pathogen Coccidioides immitis which is endemic to many areas of central and southern California. We used a modified culture-independent nested PCR approach to identify the pathogen in all soil samples and also compared the sampling sites in regard to soil physical and chemical parameters, degree of disturbance, and vegetation. Our results indicated the presence of C. immitis at four of the six sites, predominantly in non-disturbed soils of the Pond-Oban complex, which are characterized by an elevated pH and salt bush communities, but also in grassland characterized by different soil parameters and covered with native and non-native annuals. Overall, we were able to detect the pathogen in 40% of the soil samples (n = 42). Incidence of coccidioidomycosis in the Antelope Valley was positively correlated with land use and particulate matter in the air (PM10) (Pearson correlation coefficient >0.5). With the predicted population growth and ongoing large-scale disturbance of soil in the Antelope Valley in coming years, incidence of coccidioidomycosis will likely further increase if policy makers and land developers continue to ignore the risk of grading land without implementing long-term dust mitigation plans in Environmental Impact Reports.
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Affiliation(s)
- Aaron J Colson
- Department of Biology, California State University Bakersfield (CSUB), 9001 Stockdale Highway, Bakersfield, CA, 93311-1022, USA
| | - Larry Vredenburgh
- Bureau of Land Management, Bakersfield Field Office, 3801 Pegasus Drive, Bakersfield, CA, 93308, USA
| | - Ramon E Guevara
- County of Los Angeles Department of Public Health, 600 S. Commonwealth Ave, Suite 700, Los Angeles, CA, 90005, USA
| | - Natalia P Rangel
- Department of Biology, California State University Bakersfield (CSUB), 9001 Stockdale Highway, Bakersfield, CA, 93311-1022, USA
| | - Carl T Kloock
- Department of Biology, California State University Bakersfield (CSUB), 9001 Stockdale Highway, Bakersfield, CA, 93311-1022, USA
| | - Antje Lauer
- Department of Biology, California State University Bakersfield (CSUB), 9001 Stockdale Highway, Bakersfield, CA, 93311-1022, USA.
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Forrester JD, Guo HH, Weiser TG. Coccidioidomycosis: Surgical Issues and Implications. Surg Infect (Larchmt) 2016; 17:645-655. [PMID: 27740893 DOI: 10.1089/sur.2016.148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coccidioidomycosis, commonly called "valley fever," "San Joaquin fever," "desert fever," or "desert rheumatism," is a multi-system illness caused by infection with Coccidioides fungi (C. immitis or C. posadasii). This organism is endemic to the desert Southwest regions of the United States and Mexico and to parts of South America. The manifestations of infection occur along a spectrum from asymptomatic to mild self-limited fever to severe disseminated disease. METHODS Review of the English-language literature. RESULTS There are five broad indications for surgical intervention in patients with coccidioidomycosis: Tissue diagnosis in patients at risk for co-existing pathology, perforation, bleeding, impingement on critical organs, and failure to resolve with medical management. As part of a multidisciplinary team, surgeons may be responsible for the care of infected patients, particularly those with severe disease. CONCLUSION This review discusses the history, microbiology, epidemiology, pathology, diagnosis, and treatment of coccidioidomycosis, focusing on situations that may be encountered by surgeons.
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Affiliation(s)
| | - Haiwei Henry Guo
- 2 Department of Radiology, Stanford University , Stanford, California
| | - Thomas G Weiser
- 1 Department of Surgery, Stanford University , Stanford, California
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Labuschagne H, Burns C, Martinez S, Carrillo M, Waggoner M, Schwanninger I, Maher J, Hampton M, Flores-Guardado J, Schlabritz-Loutsevitch NE. Coccidioidomycosis in pregnancy: Case report and literature review of associated placental lesions. Case Rep Womens Health 2016; 12:5-10. [PMID: 29629302 PMCID: PMC5886004 DOI: 10.1016/j.crwh.2016.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/19/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Coccidioidomycosis is an endemic fungal infection found most commonly in the Southwestern United States, Northwestern Mexico, and parts of Central and South America. Although infection is relatively uncommon during pregnancy, it is imperative to have an index of suspicion in order to diagnose and begin timely treatment to prevent dissemination and dire consequences. CASE REPORT A 33-year-old Hispanic female was evaluated after she was involved in an automobile accident. Radiographic evaluation showed a 3.2 × 3.2 cm cavitary thick-walled lesion. A biopsy was negative for malignancy. Evaluation was positive for coccidioidomycosis by complement fixation reaction. Four months later, the patient presented 7 weeks into a pregnancy with massive hemoptysis. Bronchoscopy revealed bleeding from the right upper lobe and emergency embolization was performed. The patient had a spontaneous abortion 9 days after admission. The right upper and middle lobes of the lung were resected due to continuous bleeding. A subsequent pregnancy was un-eventful. Coccidioidomycosis titers remained negative throughout the second pregnancy. DISCUSSION This case demonstrates the potential for severe pulmonary coccidioidomycosis and vascular strain of pregnancy-associated vascular expansion in the first trimester of pregnancy and the possibility of a favorable pregnancy outcome in subsequent pregnancies after appropriate treatment. The route of feto-maternal transmission and placental lesions in coccidioidomycosis are discussed.
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Affiliation(s)
- Heloise Labuschagne
- Department of Internal Medicine, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
| | - C. Burns
- Department of Pathology, Medical Center Hospital, Odessa, TX, USA
| | - Stacy Martinez
- Department of Academic Affairs, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
| | - Maira Carrillo
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
| | - Melissa Waggoner
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
| | - Irene Schwanninger
- Department of Academic Affairs, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
| | - James Maher
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
| | - Moss Hampton
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
| | - Javier Flores-Guardado
- Department of Internal Medicine, Texas Tech University Health Sciences Center at the Permian Basin, Odessa, TX, USA
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Chow NA, Griffin DW, Barker BM, Loparev VN, Litvintseva AP. Molecular detection of airborne Coccidioides in Tucson, Arizona. Med Mycol 2016; 54:584-92. [PMID: 27143633 DOI: 10.1093/mmy/myw022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/03/2016] [Indexed: 11/12/2022] Open
Abstract
Environmental surveillance of the soil-dwelling fungus Coccidioides is essential for the prevention of Valley fever, a disease primarily caused by inhalation of the arthroconidia. Methods for collecting and detecting Coccidioides in soil samples are currently in use by several laboratories; however, a method utilizing current air sampling technologies has not been formally demonstrated for the capture of airborne arthroconidia. In this study, we collected air/dust samples at two sites (Site A and Site B) in the endemic region of Tucson, Arizona, and tested a variety of air samplers and membrane matrices. We then employed a single-tube nested qPCR assay for molecular detection. At both sites, numerous soil samples (n = 10 at Site A and n = 24 at Site B) were collected and Coccidioides was detected in two samples (20%) at Site A and in eight samples (33%) at Site B. Of the 25 air/dust samples collected at both sites using five different air sampling methods, we detected Coccidioides in three samples from site B. All three samples were collected using a high-volume sampler with glass-fiber filters. In this report, we describe these methods and propose the use of these air sampling and molecular detection strategies for environmental surveillance of Coccidioides.
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Affiliation(s)
- Nancy A Chow
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dale W Griffin
- US Geological Survey, Coastal and Marine Science Center, St. Petersburg, Florida
| | - Bridget M Barker
- Division of Pathogen Genomics, Translational Genomics Research Institute, Flagstaff, Arizona Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona Valley Fever Center for Excellence, University of Arizona, Tucson, Arizona
| | - Vladimir N Loparev
- Biotechnology Core Facility Branch, Centers for Disease Control and Prevention, Atlanta, GA
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Sprigg WA. Dust Storms, Human Health and a Global Early Warning System. EXTREME WEATHER, HEALTH, AND COMMUNITIES 2016. [DOI: 10.1007/978-3-319-30626-1_4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Evaluation of VT-1161 for Treatment of Coccidioidomycosis in Murine Infection Models. Antimicrob Agents Chemother 2015; 59:7249-54. [PMID: 26369964 DOI: 10.1128/aac.00593-15] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 08/30/2015] [Indexed: 12/27/2022] Open
Abstract
Coccidioidomycosis, or valley fever, is a growing health concern endemic to the southwestern United States. Safer, more effective, and more easily administered drugs are needed especially for severe, chronic, or unresponsive infections. The novel fungal CYP51 inhibitor VT-1161 demonstrated in vitro antifungal activity, with MIC50 and MIC90 values of 1 and 2 μg/ml, respectively, against 52 Coccidioides clinical isolates. In the initial animal study, oral doses of 10 and 50 mg/kg VT-1161 significantly reduced fungal burdens and increased survival time in a lethal respiratory model in comparison with treatment with a placebo (P < 0.001). Oral doses of 25 and 50 mg/kg VT-1161 were similarly efficacious in the murine central nervous system (CNS) model compared to placebo treatment (P < 0.001). All comparisons with the positive-control drug, fluconazole at 50 mg/kg per day, demonstrated either statistical equivalence or superiority of VT-1161. VT-1161 treatment also prevented dissemination of infection from the original inoculation site to a greater extent than fluconazole. Many of these in vivo results can be explained by the long half-life of VT-1161 leading to sustained high plasma levels. Thus, the efficacy and pharmacokinetics of VT-1161 are attractive characteristics for long-term treatment of this serious fungal infection.
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Development and validation of a quantitative real-time PCR assay for the early diagnosis of coccidioidomycosis. Diagn Microbiol Infect Dis 2014; 79:214-21. [DOI: 10.1016/j.diagmicrobio.2014.01.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 01/27/2014] [Accepted: 01/30/2014] [Indexed: 11/19/2022]
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Theodoro RC, Teixeira MDM, Felipe MSS, Paduan KDS, Ribolla PM, San-Blas G, Bagagli E. Genus paracoccidioides: Species recognition and biogeographic aspects. PLoS One 2012; 7:e37694. [PMID: 22666382 PMCID: PMC3364295 DOI: 10.1371/journal.pone.0037694] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 04/24/2012] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Paracoccidioidomycosis is a systemic mycosis caused by Paracoccidioides brasiliensis (species S1, PS2, PS3), and Paracoccidioides lutzii. This work aimed to differentiate species within the genus Paracoccidioides, without applying multilocus sequencing, as well as to obtain knowledge of the possible speciation processes. METHODOLOGY/PRINCIPAL FINDINGS Single nucleotide polymorphism analysis on GP43, ARF and PRP8 intein genes successfully distinguished isolates into four different species. Morphological evaluation indicated that elongated conidia were observed exclusively in P. lutzii isolates, while all other species (S1, PS2 and PS3) were indistinguishable. To evaluate the biogeographic events that led to the current geographic distribution of Paracoccidioides species and their sister species, Nested Clade and Likelihood Analysis of Geographic Range Evolution (LAGRANGE) analyses were applied. The radiation of Paracoccidioides started in northwest South America, around 11-32 million years ago, as calculated on the basis of ARF substitution rate, in the BEAST program. Vicariance was responsible for the divergence among S1, PS2 and P. lutzii and a recent dispersal generated the PS3 species, restricted to Colombia. Taking into account the ancestral areas revealed by the LAGRANGE analysis and the major geographic distribution of L. loboi in the Amazon basin, a region strongly affected by the Andes uplift and marine incursions in the Cenozoic era, we also speculate about the effect of these geological events on the vicariance between Paracoccidioides and L. loboi. CONCLUSIONS/SIGNIFICANCE The use of at least 3 SNPs, but not morphological criteria, as markers allows us to distinguish among the four cryptic species of the genus Paracoccidioides. The work also presents a biogeographic study speculating on how these species might have diverged in South America, thus contributing to elucidating evolutionary aspects of the genus Paracoccidioides.
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Affiliation(s)
| | | | | | | | | | - Gioconda San-Blas
- Venezuelan Institute for Scientific Research, Center of Microbiology and Cell Biology, Caracas, Venezuela
| | - Eduardo Bagagli
- Universidade Estadual Paulista, Campus de Botucatu-UNESP, São Paulo, Brazil
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