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Ntsame Ngoua S, Iba Ba J, Coniquet S, Moussirou Soumbou G, Boguikouma JB. [Conidiobolomycosis (rhinofacial entomophthoromycosis) in Gabon. About of one case]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2023; 3:mtsi.v3i4.2023.457. [PMID: 38390015 PMCID: PMC10879889 DOI: 10.48327/mtsi.v3i4.2023.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/28/2023] [Indexed: 02/24/2024]
Abstract
Background Entomophthoromycosis constitutes a nosological group of subcutaneous mycoses including conidiobolomycosis (rhinofacial form) and basidiobomomycosis (subcutaneous form involving the trunk and the limbs). Conidiobolomycosis is characterized by a progressive nasal and facial deformity giving, in the evolved forms, a "hippopotamus snout". The literature review finds a hundred cases, with a tropism for the humid tropical regions. Methods. We report the observation of a 25-year-old patient, living in the equatorial zone, in the south of Gabon in a humid forest area, presenting a swollen aspect of the face mainly involving the eyelids, the nose and the upper lips. Results The diagnosis of entomophthoromycosis was compatible with the histopathological and clinical aspects. The evolution was favorable in terms of facial aesthetics under itraconazole 300 mg/day for 2 months and corticosteroid therapy (bolus of methylprednisone 240 mg/day for 3 days relayed per os at a dose of 0.5 mg/kg/day, i.e. 30 mg/day) of prednisone), maintained for 3 months. The average nasal improvement could not be completed by surgery and the patient was lost to follow-up. Conclusion This second observation of conidiobolomycosis in Gabon in the same province makes Ngounié a privileged ecosystem for this affection.
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Affiliation(s)
| | - Josaphat Iba Ba
- Service de médecine interne, CHU de Libreville, Libreville, Gabon
| | - Sophie Coniquet
- Service de dermatologie, CHU de Libreville, Libreville, Gabon
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Varghese L, Kurien R, Diana Sahni R, Manesh A, Mary Cherian L, Peter D, Dayanand D, Sarojini Michael J, Thomas M, Rupa V, Pulimood S, Varghese GM. Rhinofacial conidiobolomycosis: Clinical and microbiological characterisation and shift in the management of a rare disease. Mycoses 2021; 64:882-889. [PMID: 33915007 DOI: 10.1111/myc.13294] [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] [Accepted: 04/21/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Conidiobolomycosis is a rare tropical rhinofacial fungal infection which has not been well characterised. The available evidence in its management is sparse due to lack of clinical studies and the limited data on antifungal susceptibility patterns. OBJECTIVE To analyse the clinical manifestations, antifungal treatment and outcomes of patients with conidiobolomycosis and to determine antifungal susceptibility profiles of the isolates. PATIENTS/METHODS Retrospective analysis of data of all patients with a diagnosis of conidiobolomycosis confirmed by histopathology and culture at a tertiary care hospital from 2012 to 2019 was done. RESULTS There were 22 patients, 21 males and one female, with a mean age of 37.1 years. Most common presenting symptom was nasal obstruction, found in 20 (90.90%) patients. Patients who presented within 12 months had a better cure rate (85%) compared to those who presented late (67%). Among the 19 patients who had a follow-up, good outcome was seen in 15 of the 17 (88.24%) patients who were on itraconazole or potassium iodide containing regimen. Of the six patients who received additional trimethoprim-sulphamethoxazole (co-trimoxazole), 67% showed good outcome with two patients showing complete cure and two patients still on treatment with significant improvement. High minimum inhibitory concentration (MIC) values were noted for azoles and amphotericin B, whereas co-trimoxazole showed lowest MIC ranges. CONCLUSION Itraconazole and potassium iodide are reasonable first-line options for the treatment of conidiobolomycosis. Good clinical response to KI and comparatively lower MIC of co-trimoxazole are promising. Further studies are required for developing clinical breakpoints that can predict therapeutic outcomes.
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Affiliation(s)
- Lalee Varghese
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Regi Kurien
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Rani Diana Sahni
- Department of Microbiology, Christian Medical College, Vellore, India
| | - Abi Manesh
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | - Lisa Mary Cherian
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Dincy Peter
- Department of Dermatology, Christian Medical College, Vellore, India
| | - Divya Dayanand
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | | | - Meera Thomas
- Department of Pathology, Christian Medical College, Vellore, India
| | - V Rupa
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Susanne Pulimood
- Department of Dermatology, Christian Medical College, Vellore, India
| | - George M Varghese
- Department of Infectious Diseases, Christian Medical College, Vellore, India
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Jaffey JA, Hostnik ET, Hoffman AR, Jay M, Ferguson SH, Wiederhold NP. Case Report: Successful Management of Conidiobolus Lamprauges Rhinitis in a Dog. Front Vet Sci 2021; 8:633695. [PMID: 33614770 PMCID: PMC7892434 DOI: 10.3389/fvets.2021.633695] [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] [Received: 11/25/2020] [Accepted: 01/12/2021] [Indexed: 11/17/2022] Open
Abstract
This is a case of Conidiobolus lamprauges rhinitis in a Goldendoodle, that was presented for evaluation of sneezing, coughing, lethargy, as well as right-sided epistaxis and clear ocular discharge. Computed tomography revealed a large amount of soft tissue within the right nasal passage that obscured the osseous turbinates from the right maxillary canine tooth to the right side of the choanae. Biopsies revealed eosinophilic granulomas with variable number of basophilic to negatively staining, septate, fungal hyphae with non-parallel walls and irregular branching that were subsequently determined to be Conidiobolus lamprauges via panfungal PCR and sequencing. Complete and sustained resolution of clinical disease was achieved after 75 days of systemic antifungal therapy. This report describes for the first time, important clinical features of a dog with nasal conidiobolomycosis that will facilitate its recognition, prognostication, and treatment in clinical practice.
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Affiliation(s)
- Jared A. Jaffey
- Department of Specialty Medicine, Midwestern University College of Veterinary Medicine, Glendale, AZ, United States
| | - Eric T. Hostnik
- Department of Veterinary Clinical Sciences, Veterinary Medical Center, Ohio State University, Columbus, OH, United States
| | - Aline Rodrigues Hoffman
- Department of Veterinary Pathobiology, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Maureen Jay
- Department of Surgery, Animal Medical & Surgical Center, Scottsdale, AZ, United States
| | - Sylvia H. Ferguson
- Department of Pathology and Population Medicine, Midwestern University College of Veterinary Medicine, Glendale, AZ, United States
| | - Nathan P. Wiederhold
- Fungus Testing Laboratory, Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, San Antonio, TX, United States
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Deak L, Mudalagiriyappa S, Ballin A, Saxton D, Chakrabarti A. A Rhinofacial Conidiobolus coronatus Fungal Infection Presenting as an Intranasal Tumour. Sultan Qaboos Univ Med J 2019; 18:e549-e552. [PMID: 30988980 DOI: 10.18295/squmj.2018.18.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/09/2018] [Accepted: 09/27/2018] [Indexed: 11/16/2022] Open
Abstract
Conidiobolomycosis is a rare fungal infection that affects adults in tropical regions. We report a 42-year-old male patient who was referred to the Sulaiman Al Habib Hospital, Dubai, United Arab Emirates (UAE), in 2013 with excessive nasal bleeding and a suspected nasal tumour. He reported having briefly visited central India nine months previously. Computed tomography and magnetic resonance imaging showed a highly vascularised mass in the nasal cavity. However, after surgical excision, initial treatment with amphotericin B deoxycholate was unsuccessful and the disease progressed, leading to external and internal nasal deformation and necessitating further excision and facial reconstruction. Histopathological analysis of the second biopsy revealed Splendore-Hoeppli changes consistent with a fungal infection. Microbiological findings subsequently confirmed Conidiobolus coronatus. Subsequently, the patient was successfully treated with a combination of itraconazole and fluconazole. To the best of the authors' knowledge, this is the first report of a case of rhinofacial conidiobolomycosis from the UAE.
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Affiliation(s)
- Levente Deak
- Department of Ear, Nose & Throat, Suliaman Al Habib Hospital, Dubai, UAE
| | | | - Annelyse Ballin
- Department of Ear, Nose & Throat, Al Zahra Hospital, Dubai, UAE
| | - David Saxton
- Department of Ear, Nose & Throat, Suliaman Al Habib Hospital, Dubai, UAE
| | - Arunaloke Chakrabarti
- Center of Advanced Research in Medical Mycology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Abstract
Entomopthoromycosis is a rare subcutaneous fungal infection caused by onidiobolus coronatus affecting mainly the upper respiratory mucosa in immunocompetent people.The manifestations of this disease masquerades other clinical entities.Hence, high index of suspicion is required for prompt diagnosis.Histopathological examination and culture are the gold standard diagnostic tools, however no standard treatment protocols ha been mentioned in literature.We present a case of rhinofacial entomopthoromycosis in a yearold ma with a leftsided rhinofacial swelling to highlight the presence of this unusual fungal infection and its treatment.
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Affiliation(s)
- Shalini Menon
- Head and Neck surgery, Kasturba Medical College, Manipal, India
| | - Kailesh Pujary
- Head and Neck surgery, Kasturba Medical College, Manipal, India
| | - Ranjini Kudva
- Department of Pathology, Kasturba Medical College, Manipal, India
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Janappriya GHDC, Gunasekera CN, Keragala BSDN, Dissanayake BS, Liyanagama PD, Shanmuhathas V, Thanushah B, Sigera LSM, Jayasekera PI. Disfiguring facial mycoses - a diagnostic and therapeutic challenge. J Eur Acad Dermatol Venereol 2017; 32:e167-e168. [DOI: 10.1111/jdv.14670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- G. H. D. C. Janappriya
- Senior Registrar in Dermatology; National Hospital of Sri Lanka [NHSL]; Colombo Sri Lanka
| | | | | | - B. S. Dissanayake
- Senior Registrar in Dermatology; National Hospital of Sri Lanka [NHSL]; Colombo Sri Lanka
| | | | | | - B. Thanushah
- Registrar in Dermatology; NHSL; Colombo Sri Lanka
| | - L. S. M. Sigera
- Senior Registrar in Microbiology; Medical Research Institute [MRI]; Colombo Sri Lanka
| | - P. I. Jayasekera
- Consultant Mycologist; Medical Research Institute [MRI]; Colombo Sri Lanka
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