Adiaspiromycosis and other Infections Caused by<i>Emmonsia</i>Species

Sigler, Lynne

doi:10.1002/9780470688618.taw0165

Cited by 11 publications

(34 citation statements)

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“…Other members in the Ajellomycetaceae of medical significance include the genera Blastomyces and Histoplasma, and also Paracoccidioides brasiliensis, whereas the genus Coccidioides has also been placed in the Onygenaceae (65). (For a comparison of the genus Emmonsia with these genera, see Sigler [53].) In 1996, Sigler described the teleomorph (meiotic stage) of E. crescens, Ajellomyces crescens, which is the same genus in which the teleomorphs of Blastomyces dermatitidis and Histoplasma capsulatum are contained.…”

Section: Resultsmentioning

confidence: 99%

“…In 1947, Dowding observed fungal cells, of up to 300 m in diameter, in the lungs of rodents from Alberta (16) (20) added E. crescens (the fungus from the Alberta rodents). The two species were differentiated by the size of their adiaspores and maximum growth temperatures (53).…”

Section: Resultsmentioning

confidence: 99%

“…In this infection, inhaled Emmonsia conidia enlarge to form nonreplicating adiaspores. As in other mammals, the infection in humans usually involves the lungs, with only a few other cases of infection at other sites (17,30,35,53). About 70 cases of human adiaspiromycosis have been described, but much of the literature on this infection has been dispersed in less-accessible, non-English journals.…”

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confidence: 99%

“…Invasive Chrysosporium infections typically occur in impaired hosts and can have a fatal course. Based on limited in vitro susceptibility data for Chrysosporium zonatum, amphotericin B is the most active drug, itraconazole susceptibility is strain-dependent, and fluconazole and 5-fluorocytosine are not active.A diaspiromycosis is primarily a pulmonary infection of rodents, fossorial mammals, and their predators and is caused by the soil fungi Emmonsia crescens and Emmonsia parva (17,30,35,53). It is a rare human infection.…”

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confidence: 99%

“…A diaspiromycosis is primarily a pulmonary infection of rodents, fossorial mammals, and their predators and is caused by the soil fungi Emmonsia crescens and Emmonsia parva (17,30,35,53). It is a rare human infection.…”

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Adiaspiromycosis Causing Respiratory Failure and a Review of Human Infections Due to Emmonsia and Chrysosporium spp

2012

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bWe report a case of a 27-year-old male who presented with respiratory distress that required mechanical ventilation. Transbronchial biopsy revealed adiaspores of the fungus Emmonsia crescens within granulomata, a condition known as adiaspiromycosis. The patient received amphotericin products and corticosteroids, followed by itraconazole, and made a full recovery. Emmonsia crescens is a saprobe with a wide distribution that is primarily a rodent pathogen. The clinical characteristics of the 20 cases of human pulmonary adiaspiromycosis reported since the last comprehensive case review in 1993 are described here, as well as other infections recently reported for the genus Emmonsia. Pulmonary adiaspiromycosis has been reported primarily in persons without underlying host factors and has a mild to severe course. It remains uncertain if the optimal management of severe pulmonary adiaspiromycosis is supportive or if should consist of antifungal treatment, corticosteroids, or a combination of the latter two. The classification of fungi currently in the genus Emmonsia has undergone considerable revision since their original description, including being grouped with the genus Chrysosporium at one time. Molecular genetics has clearly differentiated the genus Emmonsia from the Chrysosporium species. Nevertheless, there has been a persistent confusion in the literature regarding the clinical presentation of infection with fungi of these two genera; to clarify this matter, the reported cases of invasive Chrysosporium infections were reviewed. Invasive Chrysosporium infections typically occur in impaired hosts and can have a fatal course. Based on limited in vitro susceptibility data for Chrysosporium zonatum, amphotericin B is the most active drug, itraconazole susceptibility is strain-dependent, and fluconazole and 5-fluorocytosine are not active.A diaspiromycosis is primarily a pulmonary infection of rodents, fossorial mammals, and their predators and is caused by the soil fungi Emmonsia crescens and Emmonsia parva (17,30,35,53). It is a rare human infection. In this infection, inhaled Emmonsia conidia enlarge to form nonreplicating adiaspores. As in other mammals, the infection in humans usually involves the lungs, with only a few other cases of infection at other sites (17,30,35,53). About 70 cases of human adiaspiromycosis have been described, but much of the literature on this infection has been dispersed in less-accessible, non-English journals. Furthermore, the inconsistent nomenclature and taxonomy of Emmonsia species and their confusion with Chrysosporium species has resulted in an overall lack of consistent information on adiaspiromycosis and Chrysosporium infections. Herein, we report a case of adiaspiromycosis that resulted in respiratory failure. We also review the true cases of adiaspiromycosis that have been reported since the seminal monographs of England and Hochholzer in 1993 (21) and Sigler in 2005 (53) or omitted from those reports. Furthermore, we differentiate the cases of adiaspiromycosis from the tr...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Adiaspiromycosis Causing Respiratory Failure and a Review of Human Infections Due to Emmonsia and Chrysosporium spp

2012

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Blastomycosis

Schwartz

Kauffman

2020

Semin Respir Crit Care Med

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Blastomycosis is a serious fungal disease of humans and other mammals caused by environmentally acquired infection with geographically restricted, thermally dimorphic fungi belonging to the genus Blastomyces. The genetic and geographic diversity of these pathogens is greater than previously appreciated. In addition to Blastomyces dermatitidis and the cryptic species Blastomyces gilchristii, which cause blastomycosis in mid-western and various eastern areas of North America, atypical blastomycosis is occasionally caused by Blastomyces helicus in western parts of North America and Blastomyces percursus in Africa. Blastomycosis is acquired by inhalation of the conidia that are produced in the mold phase; in the lungs, temperature-dependent transformation occurs to the yeast phase. In this form, the organism is phagocytized by macrophages and can spread hematogenously to various organs causing disseminated infection. Pulmonary disease is most common and varies from mild, self-limited infection to severe, potentially fatal adult respiratory distress syndrome. Disseminated infection is manifested primarily by skin lesions, but many other organs can be involved. Diagnosis is established by growth of the organism in culture; however, a tentative diagnosis can be made quickly by histopathological identification of the classic yeast form in tissues or by finding Blastomyces antigen in urine or serum. Blastomycosis is treated initially with amphotericin B when the disease is severe, involves the central nervous system, or the host is immunosuppressed. Itraconazole is recommended for primary therapy in mild-to-moderate infection and for step-down therapy after initial amphotericin B treatment. Voriconazole and posaconazole can be used for patients in whom itraconazole is not tolerated.

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