Aureobasidium pullulans Septicemia

Girardi, L. S.; Malowitz, R; Tortora, George T.; Spitzer, Eric D.

doi:10.1093/clind/16.2.338-a

Cited by 38 publications

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“…Even more uncommon are infections where A. pullulans can be isolated from blood cultures (5,10). Interestingly, for our patient, who was neither immunosuppressed nor neutropenic, A. pullulans was isolated from both blood and urine.…”

mentioning

confidence: 72%

Disseminated Nosocomial Fungal Infection by Aureobasidium pullulans var. melanigenum : a Case Report

Bolignano

Criseo

2003

J Clin Microbiol

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We report on a rare case of disseminated nosocomial fungal infection due to Aureobasidium pullulans var. melanigenum in a severely traumatized patient. Repeated blood and urine cultures yielded multicellular filamentous hyphal structures of varying size accompanied by budding yeast-like-cells of ellipsoidal morphology. The patient became asymptomatic after fluconazole therapy. CASE REPORTThe patient, a 28-year-old male, was admitted to the intensive care unit of the Ospedali Riuniti of Reggio Calabria, Reggio Calabria, Italy, following multiple traumas due to a road accident. The patient suffered a head trauma and had a Glasgow coma scale rating of III-IV. After initial treatment with standard life support measures to stabilize hemodynamic and respiratory parameters, the patient underwent a total-body computed tomography scan, which showed diffuse cerebral edema, hemoperitoneum, multiple fractures of the left femur and tibia, a suspected pelvic fracture, and multiple ruptures of the liver's right lobe, which made immediate surgery mandatory. After surgery, the patient underwent mechanical ventilation and prolonged total parenteral nutrition.Following the isolation of a methicillin-resistant strain of Staphylococcus epidermidis from a blood culture (BCB-Slide system; Roche Products Pty. Ltd.) antibiotic therapy was started, with teicoplanin at 800 mg/day plus vancomycin at 2 g/day, divided into two doses daily. Four days later, following the onset of dyspnea and fever (37.5 to 38°C), a pulmonary infection was suspected. Laboratory data included a total leukocyte count of 10.7 ϫ 10 9 /liter with 70% neutrophils, 26% lymphocytes, and 4% monocytes. Microbiological examination of a bronchial aspirate showed the presence of Acinetobacter anitratus var. anitratus. Antibiotic therapy was therefore changed, replacing teicoplanin with ceftazidime pentahydrate at 4 g/day. After an initial decrease in body temperature lasting 3 days, fever increased again to 40°C. Therefore, a new blood culture was carried out, leading to the isolation of Pseudomonas aeruginosa. On the basis of antibiogram results, antibiotic treatment was changed again, with aztreonam at 6 g/day plus tobramycin at 300 mg/day, divided into three doses daily. Six days later, since fever was stable at around 38°C and the patient's condition was not improving, new cultures from blood and urine were made. After 72 h of incubation, the blood culture became diffusely turbid and several smooth and mucoid colonies appeared on agar growth media (chocolate agar and malt agar) enclosed in the BCB-Slide Roche system (Fig. 1). The urine culture, in contrast, was negative.Microscopic examination of fungal cultures revealed multicellular filamentous hyphal structures of varying size accompanied by budding ellipsoidal yeast-like cells, both in the blood culture and in the colonies growing on agar media. These fungal isolates were subsequently classified as Aureobasidium pullulans.Immediately before starting antifungal therapy, a new set of blood and urine cultures and a cu...

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mentioning

confidence: 72%

Disseminated Nosocomial Fungal Infection by Aureobasidium pullulans var. melanigenum : a Case Report

Bolignano

Criseo

2003

J Clin Microbiol

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“…Disseminated infection is the most uncommon manifestation of infection caused by melanized fungi. In a review of 72 cases (627), most patients were immunocompromised, though occasional patients without known immunodeficiency or risk factors developed disseminated disease as well (3,24,73,76,95,105,119,171,208,238,242,246,288,291,308,321,345,386,389,397,400,402,403,409,423,424,435,471,485,516,538,543,550,557,578,593,595,596,612,621,627,640,647,672,688,712,713,740,…”

Section: Phaeohyphomycosismentioning

confidence: 99%

Melanized Fungi in Human Disease

2010

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SUMMARY Melanized or dematiaceous fungi are associated with a wide variety of infectious syndromes. Many are soil organisms and are generally distributed worldwide, though certain species appear to have restricted geographic ranges. Though they are uncommon causes of disease, melanized fungi have been increasingly recognized as important pathogens, with most reports occurring in the past 20 years. The spectrum of diseases with which they are associated has also broadened and includes allergic disease, superficial and deep local infections, pneumonia, brain abscess, and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common etiologic fungi. Melanin is a likely virulence factor for these fungi. Diagnosis relies on careful microscopic and pathological examination, as well as clinical assessment of the patient, as these fungi are often considered contaminants. Therapy varies depending upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Triazoles such as voriconazole, posaconazole, and itraconazole have the most consistent in vitro activity. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.

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“…8 However, rare cases of septicemia by A. pullulans have also been reported. 5,[9][10][11][12] The purpose of the present study was to report a case of a patient who had lymphatic system lesions which were attributed to infection by A. pullulans.…”

Section: Introductionmentioning

confidence: 99%

Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum

Morais¹,

Porto²,

Coutinho³

et al. 2011

Braz J Infect Dis

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Aureobasidium pullulans is a causal agent of phaeohyphomycosis, occasionally found in men and animals. As an agent of different opportunistic fungal processes, it may cause fungemia, systemic infections and abscesses in different viscera. This paper aims to report a case of a patient with infection of the lymphatic system by A. pullulans. A 23-year-old patient being treated for erythema nodosum leprosum presented a 60-day complaint of daily fever, hoarseness, odynophagia and weight loss. Laboratory tests showed pancytopenia with severe neutropenia, cervical adenomegaly and solid contrast uptake lesion in the oropharyngeal region. Due to neutropenia and sepsis the patient was initially treated with cefepime and vancomycin, but there was no clinical improvement. Lymph node puncture-aspiration showed yeast-form fungus identified as A. pullulans by sequencing ITS region. The patient was treated with amphotericin B deoxycholate, leading to complete recovery of bone marrow function and regression of adenomegaly and the oropharyngeal lesion.

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Aureobasidium pullulans Septicemia

Cited by 38 publications

References 0 publications

Disseminated Nosocomial Fungal Infection by Aureobasidium pullulans var. melanigenum : a Case Report

Disseminated Nosocomial Fungal Infection by Aureobasidium pullulans var. melanigenum : a Case Report

Melanized Fungi in Human Disease

Infection of the lymphatic system by Aureobasidium pullulans in a patient with erythema nodosum leprosum

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