Chrysosporium parvum Keratomycosis

Wagoner, Michael D.; Badr, Ihsan A.; Hidayat, Ahmed A.

doi:10.1097/00003226-199909000-00018

Cited by 23 publications

(14 citation statements)

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“…The nomenclature and taxonomy of the fungi involved in adiaspiromycosis has been a source of ongoing confusion, which has caused many authors to lump infections due to Chrysosporium species together with those caused by E. crescens and E. parva, and so the clinical presentation of disease caused by the two genera has been quite muddled in the literature (40,41,44,63,68,69).…”

Section: Resultsmentioning

confidence: 99%

“…Unlike adiaspiromycosis, invasive Chrysosporium infection occurs in the immunocompromised host and is usually disseminated at the time of diagnosis. Eleven cases of invasive or localized Chrysosporium infection have been described in the medical literature (22,24,25,49,54,57,58,63,68,69) (Table 3). Two of these cases were patients with pulmonary fungal balls (cases 4 and 8 from Table 3), and two had localized disease (cases 6 and 9 from Table 3), leaving seven cases of invasive disease (22,24,49,59,63,69).…”

Section: Frommentioning

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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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: Frommentioning

confidence: 99%

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

2012

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“…Species and genera of fungi implicated as genuine ophthalmic pathogens in the past 5 years include Chrysosporium parvum (415), Metarhizium anisopliae var. anisopliae (76), Phaeoisaria clematidis (131), and Sarcopodium oculorum (132).…”

Section: Etiological Agents and Laboratory Diagnosis Of Ophthalmic Mymentioning

confidence: 99%

Current Perspectives on Ophthalmic Mycoses

2003

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Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors

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“…9 Primary Chrysosporium infection involving the skin is believed to be an extremely rare event; 10 however, secondary dissemination from a pulmonary focus to skin, brain, lungs, liver, and kidney have all been reported. 11 Primary infection of bone, 12,13 nose and paranasal sinus, 14 eye, 15 and heart (endocarditis) 16 has also been documented. In all cases, both adiaspores and hyphae were present in tissue sections and cultures of infected tissue with variable species designations, including Chrysosporium parvum var crescens, Chrysosporium zoonatum, 11,15 and instances where Chrysosporium could not be speciated.…”

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confidence: 99%