Endocarditis Caused by Arthrographis kalrae

Candela, Javier de Diego; Forteza, Alberto; García, Diana; Prieto, Gustavo; Bellot, Raquel; Villar, Susana; Cortina, José M.

doi:10.1016/j.athoracsur.2010.04.021

Cited by 22 publications

(15 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most frequently observed species in this group belonged to the genera Scedosporium and Fusarium. Also present were species that were rarely described previously as causing infectious diseases, such as Phomopsis longicolla, Metarhizium anisopliae (12), Arthrographis kalrae (13), and Bipolaris spicifera. Four cases of mixed infections were detected; two of those cases involved pediatric oncological patients from the same hospital (14), and the other cases involved an oncohematological patient and a subject addicted to alcohol.…”

mentioning

confidence: 99%

Performance of Panfungal- and Specific-PCR-Based Procedures for Etiological Diagnosis of Invasive Fungal Diseases on Tissue Biopsy Specimens with Proven Infection: a 7-Year Retrospective Analysis from a Reference Laboratory

et al. 2014

View full text Add to dashboard Cite

A retrospective analysis of real-time PCR (RT-PCR) results for 151 biopsy samples obtained from 132 patients with proven invasive fungal diseases was performed. PCR-based techniques proved to be fast and sensitive and enabled definitive diagnosis in all cases studied, with detection of a total of 28 fungal species. Most of the methods used in microbiology laboratories for the diagnosis of invasive fungal diseases (IFDs) present limitations (1, 2). Cultures are too slow and ineffective for early diagnosis, although the gold standard methods to prove IFD continue to be isolation in culture from a sterile sample or demonstration of invasion by fungal structures in tissues (3,4).Classic histopathological studies have significant drawbacks. Microscopic examinations are quite variable, depending on experience, but the most important limitation of tissue observation is the impossibility of differentiating species, which is essential for determining therapy, given the differences in sensitivity to antifungal agents among fungal species (5).Molecular methods, such as those based on PCRs, have been used recently for fungal DNA detection in both fresh and paraffinembedded tissue samples, using different targets (4). The great advantages of these molecular techniques are the determination of the specific agent and greater sensitivity (6). A limitation is the lack of standardization of techniques, which are mostly homemade.In recent years, the Spanish Mycology Reference Laboratory has developed a number of real-time PCR (RT-PCR) assays in order to improve the diagnosis of IFD (7-11). These techniques serve to confirm the diagnosis of IFD when culture results are negative and to determine the species involved in infections. In this work, a retrospective analysis of RT-PCR results for biopsy samples was performed. The survey included samples analyzed between 2006 and 2013. A total of 151 biopsy specimens from 132 patients with diagnoses of IFD, proven by histopathological examinations, and negative culture results were analyzed. The samples were sent to the Spanish Mycology Reference Laboratory by hospitals throughout Spain and had very heterogeneous origins, depending on the patients' symptoms, with lung, skin, liver, and brain samples being most common.Fourteen patients had more than one sample for diagnosis; the samples had the same origins (duplicates) for seven patients, and the origins of the samples were different for the rest of them. The biopsy specimens were fresh (n ϭ 92) or embedded in paraffin (n ϭ 59). For samples embedded in paraffin, the blocks were cut into 10-m sections. Three to 10 cuts were used to extract the DNA, in order to obtain approximately 25 mg of tissue. Biopsy specimens were deparaffinized by lavage with 1.5 ml of xylene (100%) followed by two washes with 1.2 ml of ethanol (96 to 100%). The tissue was incubated at 37°C for about 10 min to evaporate the remaining ethanol.DNA from fresh and paraffin-embedded tissues was extracted using a QIAmp Tissue DNA minikit (Qiagen, Izasa, Madrid, Spain), foll...

show abstract

mentioning

confidence: 99%

Performance of Panfungal- and Specific-PCR-Based Procedures for Etiological Diagnosis of Invasive Fungal Diseases on Tissue Biopsy Specimens with Proven Infection: a 7-Year Retrospective Analysis from a Reference Laboratory

et al. 2014

View full text Add to dashboard Cite

show abstract

“…In our study, we observed high MICs for AMB, and, although our results showed good in vitro activity for the azoles, the results are variable in the clinical setting. VRC and ITC have been the most commonly used drugs against A. kalrae infections, although mostly with negative results even when high doses were employed . In contrast, a mycetoma case was successfully treated using long‐term ITC therapy, whereas a case of panophthalmitis and invasive sinusitis required a combination of ITC, fluconazole and a drastic surgical debridement .…”

Section: Resultsmentioning

confidence: 99%

In vitro antifungal susceptibility of clinical isolates of Arthrographis kalrae, a poorly known opportunistic fungus

Sandoval-Denis

Giraldo

Sutton

et al. 2013

Mycoses

View full text Add to dashboard Cite

The in vitro antifungal activity of amphotericin B (AMB), itraconazole, voriconazole, posaconazole, terbinafine (TRB), caspofungin, anidulafungin and micafungin were evaluated by a broth microdilution technique against 22 isolates of Arthrographis kalrae of clinical origin. TRB showed the highest activity, followed by the azoles, particularly posaconazole. AMB exerted low activity whereas the echinocandins showed almost no antifungal activity.

show abstract

“…Only ten cases of infection with this species have been described so far (Biser et al, 2004;Chin-Hong et al, 2001;de Diego Candela et al, 2010;Degavre et al, 1997;Perlman & Binns, 1997;Pichon et al, 2008;Sugiura & Hironaga, 2010;Thomas et al, 2011;Volleková et al, 2008;Xi et al, 2004.). To our knowledge, we report the first case of a pulmonary infection caused by A. kalrae and demonstrate this organism can act as an opportunistic human pathogen.…”

Section: Introductionmentioning

confidence: 83%

“…Only 10 cases of infection with this species have been described so far (Biser et al, 2004 Thomas et al, 2011;Volleková et al, 2008;Xi et al, 2004). These infections included keratitis (Biser et al, 2004;Perlman & Binns, 1997;Thomas et al, 2011), mycetoma of the hand (Degavre et al, 1997), sinusitis (Chin-Hong et al, 2001;Xi et al, 2004), meningitis (ChinHong et al, 2001), ophthalmitis (Xi et al, 2004), onychomycosis (Sugiura & Hironaga, 2010;Volleková et al, 2008), cerebral vasculitis (Pichon et al, 2008) and endocarditis (de Diego Candela et al, 2010). To our knowledge, this is the first reported case of severe pulmonary infection caused by A. kalrae.…”

Section: Discussionmentioning

confidence: 99%