Human Pulmonary Granulomas Caused by Chrysosporium parvum Var. Crescens (Emmonsia crescens) *

Ea, Bambirra; Am, Nogueira

doi:10.4269/ajtmh.1983.32.1184

Cited by 11 publications

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“…cescens or var.parvum, which are characterized by their incapacity to multiply in host tissues; instead, the conidia increase in size and form large round bodies called adiaconidia [1-3, 6, 12]. Most of the cases published in the literature indicate that the pathological lesions occur more frequently in the lungs [1,4,5,8,13,14,18, 19]. Reports dealing with extrapulmonary lesions or disseminated lung disease are rare [7,[9][10][11][15][16][17].…”

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confidence: 98%

Disseminated adiaspiromycosis in a patient with AIDS

1993

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A case of disseminated adiaspiromycosis in an AIDS patient is described. The most notable characteristic of the infection was the extensive osteomyelitis exhibited by the patient. Positive cultures for Chrysosporium parvum var. parvum were obtained from pus taken from a lesion of the wrist during surgery as well as from sputum samples and a bone marrow aspirate. Treatment with amphotericin B controlled the fungal infection.Adiaspiromycosis is a rare fungal infection, usually confined to the lungs. The aetiological agents are Chrysosporiumparvum (Emmonsia crescens) var. cescens or var.parvum, which are characterized by their incapacity to multiply in host tissues; instead, the conidia increase in size and form large round bodies called adiaconidia [1-3, 6, 12]. Most of the cases published in the literature indicate that the pathological lesions occur more frequently in the lungs [1,4,5,8,13,14,18, 19]. Reports dealing with extrapulmonary lesions or disseminated lung disease are rare [7,[9][10][11][15][16][17]. We present a case of disseminated adiaspiromycosis with bone involvement in an HIV-positive patient. CASE REPORTA white 32-year-old homosexual male, who was receiving intermittent therapy with azidothymidine (AZT), oral nystatin and acyclovir, presented at the Hospital Pablo Tobon Uribe with pain and functional impotence of the right wrist, accompanied by slight tumefaction of the third distal portion of the radius. An X-ray of this lesion revealed an osteolytic area and slight elevation of the periostic prominence. Medical treatment included immobilization of the wrist for a month; the problem persisted, however, and a repeat X-ray revealed a defined area ofosteolysis and significant periostal eIevation (Fig. 1). At this time, the patient showed signs of severe clinical deterioration and with a presumptive diagnosis of osteomyelitis underwent surgical investigation. Direct examination of the pus obtained during surgery in KOH, as well as of a Gram stained smear, revealed the presence of peculiar oval to elongated, empty-looking cells with thick walls (Fig. 2), which were later recognized as adiaconidia. Cultures at room temperature (20_+ 4°C) produced abundant colonies of a white-tan mould while growth at 40°C in blood agar was pasty (Fig. 3). Microscopic examination of the former colonies revealed delicate septate hyphae with numerous oval and sesile conidia. At 40°C adiaconidia were formed; they appeared round, had thick walls and were large 00-25/~m) (Fig. 4). On the Correspondence address: Dr A. Restrepo, Corporacion para lnvestigaciones Biologicas (CIB), Apartado Aereo ~73-78, Medellin, Colombia. 91 Med Mycol Downloaded from informahealthcare.com by UB Wuerzburg on 11/01/14 For personal use only.

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confidence: 98%

Disseminated adiaspiromycosis in a patient with AIDS

1993

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“…The cell wall is 20 to 70/-lm thick and has an eosinophilic outer layer and a broad hyaline inner layer. 618 The GMS stain defines three wall layers, which correspond to the trilaminar appearance demonstrated by electron microscopy. The interior of the swollen cell adiaconidia is empty or contains small eosinophilic globules 1 to 3 /-lm in size (Fig.…”

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confidence: 99%

Fungal Infections

Haque

McGinnis

2008

Dail and Hammar’s Pulmonary Pathology

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The incidence of invasive fungal infections has increased dramatically over the past two decades, mostly due to an increase in the number of immunocompromised patients. l -4 Patients who undergo chemotherapy for a variety of diseases, patients with organ transplants, and patients with the acquired immune deficiency syndrome have contributed most to the increase in fungal infections. s The actual incidence of invasive fungal infections in transplant patients ranges from 15% to 25% in bone marrow transplant recipients to 5% to 42% in solid organ transplant recipients. 6 ,7 The most frequently encountered are Aspergillus species, followed by Cryptococcus and Candida species. Fungal infections are also associated with a higher mortality than either bacterial or viral infections in these patient popUlations. This is because of the limited number of available therapies, dose-limiting toxicities of the antifungal drugs, fewer symptoms due to lack of inflammatory response, and the lack of sensitive tests to aid in the diagnosis of invasive fungal infections. I A study of patients with fungal infections admitted to a university-affiliated hospital indicated that communityacquired infections are becoming a serious problem; 67% of the 140 patients had community-acquired fungal pneumonia. 8 There is also an increase in nosocomial fungal infections.9Fungi are eukaryotic, unicellular to multicellular organisms that have chitinous cell walls, and reproduce asexually, sexually, or both ways. Fungal cells are larger and genomically more complex than bacteria. Their cell wall contains polysaccharides, proteins, and sugars, and their antigens are rich in complex polysaccharides and glycoproteins. Plasma membranes of fungi contain ergosterol, which is the primary target for antifungals such as amphotericin B. Although there are more than 1.3 million fungal species in the environment, only about 150 are known to be pathogenic to humans. For detailed taxonomy of the fungi, several texts are available. W-12 The virulence factors of fungi resemble those of bacteria, such as possession of a capsule, adhesion molecules, toxins, free radicals, etc.

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“…Um inóculo maciço, único ou repetido, formado por milhões de conídios, provoca em geral inflamação tão extensa e grave 2 que pode determinar a morte do paciente por insuficiência respiratória 4 5 . Inóculos menores causam manifestações clínicas moderadas ou leves, podendo a presença do fungo passar mesmo despercebida; os adiaconídios seriam então descobertos apenas por acidente 1…”

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Adiaspiromicose pulmonar: achado casual em paciente falecido de febre amarela

Moraes

Gomes

Vianna

2001

Rev. Soc. Bras. Med. Trop.

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During an outbreak of yellow fever (rural form of the infection) occurred recently in the State of Goiás, Brazil, a patient, with clinical manifestations suggestive of the infection, died in the University Hospital of Brasilia, DF, on the fifth day from admission. Postmortem examination revealed, microscopically, the characteristic alterations of the infection, and discovered in the lungs and hilar lymph nodes round microrganisms identified as adiaconidia of Emmonsia parva var. crescens.

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Human Pulmonary Granulomas Caused by Chrysosporium parvum Var. Crescens (Emmonsia crescens) *

Cited by 11 publications

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Disseminated adiaspiromycosis in a patient with AIDS

Disseminated adiaspiromycosis in a patient with AIDS

Fungal Infections

Adiaspiromicose pulmonar: achado casual em paciente falecido de febre amarela

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