<i>Phaeoacremonium parasiticum</i>Infective Endocarditis Following Liver Transplantation

Heath, Christopher H.; Lendrum, Joanne L.; Wetherall, B L; Wesselingh, Steven Lodewyk; Gordon, David L.

doi:10.1086/516963

Cited by 35 publications

(29 citation statements)

References 3 publications

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“…The spectrum of disease caused by P. parasiticum includes subcutaneous infections (1, 9, 15), eumycetoma (14), arthritis (16,25), osteomyelitis (26), and disseminated disease including fungemia, endocarditis, and cases with multiorgan involvement (8,12; this report). Outcomes among reported cases are relatively good, with 7 (63.6%) of 11 alive and 6 (55%) considered cured.…”

Section: Discussionmentioning

confidence: 98%

“…Presumably, the inciting event is traumatic implantation of the fungus, but in many reported cases, no known trauma occurred (9,26,27). Of cases reported to date, many involve immunocompromised patients who are organ transplant recipients (1,6,9,12,15,27). Although good outcomes have been achieved with surgical debridement and use of the antifungals amphotericin B, azoles, and flucytosine (5FC), the ideal treatment has not yet been identified.…”

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confidence: 99%

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Phaeoacremonium parasiticum Infections Confirmed by β-Tubulin Sequence Analysis of Case Isolates

Baddley¹,

Mostert

Summerbell

et al. 2006

J Clin Microbiol

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Phaeoacremonium parasiticum is an agent of opportunistic phaeohyphomycosis belonging to a genus encompassing numerous recently described and soon-to-be-described, difficult-to-identify human pathogens. It appears in the literature to be an uncommon etiologic agent, yet we encountered several cases in a single year. Each presented problems in laboratory identification and case management. We present two cases of invasive disease with definite identification and susceptibility results. These cases are analyzed in relation to a brief review of previous cases known to have been caused by this species. Our first case involved a 40-year-old male cardiac transplant recipient with multiple localized skin lesions. The second featured a 31-year-old female with aplastic anemia and prolonged neutropenia who developed disseminated disease, with multiple positive blood cultures and skin lesions. Both patients died despite aggressive surgical and antifungal therapy. Fungal susceptibility testing showed that our isolates appeared to be susceptible to amphotericin B, itraconazole, voriconazole, ravuconazole, and posaconazole. Because phenotypic identification of Phaeoacremonium is notably problematic, sequence-based confirmation was performed using a recently proposed standard based on use of a segment of the 5 end of the ␤-tubulin gene. Sequences from both isolates involved in the cases were over 99% similar to the corresponding sequence of the ex-type isolate of P. parasiticum. The close DNA similarity, corroborated by relevant morphological similarities (e.g., long, thin phialides and tuberculate hyphae bearing warts up to 3 m high), confirms these two isolates as P. parasiticum.

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

Phaeoacremonium parasiticum Infections Confirmed by β-Tubulin Sequence Analysis of Case Isolates

Baddley¹,

Mostert

Summerbell

et al. 2006

J Clin Microbiol

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“…E. dermatitidis, in contrast, is commonly seen in immunocompetent patients, particularly from Asia (13,349,565). A variety of other molds were reported in disseminated disease, including E. oligosperma, Chaetomium perlucidum, O. gallopava, Lecythophora mutabilis, P. parasiticum, B. spicifera, Exserohilum sp., E. spinifera, and Curvularia lunata (25,64,85,207,256,335,417,451,536,741,788). Interestingly, peripheral eosinophilia has been observed in 9% of cases, and these were generally due to Bipolaris and Curvularia.…”

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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“…However, in the remaining 43% of cases, a wide spectrum of infections ranging from osteoarticular involvement, pulmonary nodules, endophthalmitis, invasive disseminated infection associated with fungemia, brain abscesses, endocarditis, and liver and spleen abscesses were observed (5)(6)(7)(8)(9)(10)(11)(12). Disseminated and severe infections were commonly associated with solid organ transplantation and other immunosuppressive conditions (3,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Considering that the morphological identification of black fungi, and of Phaeoacremonium in particular, is problematic (28) and relies on sequencing of the internal transcribed space (ITS) ribosomal DNA (rDNA) region or ␤-tubulin or calmodulin genes (29)(30)(31), many cases in routine microbiology laboratories may have passed unnoticed (28).…”

mentioning

confidence: 99%

In Vitro Susceptibility Profiles of Eight Antifungal Drugs against Clinical and Environmental Strains of Phaeoacremonium

Badali

Khodavaisy

Fakhim

et al. 2015

Antimicrob Agents Chemother

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hIn vitro susceptibilities of a worldwide collection of molecularly identified Phaeoacremonium strains (n ‫؍‬ 43) belonging to seven species and originating from human and environmental sources were determined for eight antifungal drugs. Voriconazole had the lowest geometric mean MIC (0.35 g/ml), followed by posaconazole (0.37 g/ml), amphotericin B (0.4 g/ml), and isavuconazole (1.16 g/ml). Caspofungin, anidulafungin, fluconazole, and itraconazole had no activity.

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Phaeoacremonium parasiticumInfective Endocarditis Following Liver Transplantation

Cited by 35 publications

References 3 publications

Phaeoacremonium parasiticum Infections Confirmed by β-Tubulin Sequence Analysis of Case Isolates

Phaeoacremonium parasiticum Infections Confirmed by β-Tubulin Sequence Analysis of Case Isolates

Melanized Fungi in Human Disease

In Vitro Susceptibility Profiles of Eight Antifungal Drugs against Clinical and Environmental Strains of Phaeoacremonium

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