<i>Pleurostomophora richardsiae</i> – An Insidious Fungus Presenting in a Man 44 Years After Initial Inoculation: A Case Report and Review of the Literature

Levenstadt, Jeremy S; Poutanen, Susan M.; Mohan, Sindu; Zhang, Sean X.; Silverman, Michael

doi:10.1155/2012/406982

Cited by 20 publications

(29 citation statements)

References 19 publications

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“…Infection is thought to result from trauma or inoculation injury such as a splinter, although many cases do not have such a history. This may be due to the long interval between the trauma and development of symptoms and therefore patients may not remember the inciting injury [13, 16]. Rare cases of endocarditis of a porcine mitral valve, dacryocystitis, and exogenous endophthalmitis have also been reported [3, 13, 14].…”

Section: Discussionmentioning

confidence: 99%

“…Rare cases of endocarditis of a porcine mitral valve, dacryocystitis, and exogenous endophthalmitis have also been reported [3, 13, 14]. Similar to other dematiaceous fungi, many cases of P. richardsiae infection involve patients who are immunocompromised or immunosuppressed; however, multiple cases have been described in immunocompetent patients [13, 16, 17]. Risk factors for infection include immunosuppression, corticosteroid use, intravenous drug abuse, malignancy, heart valve replacement, and penetrating injury with retained wood material [18].…”

Section: Discussionmentioning

confidence: 99%

“…Most cases of P. richardsiae infection are superficial and localized, and surgical excision is typically effective, if not curative [4, 15, 16]. However, antifungal therapy is necessary for more invasive P. richardsiae infections, including endophthalmitis [4, 16, 17].…”

Section: Discussionmentioning

confidence: 99%

“…However, antifungal therapy is necessary for more invasive P. richardsiae infections, including endophthalmitis [4, 16, 17]. Unfortunately, no universally effective treatment for disseminated disease has been identified, and the mortality rate for such infections is high.…”

Section: Discussionmentioning

confidence: 99%

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Dematiaceous fungal endophthalmitis: report of a case and review of the literature

Fox

Houser

Morris

et al. 2016

J Ophthal Inflamm Infect

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Background Pleurostomophora richardsiae (formerly Phialophora richardsiae) is a dematiaceous fungus that is an uncommon cause of ocular infection. Herein, we present a case of endogenous endophthalmitis associated with disseminated P. richardsiae infection.FindingsThis is a descriptive case report with a brief review of literature. A 43-year-old male admitted to the hospital following an acute cerebellar hemorrhage was found to have a swollen and tender wrist. The patient was afebrile with leukocytosis. Visual acuity was hand motion in the right eye and 20/20 in the left. Right eye examination noted anterior chamber cells and flare, vitreous haze and multiple large, and fluffy retinal infiltrates. Diagnostic vitrectomy revealed a mixed inflammatory cell infiltrate with numerous fungal elements. Blood cultures were negative, multiple transesophageal echocardiography studies revealed no vegetations, and synovial fluid aspiration of the wrist and biopsy of the radius were unremarkable. The patient was treated with intravitreal cefazolin, vancomycin, and amphotericin B, topical ciprofloxacin and natamycin, and intravenous amphotericin B and voriconazole. Visual acuity in the right eye declined to light perception, and examination revealed increasing anterior and posterior chamber inflammation. The patient died several weeks after presentation due to a massive intracranial hemorrhage. Fungal culture results from the vitrectomy were received post mortem and were positive for P. richardsiae.Conclusions P. richardsiae endophthalmitis is rare, and outcomes are typically poor. Infections typically occur following traumatic skin inoculation; however, a long refractory period may occur before symptoms develop. Early diagnosis and combination antimicrobial therapy are essential to optimize visual outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Dematiaceous fungal endophthalmitis: report of a case and review of the literature

Fox

Houser

Morris

et al. 2016

J Ophthal Inflamm Infect

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“…Common genera of dematiaceous molds that cause opportunistic infection in humans include Alternaria , Bipolaris , Curvularia , Cladophialophora , Exophiala , and Phaeoacremonium . Pleurostomophora richardsiae , a genus of dematiaceous mold that was formerly known as Phialophora richardsiae , is found in soil, decaying wood, and vegetation—especially in tropical climates . Normally, Pleurostomophora richardsiae is a wood decay fungus that only rarely causes diseases in humans .…”

Section: Introductionmentioning

confidence: 99%

Disseminated phaeohyphomycosis with hepatic artery and portal vein thrombosis caused by Pleurostomophora richardsiae in a liver transplant recipient: A case report

Sribenjalux

Chongtrakool

Chayakulkeeree

2019

Transplant Infectious Dis

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Pleurostomophora richardsiae is a dematiaceous mold that causes subcutaneous cystic phaeohyphomycosis. Few cases of invasive P richardsiae infection have been reported. Hepatic artery thrombosis following organ transplantation caused by a fungal organism is also very rare. We present here a 57‐year‐old man with refractory ascites and liver failure following liver transplantation for treatment of hepatocellular carcinoma. Abdominal computed tomography demonstrated total occlusion of hepatic artery and blood clot in the portal vein and inferior vena cava. P richardsiae was isolated from blood culture and the blood clot in his liver. The patient was treated successfully with a 4‐week course of amphotericin B deoxycholate and liver retransplantation.

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Larone's Medically Important Fungi

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Pleurostomophora richardsiae – An Insidious Fungus Presenting in a Man 44 Years After Initial Inoculation: A Case Report and Review of the Literature

Cited by 20 publications

References 19 publications

Dematiaceous fungal endophthalmitis: report of a case and review of the literature

Dematiaceous fungal endophthalmitis: report of a case and review of the literature

Disseminated phaeohyphomycosis with hepatic artery and portal vein thrombosis caused by Pleurostomophora richardsiae in a liver transplant recipient: A case report

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