<i>Pseudozyma aphidis</i> fungaemia with invasive fungal pneumonia in a patient with acute myeloid leukaemia: case report and literature review

Joo, Hyonsoo; Choi, Yeon-Geun; Cho, Sung‐Yeon; Choi, Jae-Ki; Lee, Dong Gun; Kim, Hee-Je; Jo, Irene; Park, Yeon-Joon; Lee, Kyo‐Young

doi:10.1111/myc.12435

Cited by 14 publications

(18 citation statements)

References 15 publications

(57 reference statements)

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“… 8 , 10 It is thought to have low pathogenicity but has been implicated in a few cases of invasive infection in humans, most of whom were immunocompromised. 8 , 9 , 10 , 11 First described as a possible human pathogen in 2008, P. aphidis had since been the primary pathogen in 8 cases of human infection. 8 , 9 , 10 , 11 Due to the rare occurrence of this pathogen in human infections, this species cannot be identified using commercial systems that are available in routine laboratories.…”

Section: Discussionmentioning

confidence: 99%

“… 8 , 9 , 10 , 11 First described as a possible human pathogen in 2008, P. aphidis had since been the primary pathogen in 8 cases of human infection. 8 , 9 , 10 , 11 Due to the rare occurrence of this pathogen in human infections, this species cannot be identified using commercial systems that are available in routine laboratories. 8 To our knowledge, this is the first reported episode of ocular infection involving P. aphidis in medical literature.…”

Section: Discussionmentioning

confidence: 99%

“… 8 , 9 , 10 , 11 Due to the rare occurrence of this pathogen in human infections, this species cannot be identified using commercial systems that are available in routine laboratories. 8 To our knowledge, this is the first reported episode of ocular infection involving P. aphidis in medical literature.

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Section: Discussionmentioning

confidence: 99%

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Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management

Voon

Upton

Gupta

2019

American Journal of Ophthalmology Case Reports

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Purpose To present a case of fungal endophthalmitis with a novel organism and our management. Observations A 46 year old male presented with delayed-onset acute endophthalmitis 6 weeks after routine phacoemulsification and intraocular lens implantation. Initial treatment with intravitreal antibiotics did not improve his condition. With repeated vitreal taps, the causative organism was eventually identified as a fungus, Pseudozyma aphidis . Treatment with oral and intravitreal voriconazole, as well as pars plana vitrectomy, led to resolution of the endophthalmitis and recovery of vision to 20/25. Conclusions and importance Fungal endophthalmitis is a rare, potentially blinding complication of cataract surgery. We report our approach to this previously unreported organism, that led to an excellent visual outcome. There are no specific guidelines for fungal endophthalmitis. The management approach has to be tailored to the clinical response and emerging laboratory data from the microbiologist. Identification of the organism will require specialist laboratory references that may not be available in all hospitals. Ophthalmologists must work closely with microbiologists in order to ensure an optimal outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management

Voon

Upton

Gupta

2019

American Journal of Ophthalmology Case Reports

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“…The plant pathogen Ustilago (the agent of corn smut) and the closely related genus Pseudozyma are ubiquitous in the environment and are commonly regarded as laboratory contaminants. However, these organisms can be transmitted by the airborne route and have occasionally caused fungemia and central venous catheter infections in humans (5,7,(10)(11)(12)(13)(14)(15)(16).…”

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Cross-Reacting Ustilago maydis Causing False-Positive Cryptococcal Antigen Test Results

et al. 2017

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C ryptococcus neoformans is a yeast within the division Basidiomycota that may cause pulmonary and central nervous system (CNS) disease. Latex agglutination (LA) and lateral flow assay (LFA) for detection of cryptococcal polysaccharide antigen are sensitive and specific tests for diagnosis of invasive disease (1, 2); however, cross-reactivity has been described with Trichosporon asahii (3). Our objective was to determine if there is cross-reactivity with other Basidiomycete yeasts, including rare agents of human disease such as Rhodotorula, Sporobolomyces, and Ustilago spp. (4-8). Clinical isolates of Trichosporon, Rhodotorula, Sporobolomyces, and Ustilago spp. were retrieved from the Quebec provincial reference laboratory (LSPQ). Sporobolomyces, Trichosporon asahii, Rhodotorula glutinis, R. minuta, and R. mucilaginosa isolates were taxonomically confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) (Vitek MS; bioMérieux, Inc., Saint-Laurent, Quebec, Canada). Ustilago spp. and Rhodotorula slooffiae were confirmed by sequencing their ribosomal DNA D 1-D 2 and internal transcribed spacer (ITS) regions. Cryptococcus neoformans (LSPQ-16-A479650) and Candida albicans (ATCC 60433) strains were used as positive and negative controls, respectively. Growth in Sabouraud dextrose broth was confirmed by measuring the increase in optical density after 24 h (DensiCHEK Plus; bioMérieux, Inc.). Turbidity was adjusted to a 0.5 McFarland (MF) standard equivalent, and organism count/ml was determined by a hemocytometer. This turbidity corresponded to an average of 3.2 organisms/ml (standard deviation, 0.9 organisms/ ml), which is similar to the organism burden reported to occur in the cerebrospinal fluid of patients with cryptococcal meningitis (9). Serial 2-fold dilutions were performed to determine the cutoff for positivity. LA testing was performed using the CALAS cryptococcal antigen latex agglutination kit (Meridian Bioscience, Inc., Cincinnati, OH, USA). Flocculation was graded on a scale from 0 to 4ϩ, with 2 or higher representing a positive result. LFA was performed using the IMMY cryptococcal lateral flow assay (Immuno-Mycologics, Inc., Norman, OK, USA). Both assays were performed per the manufacturers' instructions, and assessment was made in a blind fashion. In total, 23 samples were tested, including 9 isolates of Rhodotorula spp., 5 isolates of Sporobolomyces salmonicolor, 3 isolates of Trichosporon asahii, and 3 isolates of Ustilago maydis (Table 1). Only C. neoformans, Trichosporon, and Ustilago isolates were unequivocally positive by both assays. One Rhodotorula mucilaginosa isolate and one Sporobolomyces salmonicolor isolate had discordant results; these isolates were weakly positive by the LA assay at titers of 1:1 and 1:4, respectively, but were negative by the LFA. All other isolates had concordant results between assays

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“…This species is commonly found as a saprotroph on leaves and flowers (Han et al 2015, Limtong & Kaewwichian 2015, Tantrungkij et al 2015, although it is not pathogenic to plants. However, there are reports of this species as pathogenic in humans (Prakash et al 2014, Herb et al 2015, Joo et al 2015, Orecchini et al 2015, usually occurring in patients with some type of immunosuppression that predisposes opportunistic infections.…”

Section: Introductionmentioning

confidence: 99%

Molecular identification of Pseudozyma aphidis (Henninger & Windisch) Boekhout: first record from a Brazilian mangrove swamp

Boro

Jesus

Souza

et al. 2017

Hoehnea

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-(Molecular identification of Pseudozyma aphidis (Henninger & Windisch) Boekhout: first record from a Brazilian mangrove swamp). Pseudozyma aphidis (Henninger & Windisch) Boekhout is an anamorph yeast-like basidiomycete commonly found as saprotroph in vegetable debris, such as leaves and flowers. However, there are also reports that this species is pathogenic in humans, usually occurring in patients with some type of immunosuppression, which predisposes to opportunistic infections. Specimens of P. aphidis were collected from water samples and Rhizophora mangle L. leaves at different salinities along the Perequê River, located in a mangrove swamp area at Parque Estadual da Ilha do Cardoso, Cananéia municipality, São Paulo State, Brazil. Aliquots of these samples were spread in Petri dishes. The samples baited with cataphylls of Allium cepa L. were incubated for seven days at 21 ºC. After incubation, the baits were observed under microscope and the specimens were isolated and purified. The identification of the specimens was made through the phylogenetic analysis of the ITS rDNA region. This is the first record of P. aphidis in São Paulo State.

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Pseudozyma aphidis fungaemia with invasive fungal pneumonia in a patient with acute myeloid leukaemia: case report and literature review

Cited by 14 publications

References 15 publications

Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management

Pseudozyma aphidis endophthalmitis post-cataract operation: Case discussion and management

Cross-Reacting Ustilago maydis Causing False-Positive Cryptococcal Antigen Test Results

Molecular identification of Pseudozyma aphidis (Henninger & Windisch) Boekhout: first record from a Brazilian mangrove swamp

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