Intrabronchial Aspergillus nidulans Infection in an Immnocompetent Man.

Yano, Shuichi; Kobayashi, Kanako; Shishido, Shinji; Nakano, Hiroko

doi:10.2169/internalmedicine.38.372

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…We add 1 case of central nervous system aspergillosis and 3 cases of invasive pulmonary aspergillosis in patients with CGD. The 3 cases may not be surprising because E. quadrilineata is very closely related to E. nidulans, a fungus known to cause infections in humans (3,5,(28)(29)(30), primarily in patients with CGD (6,7). Emericella spp.…”

Section: Discussionmentioning

confidence: 99%

Emericellaquadrilineataas Cause of Invasive Aspergillosis

Verweij

Varga

Houbraken

et al. 2008

Emerg. Infect. Dis.

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We noted a cluster of 4 cases of infection or colonization by Emericella spp., identifi ed by sequence-based analysis as E. quadrilineata. Sequence-based analysis of an international collection of 33 Emericella isolates identifi ed 12 as E. nidulans, all 12 of which had previously been identifi ed by morphologic methods as E. nidulans. For 12 isolates classifi ed as E. quadrilineata, only 6 had been previously identifi ed accordingly. E. nidulans was less susceptible than E. quadrilineata to amphotericin B (median MICs 2.5 and 0.5 mg/L, respectively, p<0.05); E. quadrilineata was less susceptible than E. nidulans to caspofungin (median MICs, 1.83 and 0.32 mg/L, respectively, p<0.05). These data indicate that sequence-based identifi cation is more accurate than morphologic examination for identifying Emericella spp. and that correct species demarcation and in vitro susceptibility testing may affect patient management.T he genus Aspergillus includes >250 species; ≈20 have been reported to cause opportunistic infections in humans. The most important human pathogens in this genus are A. fumigatus, A. fl avus, A. niger, A. terreus, and Emericella nidulans (anamorph: A. nidulans) (1). A. fumigatus is the most common cause of invasive aspergillosis, a condition associated with substantial severity and mortality rates (2). Invasive infections caused by E. nidulans are uncommon in animals and humans (3-5); in humans they appear to occur predominantly in patients who have chronic granulomatous disease (CGD), a rare disorder of phagocytes in which the absence of both superoxide and hydrogen peroxide production in phagocytes predisposes patients to bacterial and fungal infections. Invasive E. nidulans infections in this patient group are associated with higher mortality rates than those caused by A. fumigatus (6,7). The most common site of infection is the lungs; other manifestations are subcutaneous abscesses or liver abscesses, suppurative adenitis, osteomyelitis, fungemia, cellulitis, and meningitis (7,8). Within the genus Emericella, other species have only rarely been identifi ed as agents of human or animal infections.The identifi cation of E. nidulans in clinical microbiology laboratories is commonly based on the characteristic microscopic morphology, the production of hülle cells, or the production of ascospores. A. fumigatus is identifi ed by its heat tolerance; other species fail to grow when incubated at high temperature, typically 48°C.We recently noted a cluster of infection or colonization by E. quadrilineata, a species closely related to E. nidulans. Within a 3-month period, 4 cases were identifi ed at the Radboud University Nijmegen Medical Center. No apparent epidemiologic link between the cases was found because each patient was cared for in a different ward, and 2 patients with invasive aspergillosis were admitted directly from home. One of the latter 2 patients was a 10-year-old boy with X-linked CGD and a probable diagnosis of invasive pulmonary aspergillosis (9); the other patient was a 60-year-old man...

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Section: Discussionmentioning

confidence: 99%

Emericellaquadrilineataas Cause of Invasive Aspergillosis

Verweij

Varga

Houbraken

et al. 2008

Emerg. Infect. Dis.

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“…In a study among transplant recipients, tracheobronchitis and anastomotic infections were seen in 37 and 20% of the patients, respectively [39]. Among 121 patients (both transplant recipients and other cases) retrieved from the literature, 1 patient had A. fumigatus and A. flavus [25], 2 had A. nidulans [8, 20], 4 had A. niger [1, 9, 12, 28] and4 had A. flavus [5, 15, 21, 28]. In 34 patients no species were identified [2,5,6,7, 16, 17, 27, 31, 34, 42] while the rest (63%) had A. fumigatus.…”

Section: Discussionmentioning

confidence: 99%

“…Reviewing the English literature, we recognized that the most common agents causing EBFI are Aspergillus spp. [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45], Coccidioides immitis [46] , agents of zygomycosis [6,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73], Candida spp. [6, 34,74,75,76], Cryptococcus neoformans [77,78,79,80,81,82,83,84,85,86,87,88], and Histoplasma capsulatum [89,…”

Section: Introductionmentioning

confidence: 99%

Endobronchial Fungal Disease: An Under-Recognized Entity

Karnak

Avery²,

Gildea

et al. 2006

Respiration

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Most fungi enter the human body via inhalation; however, endobronchial fungal infection (EBFI) seems to be a rare manifestation compared to pulmonary or systemic disease. This presentation seems to be related to environmental factors as well as to the host status. With the increasing popularity of flexible bronchoscopy, it is being recognized with a higher frequency. Bronchoscopic findings in EBFI vary from mild mucosal inflammation to central airway obstruction. We searched English literature related to the topic and found 228 total cases of EBFI: Aspergillus species (121), Coccidioides immitis (38), Zygomycetes (31), Candida species (14) Cryptococcus neoformans (13), and Histoplasma capsulatum (11). We have also included a single case of endobronchial Pseudallescheria boydii infection in a lung transplant recipient that has not been reported previously. Most patients were immunocompromised, exhibited systemic manifestations of the primary infection, and responded to appropriate therapy. EBFI should be included in the differential diagnosis of any form of airway lesions in immunocompromised patients, especially among residents from the endemic areas.

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“…The importance of filamentous fungi as fermentation organisms is well exemplified by the estimate that 50% of the world's pharmaceutical and biotechnological products rely on these cells. Given also that some fungal cells are a common pathogen in many living organisms, there is a significant interest in understanding the mechanisms of tip growth [2,3]. In particular, the impact on human health of Aspergillus is well proven by the 20 human pathogens among them, such as A. fumigatus, which is life threatening in immune-compromised patients.…”

Section: Introductionmentioning

confidence: 99%

Probing the effect of tip pressure on fungal growth: Application toAspergillus nidulans

González‐Bermúdez

Guinea

et al. 2017

Phys. Rev. E

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The study of fungal cells is of great interest due to their importance as pathogens and as fermenting fungi and for their appropriateness as model organisms. The differential pressure between the hyphal cytoplasm and the bordering medium is essential for the growth process, because the pressure is correlated with the growth rate. Notably, during the invasion of tissues, the external pressure at the tip of the hypha may be different from the pressure in the surrounding medium. We report the use of a method, based on the micropipette-aspiration technique, to study the influence of this external pressure at the hyphal tip. Moreover, this technique makes it possible to study hyphal growth mechanics in the case of very thin hyphae, not accessible to turgor pressure probes. We found a correlation between the local pressure at the tip and the growth rate for the species Arpergillus nidulans. Importantly, the proposed method allows one to measure the pressure at the tip required to arrest the hyphal growth. Determining that pressure could be useful to develop new medical treatments for fungal infections. Finally, we provide a mechanical model for these experiments, taking into account the cytoplasm flow and the wall deformation.

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Intrabronchial Aspergillus nidulans Infection in an Immnocompetent Man.

Cited by 5 publications

References 21 publications

Emericellaquadrilineataas Cause of Invasive Aspergillosis

Emericellaquadrilineataas Cause of Invasive Aspergillosis

Endobronchial Fungal Disease: An Under-Recognized Entity

Probing the effect of tip pressure on fungal growth: Application toAspergillus nidulans

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