Necrotizing arteritis due to emerging <b><i>pythium insidiosum</i></b> Infection in patients with thalassemia: Rapid diagnosis with pcr and serological tests — Case reports

Laohapensang, Kamphol; Supabandhu, Jitwadee; Vanittanakom, Noungnuch

doi:10.1007/s00547-005-2012-3

Cited by 7 publications

(2 citation statements)

References 13 publications

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“…Surgery with adequate disease-free surgical margins has previously been reported to be the most important predictor of mortality in vascular pythiosis. 9 Our results are consistent with previous reports that have emphasized the relationship between disease-free surgical margins and survival. 1,2,5,10 Permpalung et al 2 reported that in their cohort of eight patients, all four with disease-free margins after amputation survived, whereas the remaining four, in whom disease-free margins were not achieved, died.…”

Section: Discussionsupporting

confidence: 93%

Outcomes and factors influencing prognosis in patients with vascular pythiosis

Sermsathanasawadi

Praditsuktavorn

Hongku

et al. 2016

Journal of Vascular Surgery

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Section: Discussionsupporting

confidence: 93%

Outcomes and factors influencing prognosis in patients with vascular pythiosis

Sermsathanasawadi

Praditsuktavorn

Hongku

et al. 2016

Journal of Vascular Surgery

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“…After being treated with PIA immunotherapy, this patient has recovered from the P. insidiosum infection of external and internal carotid arteries, where radical surgery is impossible. After excluding potentially-overlapping or clinical data-lacking cases (i.e., no treatment outcome), the literature search identified 108 patients with vascular pythiosis (Table 1), 35 patients with ocular pythiosis (Table 2), and 2 patients with a periorbital infection that received the PIA immunotherapy as an adjunctive treatment, together with antimicrobial drugs or surgery [2,7,13,43,90,[106][107][108][109]131,132,[149][150][151][152][153][154][155][156][157][158][159][160]. The PIA formulation used in these patients contained both extracellular and intracellular proteins of P. insidiosum [136][137][138].…”

Section: Clinical Application Of Immunotherapy In Human Pythiosismentioning

confidence: 99%

History and Perspective of Immunotherapy for Pythiosis

Yolanda

Krajaejun

2021

Vaccines

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The fungus-like microorganism Pythium insidiosum causes pythiosis, a life-threatening infectious disease increasingly reported worldwide. Antimicrobial drugs are ineffective. Radical surgery is an essential treatment. Pythiosis can resume post-surgically. Immunotherapy using P. insidiosum antigens (PIA) has emerged as an alternative treatment. This review aims at providing up-to-date information of the immunotherapeutic PIA, with the focus on its history, preparation, clinical application, outcome, mechanism, and recent advances, in order to promote the proper use and future development of this treatment modality. P. insidiosum crude extract is the primary source of immunotherapeutic antigens. Based on 967 documented human and animal (mainly horses) pythiosis cases, PIA immunotherapy reduced disease morbidity and mortality. Concerning clinical outcomes, 19.4% of PIA-immunized human patients succumbed to vascular pythiosis instead of 41.0% in unimmunized cases. PIA immunotherapy may not provide an advantage in a local P. insidiosum infection of the eye. Both PIA-immunized and unimmunized horses with pythiosis showed a similar survival rate of ~70%; however, demands for surgical intervention were much lesser in the immunized cases (22.8% vs. 75.2%). The proposed PIA action involves switching the non-protective T-helper-2 to protective T-helper-1 mediated immunity. By exploring the available P. insidiosum genome data, synthetic peptides, recombinant proteins, and nucleic acids are potential sources of the immunotherapeutic antigens worth investigating. The PIA therapeutic property needs improvement for a better prognosis of pythiosis patients.

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Evaluation for the Clinical Diagnosis of Pythium insidiosum Using a Single-Tube Nested PCR

et al. 2013

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Pythiosis is a rare infectious disease caused by Pythium insidiosum, which typically occurs in tropical and subtropical regions. The high mortality rate may be in consequence of the lack of diagnosis. The objective of this study was to evaluate reliability of a new single-tube nested PCR for detection of P. insidiosum DNA. A total of 78 clinical isolates of various fungi and bacteria, 106 clinical specimens and 80 simulated positive blood samples were tested. The developed primer pairs CPL6–CPR8 and YTL1–YTR1 are located on 18S subunit of the rRNA gene of P. insidiosum. The specificity, negative and positive predictive values were 100, 100 and 87.5 %, respectively, as compared with direct microscopy and cultivation. The detection limit of the single-tube nested PCR was 21 zoospores corresponding to 2.7 pg of the DNA. The results demonstrate that the new single-tube nested PCR offers a highly sensitive, specific and rapid genetic method for detecting P. insidiosum.

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Necrotizing arteritis due to emerging pythium insidiosum Infection in patients with thalassemia: Rapid diagnosis with pcr and serological tests — Case reports

Cited by 7 publications

References 13 publications

Outcomes and factors influencing prognosis in patients with vascular pythiosis

Outcomes and factors influencing prognosis in patients with vascular pythiosis

History and Perspective of Immunotherapy for Pythiosis

Evaluation for the Clinical Diagnosis of Pythium insidiosum Using a Single-Tube Nested PCR

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