Phaeohyphomycosis due to <i>Exophiala</i> infections in solid organ transplant recipients: Case report and literature review

Oberlin, Kate E.; Nichols, Anna; Rosa, Rossana; Dejman, Adriana; Mattiazzi, Adela; Guerra, Giselle; Elgart, George W.; Abbo, Lilian M.

doi:10.1111/tid.12723

Cited by 18 publications

(10 citation statements)

References 33 publications

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“…Dematiaceous fungi cause opportunistic cutaneous infections most often in solid organ transplant recipients than in AIDS patients (21,22). In AIDS patients, cryptococcosis,…”

Section: Discussionmentioning

confidence: 99%

“…Dematiaceous fungi cause opportunistic cutaneous infections most often in solid organ transplant recipients than in AIDS patients [ 21 , 22 ]. In AIDS patients, cryptococcosis, histoplasmosis and Talaromyces marneffei infections are more common [ 23 ] The genus Phialemoniopsis is closely allied to Phialemonium , and is widely distributed in air, soil, and plant materials [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

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Phialemoniopsis limonesiae sp. nov. causing cutaneous phaeohyphomycosis in an immunosuppressed woman

Martínez

Alberto

Riat

et al. 2021

Emerging Microbes & Infections

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Rare or opportunistic fungal infections are mostly described in immunosuppressed patients. We present a case of a cutaneous phaeohyphomycosis that developed on the dorsal foot in an immunosuppressed woman suffering from AIDS, caused by a novel Phialemoniopsis species. It clinically presented as an indurated violaceous plaque, surmounted by nodules exuding a sero-purulent discharge. A filamentous fungus was isolated from pus and cutaneous biopsy. ITS and LSU sequences phylogenetically resolved the fungus as an unknown species of Phialemoniopsis, which is an unresolved family within Sordariomycetes. In this study we describe the new species as Phialemoniopsis limonesiae, which clusters on a single branch clearly separated from its closest phylogenetic neighbours. This new strain showed low MIC to itraconazole, voriconazole and posaconazole.

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“…Dematiaceous fungi cause opportunistic cutaneous infections most often in solid organ transplant recipients than in AIDS patients (21,22). In AIDS patients, cryptococcosis,…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Phialemoniopsis limonesiae sp. nov. causing cutaneous phaeohyphomycosis in an immunosuppressed woman

Martínez

Alberto

Riat

et al. 2021

Emerging Microbes & Infections

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“…Relatively few cases occurred following organ transplantation, which was the case with our patient. A review 4 of phaeohyphomycosis cases developing after organ transplantation and reported until 2016 identified a total of 32 reports. Most cases occurred following transplantation of a kidney, followed in frequency by heart, liver and lung.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous phaeohyphomycosis due to Exophiala jeanselmei following renal transplantation: A case report with a published work review of phaeohyphomycosis in Japan

Takenaka

Murota

Nishimoto³

2020

The Journal of Dermatology

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We describe a case of cutaneous phaeohyphomycosis following renal transplantation and include a review of the previously published Japanese cases. A 40‐year‐old Japanese woman taking immunosuppressants following renal transplantation 6 years prior presented to our hospital with a subcutaneous lesion on her right leg. Skin biopsy revealed an abscess, and culture confirmed Exophiala jeanselmei to be the causative agent. Treatment with itraconazole combined with surgical drainage was effective, and the lesion disappeared after 15 months. Upon review of 128 Japanese phaeohyphomycosis cases, it was found that more than 80% of the cases occurred in patients aged more than 60 years, and most cases involved underlying diseases associated with immunodeficiency. E. jeanselmei was the most common etiologic fungus. Recently, however, the Exophiala species has been reclassified based on molecular identification, and cases due to E. jeanselmei decreased with the concomitant increase of cases due to Exophiala oligosperma and Exophiala xenobiotica. In approximately half of the cases, lesions were treated by surgical removal, with or without concomitant antifungal drugs. Itraconazole was the antifungal agent most frequently used. In many cases, the disease course was reported as either healing or improving. There was no difference in either treatment or prognosis based on the etiologic species of fungus.

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“…However, oral azole therapy (mostly with itraconazole) for several months is considered a treatment of choice for subcutaneous infection. In cases of extensive skin lesions, local excisions may be performed [98,157,158]. The most appropriate treatment for disseminated phaehyphomycosis is unclear, but combinations of systemic antifungal therapies (e.g.…”

Section: Treatment Of Fungal Diseases In Card9-deficient Patientsmentioning

confidence: 99%

Inherited CARD9 Deficiency: Invasive Disease Caused by Ascomycete Fungi in Previously Healthy Children and Adults

2018

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• Inherited CARD9 deficiency (OMIM #212050) is an AR PID due to mutations that may be present in a homozygous or compound heterozygous state. • CARD9 is expressed principally in myeloid cells and transduces signals downstream from CLR activation by fungal ligands. • Endogenous mutant CARD9 levels differ between alleles (from full-length normal protein to an absence of normal protein). • The functional impacts of CARD9 mutations involve impaired cytokine production in response to fungal ligands, impaired neutrophil killing and/or recruitment to infection sites, and defects of Th17 immunity. • The key clinical manifestations in patients are fungal infections, including CMC, invasive (in the CNS in particular) Candida infections, extensive/deep dermatophytosis, subcutaneous and invasive phaeohyphomycosis, and extrapulmonary aspergillosis. • The clinical penetrance of CARD9 deficiency is complete, but penetrance is incomplete for each of the fungi concerned. • Age at onset is highly heterogeneous, ranging from childhood to adulthood for the same fungal disease. • All patients with unexplained IFD should be tested for CARD9 mutations. Familial screening and genetic counseling should be proposed. • The treatment of patients with CARD9 mutations is empirical and based on antifungal therapies and the surgical removal of fungal masses. Patients with persistent/relapsing Candida infections of the CNS could be considered for adjuvant GM-CSF/G-CSF therapy. The potential value of HSCT for CARD9-deficient patients remains unclear.

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Phaeohyphomycosis due to Exophiala infections in solid organ transplant recipients: Case report and literature review

Cited by 18 publications

References 33 publications

Phialemoniopsis limonesiae sp. nov. causing cutaneous phaeohyphomycosis in an immunosuppressed woman

Phialemoniopsis limonesiae sp. nov. causing cutaneous phaeohyphomycosis in an immunosuppressed woman

Subcutaneous phaeohyphomycosis due to Exophiala jeanselmei following renal transplantation: A case report with a published work review of phaeohyphomycosis in Japan

Inherited CARD9 Deficiency: Invasive Disease Caused by Ascomycete Fungi in Previously Healthy Children and Adults

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