Pulmonary <i>Cladosporium </i>infection coexisting with subcutaneous <i>Corynespora cassiicola </i>infection in a patient: A case report

Background The striped field mouse Apodemus agrarius is a wild rodent commonly found in fields in Korea. It is a known carrier of various pathogens. Amplicon-based next-generation sequencing (NGS) targeting the 16S ribosomal RNA (rRNA) gene is the most common technique used to analyze the bacterial microbiome. Although many bacterial microbiome analyses have been attempted using feces of wild animals, only a few studies have used NGS to screen for parasites. This study aimed to rapidly detect bacterial, fungal and parasitic pathogens in the guts of A. agrarius using NGS-based metabarcoding analysis. Methods We conducted 18S/16S rDNA-targeted high-throughput sequencing on cecal samples collected from A. agrarius (n = 48) trapped in May and October 2017. Taxa of protozoa, fungi, helminths and bacteria in the cecal content were then identified. Results Among the protozoa identified, the most prevalent was Tritrichomonas sp., found in all of the cecal samples, followed by Monocercomonas sp. (95.8% prevalence; in 46/48 samples) and Giardia sp. (75% prevalence; in 36/48 samples). For helminths, Heligmosomoides sp. was the most common, found in 85.4% (41/48) of samples, followed by Hymenolepis sp. (10.4%; 5/48) and Syphacia sp. (25%; 12/48). The 16S rRNA gene analysis showed that the microbial composition of the cecal samples changed by season (P = 0.005), with the linear discriminant analysis effect size showing that in the spring Escherichia coli and Lactobacillus murinus were more abundant and Helicobacter rodentium was less abundant. Helicobacter japonicus was more abundant and Prevotella_uc was less abundant in males. The microbial composition changed based on the Heligmosomoides sp. infection status (P = 0.019); specifically, Lactobacillus gasseri and Lactobacillus intestinalis were more abundant in the Heligmosomoides sp.-positive group than in the Heligmosomoides sp.-negative group. Conclusions This study demonstrated that bacterial abundance changed based on the season and specific parasitic infection status of the trapped mice. These results highlight the advantages of NGS technology in monitoring zoonotic disease reservoirs. Graphical Abstract

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“…and Kazachstania sp. were also found, the presence of which were previously reported in human infection cases [ 66 – 68 ].…”

Section: Discussionsupporting

confidence: 65%

Metabarcoding of bacteria and parasites in the gut of Apodemus agrarius

Kim

Choi

et al. 2022

Parasites Vectors

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“…Studies have shown that C. cassiicola has the potential to be vascular invasive and may lead to disseminated infections in immunodeficient hosts ( Lv et al., 2011 ). Three cases of CARD9 deficiency causing infection with this fungus had been reported, and the treatment of antifungal infection was ineffective in two of them ( Yan et al., 2016 ; Arango-Franco et al., 2018 ; Wang et al., 2022 ). Notably, most cases were from Asia.…”

Section: Discussionmentioning

confidence: 99%

Case report: A case of ocular infection caused by Corynespora cassiicola

Wang¹,

Wang²,

Lian³

et al. 2023

Front. Cell. Infect. Microbiol.

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ObjectiveThe aim of this study is to identify the pathogen causing ocular infection in a Chinese patient and to describe its morphological characteristics.MethodsSamples from the patient’s intraoperative pus were collected for microscopic examination and culture. Morphology and drug sensitivities of the isolated fungus were analyzed. Ribosomal DNA (rDNA) sequencing was performed and blasted in GenBank.ResultsA strain of fungi was repeatedly isolated from pus samples in different types of medium. No conidia were shown when the isolate cultured on normal PDA medium, whereas pseudoseptate thick-walled conidia were shown when cultured on medium containing leaf leachate. The results of BLAST and phylogenetic trees based on internal transcribed spacer, beta-tubulin, translation elongation factor 1-alpha, and RNA polymerase II gene demonstrated that the isolated fungus was Corynespora cassiicola. Minimum inhibitory concentration results of this organism were as follows: anidulafungin, 0.06 μg/ml; amphotericin B, 0.12 μg/ml; micafungin, 0.06 μg/ml; caspofungin, 0.5 μg/ml; 5-fluorocytosine, >64 μg/ml; posaconazole, 2 μg/ml; voriconazole, 0.25 μg/ml; itraconazole, 0.5 μg/ml; fluconazole, 64 μg/ml.ConclusionThe case was infected with Corynespora cassiicola and led to eye suppurative endophthalmitis and blindness. Combined applications of morphological and molecular biology techniques facilitate accurate diagnosis of fungal infections.

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“…C. cassiicola causes multiple diseases in plants ( 39 ). It also rarely causes human phaeohyphomycosis, affecting diabetic ( 40 ), CARD9-deficient ( 4 , 21 , 41 ), and apparently immunocompetent patients ( 42 – 44 ). Human Dectin-1 deficiency caused by p.Y238* homozygosity was previously associated with vulvovaginal candidiasis and onychomycosis ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Human Dectin-1 deficiency impairs macrophage-mediated defense against phaeohyphomycosis

Drummond¹,

Desai²,

Hsu³

et al. 2022

Journal of Clinical Investigation

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Subcutaneous phaeohyphomycosis typically affects immunocompetent individuals following traumatic inoculation. Severe or disseminated infection can occur in CARD9 deficiency or after transplantation, but the mechanisms protecting against phaeohyphomycosis remain unclear. We evaluated a patient with progressive, refractory Corynespora cassiicola phaeohyphomycosis and found that he carried biallelic deleterious mutations in CLEC7A encoding the CARD9-coupled, β-glucan–binding receptor, Dectin-1. The patient’s PBMCs failed to produce TNF-α and IL-1β in response to β-glucan and/or C. cassiicola . To confirm the cellular and molecular requirements for immunity against C. cassiicola , we developed a mouse model of this infection. Mouse macrophages required Dectin-1 and CARD9 for IL-1β and TNF-α production, which enhanced fungal killing in an interdependent manner. Deficiency of either Dectin-1 or CARD9 was associated with more severe fungal disease, recapitulating the human observation. Because these data implicated impaired Dectin-1 responses in susceptibility to phaeohyphomycosis, we evaluated 17 additional unrelated patients with severe forms of the infection. We found that 12 out of 17 carried deleterious CLEC7A mutations associated with an altered Dectin-1 extracellular C-terminal domain and impaired Dectin-1–dependent cytokine production. Thus, we show that Dectin-1 and CARD9 promote protective TNF-α– and IL-1β–mediated macrophage defense against C . cassiicola . More broadly, we demonstrate that human Dectin-1 deficiency may contribute to susceptibility to severe phaeohyphomycosis by certain dematiaceous fungi.

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Pulmonary Cladosporium infection coexisting with subcutaneous Corynespora cassiicola infection in a patient: A case report

Cited by 11 publications

References 20 publications

Metabarcoding of bacteria and parasites in the gut of Apodemus agrarius

Metabarcoding of bacteria and parasites in the gut of Apodemus agrarius

Case report: A case of ocular infection caused by Corynespora cassiicola

Human Dectin-1 deficiency impairs macrophage-mediated defense against phaeohyphomycosis

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