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Medical Mycology Case Reports

Taher Sabobeh, Kamran Mushtaq, Ahmed Elsotouhy, Adham A Ammar, Sameera Rashid
Immunocompromised status is associated with invasive fungal infections including mucormycosis. These infections are challenging to treat and associated with high overall mortality. Here we report a fatal case of invasive mucormycosis in a cirrhotic, diabetic patient. Despite the swift diagnosis and management; the fungal invasion of the right internal carotid artery lead to massive ischemic stroke. Timely diagnosis and management is crucial for management but it seems not always enough and new approaches for treatment must be sought...
December 2018: Medical Mycology Case Reports
Laura Trovato, Maria Domina, Ada Vancheri, Salvatore Oliveri, Nicola Ciancio
Several cases have been reported of B. capitatus infections in immunocompromised patients. Acute leukemia is the main predisposing factor. Chronic lymphocytic leukemia (CLL) is not usually associated with opportunistic infections. We report a case of pulmonary infection by B. capitatus in a patient with untreated chronic lymphocytic leukemia. Although the patient had a complete recovery, we believe that this report will alert clinicians to consider B. capitatus as possible cause of severe pneumonia in untreated CLL...
December 2018: Medical Mycology Case Reports
Tina Marinelli, Sarah Kidd, David Shaw, Emily Rowe
Aspergillus endocarditis is rare with most cases occurring in immunosuppressed patients. We present the case of an "immunocompetent" Indigenous Australian male with culture confirmed Aspergillus brain abscesses complicating bilateral endocarditis. The reported mortality rate for Aspergillus endocarditis approaches 100%. Despite sub-optimal therapy this patient survived beyond expectation.
December 2018: Medical Mycology Case Reports
Pongpratch Puapatanakul, Nuttha Lumlertgul, Nisa Thongbor, Jidapa Mahamongkholsawat, Talerngsak Kanjanabuch
As peritoneal dialysis (PD)-related fungal infection is associated with a high mortality rate, the international guidelines recommend immediate removal of the PD catheter in conjunction with at least 2-weeks of antifungal treatment. Some authors have reported successful management of such cases without removing the PD catheter - by instilling an antifungal lock into the retained PD catheter. However, the use of antifungal locks has generally not been well accepted as the standard treatment for fungal peritonitis in PD patients...
December 2018: Medical Mycology Case Reports
Peggy Vieille, Rodrigo Cruz, Paula León, Nicolás Cáceres, Gustavo Giusiano
Hereby we communicate the first autochthon isolation of Cryptococcus gattii VGIII in Chile, which was obtained from a nasal injury in a domestic cat in the Valparaíso region in Chile. The strain was identified using morphophysiological tests, MALDI-TOF, and URA5 gene PCR-RFLP analysis.
December 2018: Medical Mycology Case Reports
McKenna E Boyd, Harry Dao, Jerry D Estep, Yve T Huttenbach, Vagish Hemmige
We report the use of voriconazole troughs to achieve appropriate therapeutic levels in treatment of a cutaneous Scedosporium apiospermum infection. Following heart transplantation, a 63-year-old immunocompromised patient presented with post-traumatic nodular lesions on his right shin. Pathology showed fungal yeasts with culture revealing Scedosporium apiospermum. According to therapeutic drug monitoring, initial voriconazole treatment was subtherapeutic requiring increased dosing until appropriate therapeutic trough levels were attained, and resolution of the fungal infection was achieved...
December 2018: Medical Mycology Case Reports
José Antonio Vargas Soler, William Javier Morales Camacho, Claudia Ximena Flórez Rodríguez, Johana Andrea Navarro Mejía, Carlos Fernando Guerrero, María Alejandra Morales Camacho
Fungal endocarditis (FE) is a rare infection in pediatrics which accounts for 5% of the cases of infective endocarditis. This pathology affects immunosuppressed patients in a greater proportion. We present an immunocompetent 7- year-old female with a history of multiple cardiac surgeries who developed fungal endocarditis due to Aspergillus flavus . The histology study showed liquefactive necrosis and septate hyphae of Aspergillus sp type. The clinical outcome was favorable and the ambulatory follow-up after 12 months showed no new complications...
December 2018: Medical Mycology Case Reports
Stephanie Egge, Eric Wei, Erin Clements, Andrew Stevenson Joel Chandranesan
Mucorales infections typically occur in immunocompromised hosts. We describe a case of disseminated post-traumatic Apophysomyces elegans in an immunocompetent patient status-post soil inoculation. Fungi introduced at a deep arm laceration leads to neurovascular invasion and dissemination prior to amputation and systemic treatment. We specify strict post-traumatic wound surveillance protocol and roles of novel tissue tests to improve time to diagnosis and prognosis of frequently fatal post-traumatic Mucorales infections...
December 2018: Medical Mycology Case Reports
Patrizia Posteraro, Katia Vacca, Massimiliano Celi, Giulia De Angelis, Antonietta Vella, Maurizio Sanguinetti, Brunella Posteraro
Cryptococcosis may be a life-threatening complication of sarcoidosis. We describe a case of cryptococcemia that rapidly progressed toward fatality without apparent other sites of infection. We discuss on the importance of serum cryptococcal polysaccharide antigen testing for identifying at-risk patients who might benefit from timely diagnosis and treatment of cryptococcosis.
December 2018: Medical Mycology Case Reports
Christopher G Smith, Lucy Woolford, Jessica J Talbot, Ken C Lee, Paul Crocker
A Golden Retriever cross was presented with a four week history of violent sneezing and licking at the nasal planum. Nasal mycosis was diagnosed and Aspergillus sp. presumed the causative agent, until culture, PCR and DNA sequencing showed that Scedosporium apiospermum, an uncommonly diagnosed, yet emerging, fungal pathogen, was the agent responsible. Debridement of the fungal plaques and systemic itraconazole therapy resulted in complete resolution of clinical disease. We discuss the current literature on S...
December 2018: Medical Mycology Case Reports
Tanu Singhal, Abhaya Kumar, Prashant Borade, Sweta Shah, Rajeev Soman
C. auris is an emerging fungal pathogen with high prevalence of resistance to current antifungal agents. Central nervous system infection with C. auris has been infrequently described. We describe here an adult with nosocomial CSF shunt infection due to multi drug resistant C. auris . Systemic therapy with echinocandin and flucytosine failed. Fortunately, administration of daily intraventricular caspofungin 10 mg for 10 days in conjunction with systemic voriconazole resulted in both clinical and microbiological cure...
December 2018: Medical Mycology Case Reports
Fatehi Elzein, Mohammed Mursi, Ahmed M Albarrag, Abdullah Alfiaar, Abdulaziz Alzahrani
Basidiobolomycosis, a rare fungal infection, is of worldwide distribution but areas commonly involved include the tropical areas of Africa, USA and South East Asia. 88% of the cases are reported among patients younger than 20 years. Many of the case reports in Saudi Arabia are from Tohama area where our patient lives. The diagnosis tends to be overlooked as the presentation may mimic colonic carcinoma in adults or inflammatory bowel diseases and tuberculosis in both children and adults. Angioinvasion seen in our patient is extremely rare suggesting the diagnosis of mucormycosis and resulting in a delay in choosing the most appropriate treatment...
December 2018: Medical Mycology Case Reports
Gabriel J Echeverri, Luis-Armando Caicedo, Alejandro Delgado, Laura-Sofia Thomas, Victor H Garcia, Catalina Gomez, Ana M Aristizabal, Ana M Arrunátegui, Fernando Rosso
We present the first cirrhotic patient who underwent liver transplantation (LT) and presented a hepatic artery thrombosis of the graft due to Aspergillus fumigatu s, within the first month of LT. This culminated in graft loss, re-transplant with multiple biliary and infectious complications. To our knowledge, this is a case report of an early hepatic artery thrombosis due to Aspergillus fumigatus in an infection-free patient.
December 2018: Medical Mycology Case Reports
Maricela Valerio, Marina Machado, Santiago Cedeño, Maria Luisa Rodríguez, Fernando Anaya, Antonio Vena, Jesús Guinea, Pilar Escribano, Emilio Bouza, Patricia Muñoz
The risk of transmission of infectious diseases from allograft to recipient is well known. Viruses and bacteria are the most frequent causes of transmissible infections. Donor-derived invasive aspergillosis is rare and occurred under particular circumstances. We report 2 cases of kidney transplant recipients who acquired aspergillosis from a single donor.
December 2018: Medical Mycology Case Reports
Ayaka Tashiro, Takahito Nei, Ryoji Sugimoto, Akiko Watanabe, Jun Hagiwara, Toru Takiguchi, Hiroyuki Yokota, Katsuhiko Kamei
Kodamaea ohmeri is a relatively rare yeast isolated form clinical specimens, and it is known to be a causative fungus of severe invasive infectious diseases in immunocompromised hosts. Herein, we describe fungemia due to K. ohmeri in a patient with a severe extended burn. The isolate was obtained from not only blood specimens but also skin lesions. We should be aware of risk for fungemia including K. ohmeri in case of severe burn.
December 2018: Medical Mycology Case Reports
Tjomme van der Bruggen, Anna Kolecka, Bart Theelen, Johanna M Kwakkel-van Erp, Bert Arets, Teun Boekhout
Cystic fibrosis (CF) patients are colonized with a multitude of bacteria and fungi. From respiratory samples of two CF patients in our institute, a difficult to identify yeast was isolated repeatedly. This yeast was eventually identified as Cutaneotrichosporon ( Cryptococcus ) cyanovorans by internal transcribed spacer (ITS) and ribosomal large subunit (LSU) sequencing. C. cyanovorans is a basidiomycetous yeast originally reported as environmental isolate from South African soil and has not been described before as clinical isolate from CF patients...
December 2018: Medical Mycology Case Reports
Simon Arunga, Teddy Kwaga, Astrid Leck, Victor H Hu, Matthew J Burton
A 35-year-old male presented with Candida keratitis in the left eye. He was HIV positive with a CD4 of 352 cells/µL. The eye quickly deteriorated, despite intensive antifungal treatment and was eviscerated. Five months later, he re-presented with Candida keratitis in his right eye. A focal source of Candida infection was suspected and a urine culture identified Candida spp, despite being asymptomatic for genitourinary candidiasis. He was subsequently treated with good outcome (max. 75 words).
December 2018: Medical Mycology Case Reports
Felix Bongomin, Isabel Rodriguez-Goncer, Carol Lorden, Akaninyene Otu, Rohit Bazaz
Antifungal agents account for approximately 3% of Drug-Induced Liver Injury (DILI) cases. Isavuconazole is a novel triazole, and experience with long-term use of it is lacking. We report a case of late-onset DILI occurring after 11 months of isavuconazole therapy in a 55-year old man of Angolan descent on long-term antifungal therapy for the management of chronic pulmonary aspergillosis complicating previously treated pulmonary tuberculosis. The DILI could be described as idiosyncratic as it was not associated with high isavuconazole serum levels and his liver function tests returned to normal following treatment discontinuation...
December 2018: Medical Mycology Case Reports
Iker Falces-Romero, Emilio Cendejas-Bueno, María Laplaza-González, Luis Escosa-García, Cristina Schuffelmann-Gutiérrez, Belén Calderón-Llopis, Javier Pemán, Pedro de la Oliva, Julio García-Rodríguez
A case of 1-year- old male multivisceral transplant recipient with candidemia diagnosed by the T2Candida® test is presented. Optimal management of the candidemia complemented the treatment of the global clinical episode. Duration of treatment might be established much more precisely with the T2Candida® test than with blood cultures.
September 2018: Medical Mycology Case Reports
Jennifer L Anderson, Matthew C Hall, Jennifer K Meece
Asymptomatic blastomycosis infections are rarely identified or described in the literature, but are believed to comprise 50% of cases. In this report we describe five sporadic cases of blastomycosis in asymptomatic patients. All of these cases were initially identified as incidental findings of lung nodules on CXR or CT. To our knowledge, these are the first detailed descriptions of asymptomatic blastomycosis, occurring as sporadic disease, in the literature.
September 2018: Medical Mycology Case Reports
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