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[PMID]:29433463
[Au] Autor:Todokoro D; Hoshino J; Yo A; Makimura K; Hirato J; Akiyama H
[Ad] Endereço:Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan. dtodokor@gunma-u.ac.jp.
[Ti] Título:Scedosporium apiospermum infectious scleritis following posterior subtenon triamcinolone acetonide injection: a case report and literature review.
[So] Source:BMC Ophthalmol;18(1):40, 2018 Feb 13.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ubiquitous fungi of the Scedosporium apiospermum species complex (SASC) cause various opportunistic infections. Posterior subtenon triamcinolone acetonide (STTA) injection is a standard therapy for intraocular inflammation and macular edema. We report a case of Scedosporium apiospermum infectious scleritis after a posterior STTA injection. CASE PRESENTATION: A 75-year-old man received a posterior STTA injection to treat macular edema in his left eye. After 3 months, he complained of ocular pain and hyperemia in his left eye. Examination showed a subtenon abscess in the site corresponding with the STTA injection. After incising the abscess, the smear revealed numerous conidia-like structures. Although we suspected fungal infection and started topical voriconazole (VRCZ) and levofloxacin, the inflammation of the eye worsened. Fungal culture revealed filamentous fungus growth. Subsequently, we added systemic VRCZ and performed surgical debridement of the infected sclera and Tenon's capsule. Pathology of the sclera showed fungal hyphae. The antifungal susceptibility test revealed low minimum inhibitory concentrations for micafungin, VRCZ and miconazole (0.06, 0.25 and 0.5 µg/mL, respectively). After 2 months, the ciliary injection subsided and VRCZ therapy was stopped. However, subtenon abscess recurred 1 month after discontinuation of topical VRCZ. Surgical debridement and topical VRCZ were resumed, with the eye finally improving after 5 months of management. The fungal species was identified as Scedosporium apiospermum sensu stricto morphologically and by DNA sequencing. CONCLUSIONS: This case was successfully treated by topical and systemic VRCZ and repeated surgical debridement. Infectious scleritis caused by SASC rarely develops after posterior STTA. SASC can produce conidia in the enclosed subtenon space. Late-onset infectious scleritis after a posterior STTA injection suggests the presence of a fungal infection, including SASC, thereby requiring extensive and prolonged medical and surgical treatment.
[Mh] Termos MeSH primário: Infecções Oculares Fúngicas/microbiologia
Imunossupressores/administração & dosagem
Micoses/microbiologia
Complicações Pós-Operatórias
Scedosporium/isolamento & purificação
Esclerite/microbiologia
Triancinolona Acetonida/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Antifúngicos/uso terapêutico
Terapia Combinada
Desbridamento
Infecções Oculares Fúngicas/diagnóstico
Infecções Oculares Fúngicas/terapia
Seres Humanos
Injeções Intraoculares
Edema Macular/tratamento farmacológico
Imagem por Ressonância Magnética
Masculino
Testes de Sensibilidade Microbiana
Micoses/diagnóstico
Micoses/terapia
Esclerite/diagnóstico
Esclerite/terapia
Cápsula de Tenon/efeitos dos fármacos
Voriconazol/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Immunosuppressive Agents); F446C597KA (Triamcinolone Acetonide); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180218
[Lr] Data última revisão:
180218
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0707-4


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[PMID]:28704511
[Au] Autor:Wongsuk T; Pumeesat P; Luplertlop N
[Ad] Endereço:Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
[Ti] Título:Genetic variation analysis and relationships among environmental strains of Scedosporium apiospermum sensu stricto in Bangkok, Thailand.
[So] Source:PLoS One;12(7):e0181083, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The Scedosporium apiospermum species complex is an emerging filamentous fungi that has been isolated from environment. It can cause a wide range of infections in both immunocompetent and immunocompromised individuals. We aimed to study the genetic variation and relationships between 48 strains of S. apiospermum sensu stricto isolated from soil in Bangkok, Thailand. For PCR, sequencing and phylogenetic analysis, we used the following genes: actin; calmodulin exons 3 and 4; the second largest subunit of the RNA polymerase II; ß-tubulin exon 2-4; manganese superoxide dismutase; internal transcribed spacer; transcription elongation factor 1α; and beta-tubulin exons 5 and 6. The present study is the first phylogenetic analysis of relationships among S. apiospermum sensu stricto in Thailand and South-east Asia. This result provides useful information for future epidemiological study and may be correlated to clinical manifestation.
[Mh] Termos MeSH primário: Filogenia
Polimorfismo Genético
Scedosporium/genética
[Mh] Termos MeSH secundário: Actinas/genética
Calmodulina/genética
Proteínas Fúngicas/genética
RNA Polimerase II/genética
Scedosporium/classificação
Superóxido Dismutase/genética
Fatores de Elongação da Transcrição/genética
Tubulina (Proteína)/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Actins); 0 (Calmodulin); 0 (Fungal Proteins); 0 (Transcriptional Elongation Factors); 0 (Tubulin); EC 1.15.1.1 (Superoxide Dismutase); EC 2.7.7.- (RNA Polymerase II)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181083


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[PMID]:28420849
[Au] Autor:Masukane S; Kitahara Y; Okumoto J; Sasaki K; Nakano K
[Ad] Endereço:Department of Postgraduate Clinical Education, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Japan.
[Ti] Título:The Effective Treatment of Lung Infection Due to Scedosporium prolificans with Voriconazole and Surgery.
[So] Source:Intern Med;56(8):973-977, 2017.
[Is] ISSN:1349-7235
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Scedosporium prolificans is a fungus that has demonstrated resistance against most currently available antifungal agents and which causes a rapidly disseminating and potentially fatal infection. A 68-year-old woman presented with a fever and consolidation in the lung field. Her symptoms and inflammatory reaction did not improve despite treatment with tazobactam/piperacillin, meropenem, and micafungin. Scedosporium prolificans was detected from the patient's bronchial lavage fluid, and we initiated treatment with voriconazole. Voriconazole was effective in shrinking the consolidation and suppressing the inflammatory reaction. The residual lesion was surgically resected because of the risk of systemic dissemination. The patient is currently alive without relapse or dissemination.
[Mh] Termos MeSH primário: Antifúngicos/uso terapêutico
Pneumopatias Fúngicas/tratamento farmacológico
Pneumopatias Fúngicas/cirurgia
Scedosporium/isolamento & purificação
Voriconazol/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170620
[Lr] Data última revisão:
170620
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.2169/internalmedicine.56.7447


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[PMID]:28410611
[Au] Autor:Tóth EJ; Nagy GR; Homa M; Ábrók M; Kiss IÉ; Nagy G; Bata-Csörgo Z; Kemény L; Urbán E; Vágvölgyi C; Papp T
[Ad] Endereço:MTA-SZTE "Lendület" Fungal Pathogenicity Mechanisms Research Group, Hungarian Academy of Sciences, University of Szeged, Közép fasor 52, Szeged, 6726, Hungary.
[Ti] Título:Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature.
[So] Source:Ann Clin Microbiol Antimicrob;16(1):31, 2017 Apr 14.
[Is] ISSN:1476-0711
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Scedosporium apiospermum is an emerging opportunistic filamentous fungus, which is notorious for its high levels of antifungal-resistance. It is able to cause localized cutaneous or subcutaneous infections in both immunocompromised and immunocompetent persons, pulmonary infections in patients with predisposing pulmonary diseases and invasive mycoses in immunocompromised patients. Subcutaneous infections caused by this fungus frequently show chronic mycetomatous manifestation. CASE REPORT: We report the case of a 70-year-old immunocompromised man, who developed a fungal mycetomatous infection on his right leg. There was no history of trauma; the aetiological agent was identified by microscopic examination and ITS sequencing. This is the second reported case of S. apiospermum subcutaneous infections in Hungary, which was successfully treated by surgical excision and terbinafine treatment. After 7 months, the patient remained asymptomatic. Considering the antifungal susceptibility and increasing incidence of the fungus, Scedosporium related subcutaneous infections reported in the past quarter of century in European countries were also reviewed. CONCLUSIONS: Corticosteroid treatment represents a serious risk factor of S. apiospermum infections, especially if the patient get in touch with manure-enriched or polluted soil or water. Such infections have emerged several times in European countries in the past decades. The presented data suggest that besides the commonly applied voriconazole, terbinafine may be an alternative for the therapy of mycetomatous Scedosporium infections.
[Mh] Termos MeSH primário: Antifúngicos/administração & dosagem
Desbridamento
Perna (Membro)/patologia
Micetoma/diagnóstico
Micetoma/terapia
Naftalenos/administração & dosagem
Scedosporium/isolamento & purificação
[Mh] Termos MeSH secundário: Idoso
Análise por Conglomerados
DNA Fúngico/química
DNA Fúngico/genética
DNA Espaçador Ribossômico/química
DNA Espaçador Ribossômico/genética
Dermatomicoses/diagnóstico
Dermatomicoses/microbiologia
Dermatomicoses/patologia
Dermatomicoses/terapia
Seres Humanos
Hungria
Hospedeiro Imunocomprometido
Masculino
Microscopia
Micetoma/microbiologia
Micetoma/patologia
Filogenia
Recidiva
Scedosporium/classificação
Scedosporium/citologia
Scedosporium/genética
Análise de Sequência de DNA
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (DNA, Fungal); 0 (DNA, Ribosomal Spacer); 0 (Naphthalenes); G7RIW8S0XP (terbinafine)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170424
[Lr] Data última revisão:
170424
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170416
[St] Status:MEDLINE
[do] DOI:10.1186/s12941-017-0195-z


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[PMID]:28362854
[Au] Autor:Pellon A; Ramirez-Garcia A; Buldain I; Antoran A; Rementeria A; Hernando FL
[Ad] Endereço:Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain.
[Ti] Título:Molecular and cellular responses of the pathogenic fungus Lomentospora prolificans to the antifungal drug voriconazole.
[So] Source:PLoS One;12(3):e0174885, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The filamentous fungus Lomentospora (Scedosporium) prolificans is an emerging opportunistic pathogen associated with fatal infections in patients with disturbed immune function. Unfortunately, conventional therapies are hardly of any use against this fungus due to its intrinsic resistance. Therefore, we performed an integrated study of the L. prolificans responses to the first option to treat these mycoses, namely voriconazole, with the aim of unveiling mechanisms involved in the resistance to this compound. To do that, we used a wide range of techniques, including fluorescence and electron microscopy to study morphological alterations, ion chromatography to measure changes in cell-wall carbohydrate composition, and proteomics-based techniques to identify the proteins differentially expressed under the presence of the drug. Significantly, we showed drastic changes occurring in cell shape after voriconazole exposure, L. prolificans hyphae being shorter and wider than under control conditions. Interestingly, we proved that the architecture and carbohydrate composition of the cell wall had been modified in the presence of the drug. Specifically, L. prolificans constructed a more complex organelle with a higher presence of glucans and mannans. In addition to this, we identified several differentially expressed proteins, including Srp1 and heat shock protein 70 (Hsp70), as the most overexpressed under voriconazole-induced stress conditions. The mechanisms described in this study, which may be directly related to L. prolificans antifungal resistance or tolerance, could be used as targets to improve existing therapies or to develop new ones in order to successfully eliminate these mycoses.
[Mh] Termos MeSH primário: Antifúngicos/farmacologia
Scedosporium/efeitos dos fármacos
Scedosporium/metabolismo
Voriconazol/farmacologia
[Mh] Termos MeSH secundário: Microscopia Eletrônica
Microscopia de Fluorescência
Proteômica
Scedosporium/ultraestrutura
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170401
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0174885


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[PMID]:28355462
[Au] Autor:Lass-Flörl C; Cuenca-Estrella M
[Ad] Endereço:Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstraße 41, 6020 Innsbruck, Austria.
[Ti] Título:Changes in the epidemiological landscape of invasive mould infections and disease.
[So] Source:J Antimicrob Chemother;72(suppl_1):i5-i11, 2017 Mar 01.
[Is] ISSN:1460-2091
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Although a wide variety of pathogens are associated with invasive mould diseases, Aspergillus spp. have historically been one of the most common causative organisms. Most invasive mould infections are caused by members of the Aspergillus fumigatus species complex and an emerging issue is the occurrence of azole resistance in A. fumigatus, with resistance to amphotericin B documented in other Aspergillus spp. The epidemiology of invasive fungal disease has shifted in recent years as non-A. fumigatus Aspergillus spp. and other moulds have become progressively more important, although there are no consolidated data on the prevalence of less common species of moulds. The incidence of mucormycosis may have been underestimated, which is a potential concern since species belonging to the order Mucorales are more resistant to antifungal agents than Aspergillus spp. All species of Mucorales are unaffected by voriconazole and most show moderate resistance in vitro to echinocandins. Fusarium spp. may be the second most common nosocomial fungal pathogen after Aspergillus in some tertiary hospitals, and show a susceptibility profile marked by a higher level of resistance than that of Aspergillus spp. Recently, Scedosporium aurantiacum has been reported as an emerging opportunistic pathogen, against which voriconazole is the most active antifungal agent. Other mould species can infect humans, although invasive fungal disease occurs less frequently. Since uncommon mould species exhibit individual susceptibility profiles and require tailored clinical management, accurate classification at species level of the aetiological agent in any invasive fungal disease should be regarded as the standard of care.
[Mh] Termos MeSH primário: Antifúngicos/uso terapêutico
Aspergilose/tratamento farmacológico
Aspergilose/epidemiologia
Aspergillus fumigatus/efeitos dos fármacos
Farmacorresistência Fúngica/fisiologia
Infecções Fúngicas Invasivas/tratamento farmacológico
[Mh] Termos MeSH secundário: Aspergilose/microbiologia
Fusariose/tratamento farmacológico
Fusariose/epidemiologia
Fusariose/microbiologia
Fusarium/efeitos dos fármacos
Seres Humanos
Hospedeiro Imunocomprometido
Infecções Fúngicas Invasivas/imunologia
Infecções Fúngicas Invasivas/microbiologia
Mucorales/efeitos dos fármacos
Mucormicose/tratamento farmacológico
Mucormicose/epidemiologia
Mucormicose/microbiologia
Scedosporium/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE
[do] DOI:10.1093/jac/dkx028


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[PMID]:28178337
[Au] Autor:Schwarz C; Brandt C; Antweiler E; Krannich A; Staab D; Schmitt-Grohé S; Fischer R; Hartl D; Thronicke A; Tintelnot K
[Ad] Endereço:Department of Pediatric Pneumology and Immunology, Cystic Fibrosis Center Berlin/Charité -Universitätsmedizin Berlin, Berlin, Germany.
[Ti] Título:Prospective multicenter German study on pulmonary colonization with Scedosporium /Lomentospora species in cystic fibrosis: Epidemiology and new association factors.
[So] Source:PLoS One;12(2):e0171485, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: An increasing rate of respiratory colonization and infection in cystic fibrosis (CF) is caused by fungi of the Scedosporium apiospermum species complex or Lomentospora prolificans (Sac-Lp). These fungi rank second among the filamentous fungi colonizing the CF airways, after Aspergillus fumigatus. However, the epidemiology, clinical relevance and risk of pulmonary colonization with Sac-Lp are rarely understood in CF. The objective of the present prospective multicenter study was to study pathogen distribution and determine association factors of pulmonary Sac-Lp colonization in patients with CF. MATERIAL AND METHODS: Clinical, microbiological and laboratory data of 161 patients aged 6-59 years with CF in Germany were analyzed for Sac-Lp distribution and association factors. The free statistical software R was utilized to investigate adjusted logistic regression models for association factors. RESULTS: Of the 161 patients included in the study, 74 (56%) were male. The median age of the study cohort was 23 years (interquartile range 13-32 years). 58 patients of the total cohort (36%) were < 18 years old. Adjusted multivariate regression analysis revealed that Sac-Lp colonization was associated with younger age (OR 0.8684, 95%CI: 0.7955-0.9480, p<0.005) and less colonization with H. influenzae (OR 0.0118, 95%CI: 0.0009-0.1585, p<0.001). In addition, Sac-Lp-colonized patients had more often allergic bronchopulmonary aspergillosis (ABPA) (OR 14.6663, 95%CI: 2.1873-98.3403, p<0.01) and have been colonized more often with the mucoid phenotype of Pseudomonas aeruginosa (OR 9.8941, 95%CI: 1.0518-93.0705, p<0.05). CONCLUSION: Newly found association of ABPA and Pseudomonas revealed new probable risk factors for Sac-Lp colonization. Allergy might play a role in inducing immunologic host reactions which lead to a less effective response to species of Sac-Lp.
[Mh] Termos MeSH primário: Fibrose Cística/complicações
Fibrose Cística/epidemiologia
Pneumopatias Fúngicas/epidemiologia
Pneumopatias Fúngicas/etiologia
Infecções Oportunistas
Scedosporium
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Casos e Controles
Criança
Estudos de Coortes
Fibrose Cística/diagnóstico
Feminino
Alemanha/epidemiologia
Seres Humanos
Pneumopatias Fúngicas/diagnóstico
Masculino
Meia-Idade
Razão de Chances
Prevalência
Sistema de Registros
Testes de Função Respiratória
Fatores de Risco
Scedosporium/classificação
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170209
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0171485


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[PMID]:28115402
[Au] Autor:Stoneham AC; Stoneham SE; Wyllie SA; Pandya AN
[Ad] Endereço:Department of Plastic Surgery, Salisbury NHS Foundation Trust, Salisbury, UK.
[Ti] Título:Surgical resection of a rare cutaneous manifestation of Scedosporium apiospermum in a patient who underwent renal transplant.
[So] Source:BMJ Case Rep;2017, 2017 Jan 23.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A man aged 47 years who was immunosuppressed following renal transplantation for focal segmental glomerulosclerosis was referred to the Plastic Surgery team for management of a painful, chronic, granulomatous lesion of the right forearm. Serial ultrasound scans and MRI scans were not diagnostic, but microbiological specimens tested positive for the fungus Scedosporium apiospermum The renal transplant graft-which was failing-was removed, allowing him to cease immunosuppression. He then underwent a resection of the lesion and reconstruction with a split thickness skin graft. Analysis of the specimen revealed fibrosis, granulomatosis and a collection of S. apiospermum He was started on voriconazole which, in conjunction with his surgical resection, appears to have kept the disease at bay. With increasing numbers of solid organ transplants and improved survival, this case highlights the growing burden of rare, opportunistic infections, the difficulty in diagnosis and the need for specialist intervention.
[Mh] Termos MeSH primário: Antifúngicos/uso terapêutico
Dermatomicoses/terapia
Rejeição de Enxerto/prevenção & controle
Imunossupressores/efeitos adversos
Transplante de Rim
Scedosporium
Transplante de Pele
Voriconazol/uso terapêutico
[Mh] Termos MeSH secundário: Dermatomicoses/diagnóstico por imagem
Dermatomicoses/etiologia
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Immunosuppressive Agents); JFU09I87TR (Voriconazole)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170309
[Lr] Data última revisão:
170309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170125
[St] Status:MEDLINE


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[PMID]:28088169
[Au] Autor:Kim CM; Lim SC; Kim J; Jang HS; Chung JH; Yun NR; Kim DM; Jha P; Jha B; Kim SW; Jang SJ; Shin JH
[Ad] Endereço:Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea.
[Ti] Título:Tenosynovitis caused by Scedosporium apiospermum infection misdiagnosed as an Alternaria species: a case report.
[So] Source:BMC Infect Dis;17(1):72, 2017 Jan 14.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Scedosporium apiospermum, which can usually be isolated from soil, polluted stream water and decaying vegetation, is increasingly recognized as an opportunistic dematiaceous fungus. The mortality rate of infection in immunocompromised hosts is over 50%. S. apiospermum is commonly responsible for dermal and epidermal infections (i.e., mycetoma) after traumatic penetration. CASE PRESENTATION: A 73-year-old woman was admitted to our hospital complaining of painful swelling and tenderness on the dorsum of the proximal left wrist and hand. The symptoms had persisted for approximately 2 months. A physical examination revealed a 4 x 3 cm, poorly defined, erythematous papule, which was fluctuant, with pustules and crusts on the dorsum of the left hand. CONCLUSIONS: We report a very rare case of tenosynovitis caused by S. apiospermum infection. We identified the infectious agent via molecular DNA sequencing. The infectious agent was initially misidentified as an Alternaria species by microscopic examination with lactophenol cotton blue (LPCB) staining. The infection was successfully treated with debridement and adjuvant fluconazole therapy.
[Mh] Termos MeSH primário: DNA Fúngico/genética
Erros de Diagnóstico
Articulação da Mão
Micoses/diagnóstico
Scedosporium/genética
Tenossinovite/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Alternaria
Alternariose/diagnóstico
Antifúngicos/uso terapêutico
Desbridamento
Diabetes Mellitus Tipo 2/complicações
Diabetes Mellitus Tipo 2/imunologia
Feminino
Fluconazol/uso terapêutico
Seres Humanos
Hospedeiro Imunocomprometido
Imagem por Ressonância Magnética
Micoses/complicações
Micoses/imunologia
Micoses/terapia
Análise de Sequência de DNA
Tenossinovite/complicações
Tenossinovite/imunologia
Tenossinovite/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (DNA, Fungal); 8VZV102JFY (Fluconazole)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170116
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-016-2098-6


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[PMID]:28060882
[Au] Autor:Han Z; Kautto L; Nevalainen H
[Ad] Endereço:Department of Chemistry and Biomolecular Sciences, Macquarie University, Sydney, Australia.
[Ti] Título:Secretion of Proteases by an Opportunistic Fungal Pathogen Scedosporium aurantiacum.
[So] Source:PLoS One;12(1):e0169403, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Scedosporium aurantiacum is an opportunistic filamentous fungus increasingly isolated from the sputum of cystic fibrosis patients, and is especially prevalent in Australia. At the moment, very little is known about the infection mechanism of this fungus. Secreted proteases have been shown to contribute to fungal virulence in several studies with other fungi. Here we have compared the profiles of proteases secreted by a clinical isolate Scedosporium aurantiacum (WM 06.482) and an environmental strain (WM 10.136) grown on a synthetic cystic fibrosis sputum medium supplemented with casein or mucin. Protease activity was assessed using class-specific substrates and inhibitors. Subtilisin-like and trypsin-like serine protease activity was detected in all cultures. The greatest difference in the secretion of proteases between the two strains occurred in mucin-supplemented medium, where the activities of the elastase-like, trypsin-like and aspartic proteases were, overall, 2.5-75 fold higher in the clinical strain compared to the environmental strain. Proteases secreted by the two strains in the mucin-supplemented medium were further analyzed by mass spectrometry. Six homologs of fungal proteases were identified from the clinical strain and five from the environmental strain. Of these, three were common for both strains including a subtilisin peptidase, a putative leucine aminopeptidase and a PA-SaNapH-like protease. Trypsin-like protease was identified by mass spectrometry only in the clinical isolate even though trypsin-like activity was present in all cultures. In contrast, high elastase-like activity was measured in the culture supernatant of the clinical strain but could not be identified by mass spectrometry searching against other fungi in the NCBI database. Future availability of an annotated genome will help finalise identification of the S. aurantiacum proteases.
[Mh] Termos MeSH primário: Micoses/microbiologia
Infecções Oportunistas
Peptídeo Hidrolases/secreção
Scedosporium/metabolismo
[Mh] Termos MeSH secundário: Fibrose Cística/complicações
Ativação Enzimática
Seres Humanos
Proteômica/métodos
Scedosporium/isolamento & purificação
Especificidade por Substrato
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.- (Peptide Hydrolases)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170815
[Lr] Data última revisão:
170815
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0169403



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