ABSTRACT
Pestalotiopsis species are filamentous fungi that are known plant pathogens commonly isolated in tropical and subtropical regions. To the best of our knowledge, this is the first case of human infection caused by Pestalotiopsis mangiferae. An 80-year-old male farmer presented with ocular pain in the right eye. At initial presentation, slit-lamp examination showed a 3.0×2.5 mm-sized epithelial defect in the cornea of the right eye accompanied by corneal thinning. A KOH examination revealed spores, and consequently, treatment with voriconazole, ceftazidime, and moxifloxacin was initiated. One month later, a second KOH examination and fungal culture were performed. The results of the KOH examination indicated the presence of many hyphae, and fungus was isolated from the culture. Molecular identification revealed that the sequence had 100% similarity to P. mangiferae. The patient was treated with therapeutic penetrating keratoplasty. During follow-up in the outpatient clinic, signs of infection were not observed.
ABSTRACT
In patients with acute myeloid leukemia (AML), pleural effusion may be attributed to various factors, including infection, hypoalbuminemia, and renal failure. However, leukemic infiltration of the pleural fluid is rarely reported and poorly understood. Extramedullary diseases have been reported with increasing frequency as the survival rates of patients with AML have increased. However, the reported prognostic effects of leukemic pleural effusion in patients with AML range from none to a worse prognosis. Here, we report a case of acute promyelocytic leukemia (APL) in a patient exhibiting leukemic pleural effusion with fluorescence in situ hybridization (FISH) results indicating the presence of the PML-RARA fusion gene. A 52-year-old man presented with pancytopenia, dyspnea, and fever. He had a medical history of hypertension, end-stage renal disease, and hepatitis B virus-related liver cirrhosis. A peripheral blood smear revealed the presence of multiple abnormally hypergranular promyelocytes. White blood cell differential counts were not performed due to severe pancytopenia. A bone marrow examination, immunophenotyping analysis, and cytogenetic and molecular studies revealed APL. The patient was treated with all-trans retinoic acid immediately after abnormal promyelocytes were observed in the peripheral blood smear, but induction chemotherapy was delayed because of his poor condition. His persistent dyspnea and abdominal discomfort led to a thoracentesis and the observation of abnormal promyelocytes that were positive for PML-RARA fusion gene by FISH. To our knowledge, this is the first report of leukemic pleural infiltration with PML-RARA fusion gene-positivity via FISH.