Mycotic Diseases in Chelonians.

Turtles and 'tortoises' populations are declining in number, the factors driving extinction risks being related to habitat loss and degradation, climate change, introduction of invasive plant and animal species, consumption by humans for food and medicinal use, and collection for international pet trade. Fungal infections represent one of the main threats for ecosystem health. The present narrative review deals with conventional and emerging mycoses of Chelonians. Although conventional mycoses in captive and pet reptiles would depend on poor husbandry, being the agents mostly opportunistic pathogens, some fungal species were reported to occur more frequently, such as the entomopathogen Purpureocillium lilacinum. Furthermore, emerging agents such as the Fusarium solani species complex have been recognized as a real threat for the surviving of some aquatic species, acting as primary pathogens. This complex has been recently included within pathogens in One Health issues. Emydomyces testavorans is recognized as an emerging threat, although, due its recent identification, information about its epidemiology is limited. Data about treatments and outcomes of mycoses in Chelonians are also referred.

Feline cutaneous nodular and ocular Cryptococcus neoformans in Belgium.

CASE SUMMARY: An 11-year-old spayed female cat presented with a 6-month history of a progressive nodular skin disease with concurrent, ocular lesions, intermittent vomiting, halitosis and weight loss. The cat had received different topical treatments without success prior to referral to the Dermatology Department of Faculty of Veterinary Medicine, Ghent University. Several fine-needle aspirations of the lesions showed a vast number of macrophages with intra-cytoplasmic inclusions compatible with Cryptococcus species. Histopathological examination revealed pyogranulomatous inflammation with capsulated yeast. Periodic acid-Schiff stain was positive. Latex cryptococcal antigen agglutination test on serum was positive with a titre of >1/524,288. PCR and fungal culture identified Cryptococcus neoformans. The cat was treated with itraconazole 10 mg/kg PO q24h. After 10 months of therapy, there was a complete resolution of the lesions except for a small nodule on the ventral aspect of the tongue. RELEVANCE AND NOVEL INFORMATION: As far as we are aware, this is the first feline case reported of cutaneous nodular cryptococcosis without nasal involvement in Belgium. Oral itraconazole therapy was well tolerated and appeared to give a good result and prognosis.

Deep fungal infections diagnosed by histology in Uganda: a 70-year retrospective study.

Fungal infections cause substantial morbidity and mortality. However, the burden of deep fungal infections is not well described in Uganda. We aimed to estimate the burden and etiology of histologically diagnosed deep fungal infections in Uganda. We retrospectively reviewed histology reports at the Pathology Reference Laboratory, Department of Pathology, Makerere University, Kampala, Uganda from January 1950 to September 2019 to identify any reports that had a fungal infection as the diagnosis. Over the study period, 697 cases of deep fungal infections were identified with an average incidence of 0.73/100,000 persons per decade. There was a general decline in the number of cases detected. Median age of the cases was 28 years (IQR: 11-40) and majority (59%) were male. The age group of 0-10 years were the most affected. The foot was the most affected part of the body (26%). Deep mycoses identified include eumycetoma (32%), subcutaneous phycomycosis (26%), histoplasmosis (9.2%), chromoblastomycosis (4.6%), aspergillosis (3.3%), cryptococcosis (3.3%), blastomycosis (1.6%), subcutaneous mycosis (1.4%), dermatomycosis (1.3%), coccidioidomycosis (0.6%), mucormycosis (0.6%), and sporotrichosis (0.1%). Histoplasma was the commonest causative agent (9.2%) followed by Aspergillus (3.4%) and Cryptococcus (3.3%), while 81% of the fungal pathogens were not identified to genus/species level. Only 31% of the cases were diagnosed clinically as deep fungal infections. There is a substantial burden of deep fungal infections caused by multiple fungal pathogens in Uganda. There is need to build local capacity for mycology so as to improve on the index of clinical suspicion and diagnostic capabilities.

The epidemiology of fungemia in an infectious diseases hospital in Mexico city: A 10-year retrospective review.

The epidemiology of invasive fungal infections has recently changed in immunosuppressed populations as a result of HIV infection, organ transplant, chemotherapy and in elderly patients. The diagnosis of invasive fungal infections by culture is prolonged since fungi grow slowly in vitro. we wanted to estimate the frequency of fungemia diagnoses established through the Clinical Mycology Laboratory over the past 10 years; through a retrospective study; data was obtained from the laboratory patient registry in the Infectious Disease Hospital's laboratory registry of patients with a systemic fungal isolate between 2005 and 2014. One hundred and thirty two (132) systemic fungal infections were identified. They were more prevalent in males, in the age group between 20 and 59 years and in patients with a diagnosis of AIDS. The most frequently isolated agents belonged to the genus Candida and others such as Histoplasma sp., Cryptococcus sp., Aspergillus sp., and Coccidioides sp. Of all blood and bone marrow cultures received 17.9% had fungal development; of these, in 70% of cases it was through blood cultures. In general, fungal agents were not diagnostically suspected. We identified that Sixty percent (60%) of fungemias developed in AIDS patients, followed by patients with sepsis. The most common agents belonged to the genus Candida, predominantly the albicans species. They were more frequently identified by blood culture than by bone marrow culture. Invasive fungal infections have not followed a usual clinical pattern and are not easily recognizable.

Deep Fungal Infections, Blastomycosis-Like Pyoderma, and Granulomatous Sexually Transmitted Infections.

Granulomatous diseases are caused by multiple infectious and noninfectious causes. Deep fungal infections can present in the skin or extracutaneously, most commonly with lung manifestations. An Azole or amphotericin B is the universal treatment. Blastomycosis-like pyoderma is a clinically similar condition, which is caused by a combination of hypersensitivity and immunosuppression. Successful treatment has been reported with antibiotics and, more recently, the vitamin A analog, acitretin. Granuloma inguinale and lymphogranuloma venereum cause ulcerative genital lesions with a granulomatous appearance on histology. The Centers for Disease Control and Prevention recommens treatment of these genital infections with doxycycline.

Two Cases of Cutaneous Infection by Alternaria alternata on Senile Purpura Site / 대한의진균학회지

Genus Alternaria is a species of dematiaceous fungi that is commonly found in the atmosphere or in the soil. It can cause hypersensitivity pneumonitis, bronchial asthma, or allergic rhinitis in immunocompromised host such as patient with organ transplantation or long-term steroid using patient. It can rarely cause skin infection. Case 1 was a 74-year-old man with well demarcated and elevated erythematous plaque with irregular scattered pustules on his right forearm. Case 2 was a 77-year-old woman with well demarcated elevated erythematous nodules within erythematous patch on her right forearm. In both cases, the lesions started at the senile purpura site. Herein, we report 2 rare cases of Alternaria alternata on senile purpura site to share the experience.

Mortality due to systemic mycoses as a primary cause of death or in association with AIDS in Brazil: a review from 1996 to 2006

Deaths caused by systemic mycoses such as paracoccidioidomycosis, cryptococcosis, histoplasmosis, candidiasis, aspergillosis, coccidioidomycosis and zygomycosis amounted to 3,583 between 1996-2006 in Brazil. When analysed as the underlying cause of death, paracoccidioidomycosis represented the most important cause of deaths among systemic mycoses (~ 51.2 percent). When considering AIDS as the underlying cause of death and the systemic mycoses as associated conditions, cryptococcosis (50.9 percent) appeared at the top of the list, followed by candidiasis (30.2 percent), histoplasmosis (10.1 percent) and others. This mortality analysis is useful in understanding the real situation of systemic mycoses in Brazil, since there is no mandatory notification of patients diagnosed with systemic mycoses in the official health system.

Histopathology of Dermatomycoses / 한양의대학술지

Dermatomycoses are defined as the fungal infections of the skin including hair and nail. Generally, dermatomycoses are divided into superficial mycoses involving hair, nail and horny layer of the epidermis, and deep mycoses involving dermis and subcutis. Superficial mycoses described herein are dermatophytosis, candidiasis and Malassezia infection. Histopathologic findings of onychomycosis were a little more focused because of recently increased interest of its usefulness in making the diagnosis of onychomycosis and its causative fungi. Deep mycoses of the skin include primary or secondary dermal and/or subcutaneous fungal infections. Deep mycoses reported only in Korea were briefly described herein. Those are sporotrichosis, the most common primary cutaneous deep mycosis in Korea, and rare deep mycoses including chromoblastomycosis, phaeohyphomycosis, mycetoma, cutaneous paecillomycosis, aspergillosis, cryptococcosis, mucormycosis, systemic candidiasis, fusariomysosis, and trichophytic granuloma. Cutaneous protothecosis, a disease by achlorophilic algae, was also included because of its similarity of clinical and pathological findings with deep mycoses.

Clinicohistopathologic Findings and Their Differential Diagnoses of Pathogenic Fungal Infections of Cutaneoua Deep Mycoses / 대한의진균학회지

The awareness of classification and differential diagnosis of deep mycoses, particularly systemic infections due to pathogenic fungal infections, is essential for the early detection on and appropriate therapy. These systemic pathogenic fungal infections such as histoplasmosis, African histoplasmosis, paracoccidioidomycosis, blastomycosis, are usually endemic in limited areas of continents of America, and Africa. A newly recognized penicilliosis due to Penicillium marneffei, a dimorphic fungus, used to be endemic in Southeast Asia, is now world-wide new threat because the increased numbers of cases have been reported in Australia, France, Italy, the Netherlands, United Kingdom, and the United States. Because of the increased international visitors to the endemic areas and a significant enlargement of the populations existing in immunocompromized state, thus susceptible to systemic mycoses, we, the primary care physicians should be on the alert for the clinicopathologic aspects of the systemic mycoses to make a diagnosis early enough to institute effective therapy.

A Review of Systemic Antifungal Agents.

Résumé- Cet article est une revue des antifongiques systémiques communément utilisés. Sont présentés les origines des diverses substances, leur pharmacocinétique, leur mode d'action, leurs effets secondaires et enfin, leurs indications en médecine vétérinaire. [Hill, P.B., Moriello, K.A., Shaw, S.E. A review of systemic antifungal agents (Antifongiques systémiques: une revue). Abstract- This paper is a review of commonly used systemic antifungal antibiotics. Included is a review of the origins of the drugs, pharmacokinetics, modes of action, adverse effects and clinical uses in veterinary medicine.