Subject(s)
Hyalohyphomycosis/microbiology , Kidney Transplantation/adverse effects , Opportunistic Infections/microbiology , Pancreas Transplantation/adverse effects , Sinusitis/microbiology , Diagnosis, Differential , Humans , Hyalohyphomycosis/diagnosis , Hyalohyphomycosis/immunology , Hyalohyphomycosis/therapy , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Male , Middle Aged , Opportunistic Infections/diagnosis , Opportunistic Infections/immunology , Opportunistic Infections/therapy , Predictive Value of Tests , Sinusitis/diagnosis , Sinusitis/immunology , Sinusitis/therapy , Treatment OutcomeSubject(s)
Hyalohyphomycosis/microbiology , Hypocreales/isolation & purification , Immunocompromised Host/immunology , Kidney Transplantation/adverse effects , Opportunistic Infections/microbiology , Aged , Arm , Female , Humans , Hyalohyphomycosis/immunology , Hyalohyphomycosis/pathology , Hypocreales/immunology , Kidney Failure, Chronic/surgery , Opportunistic Infections/immunology , Opportunistic Infections/pathology , Subcutaneous Tissue/microbiology , Subcutaneous Tissue/pathologyABSTRACT
Infection by human T-cell lymphotropic virus (HTLV-1) causes deregulation of the immune system, which makes the infected individuals more susceptible to infectious diseases. Immune deregulation is even more pronounced in HTLV-1 carriers with adult T-cell leukemia/lymphoma (ATLL), which results in frequent opportunistic infections. Hyalohyphomycosis is a rare subcutaneous mycosis which is more commonly associated with immunocompromised patients. We report a case of a HTLV-1-infected man with skin tumors, inguinal lymphadenomegaly, and lymphocytosis. Histopathological examination of skin biopsies revealed a T-cell lymphoma intermingled with a granulomatous process with abscesses and hyaline-septated hyphae. The lymph node showed only a T-cell lymphoma. The patient was diagnosed with acute ATLL and hyalohyphomycosis. He was treated with itraconazole for the subcutaneous mycosis and with chemotherapy for ATLL. A few months later, despite the treatment, he died because of progression of ATLL.
Subject(s)
Dermatomycoses/immunology , HTLV-I Infections/immunology , Human T-lymphotropic virus 1/immunology , Hyalohyphomycosis/immunology , Immunocompromised Host , Leukemia-Lymphoma, Adult T-Cell/immunology , Adult , Antifungal Agents/therapeutic use , Antineoplastic Agents/therapeutic use , Biopsy , Dermatomycoses/diagnosis , Dermatomycoses/drug therapy , Dermatomycoses/microbiology , Disease Progression , Fatal Outcome , HTLV-I Infections/diagnosis , HTLV-I Infections/virology , Human T-lymphotropic virus 1/isolation & purification , Humans , Hyalohyphomycosis/diagnosis , Hyalohyphomycosis/drug therapy , Hyalohyphomycosis/microbiology , Leukemia-Lymphoma, Adult T-Cell/diagnosis , Leukemia-Lymphoma, Adult T-Cell/drug therapy , Leukemia-Lymphoma, Adult T-Cell/virology , Male , Treatment OutcomeABSTRACT
Fusarium and Aspergillus species of mold are major causes of corneal infections in the United States and worldwide, resulting in severe visual impairment and blindness. As there is evidence for T cell responses to these pathogenic fungi in infected individuals, we examined the role of IL-17A (IL-17) and IFN-γ in murine models of fungal keratitis. We found that C57BL/6 mice given intratracheal or s.c. immunization of conidia prior to corneal infection exhibited enhanced fungal killing and lower corneal opacity compared with unimmunized mice. Protective immunity was associated with temporal recruitment of IL-17-producing neutrophils and Th17 and Th1 cells and dependent on production of IL-17 but not IFN-γ. Protection was also impaired in neutrophil-depleted and Rag2(-/-) mice. Together, the results of these studies identify an essential role for IL-17-producing neutrophils and Th17 cells in regulating the growth of fungal hyphae and the severity of corneal disease.
