RESUMO
Primary cutaneous mucormycosis is caused by environmental fungi and may complicate leg ulcers or traumatic wounds even in immunocompetent individuals. This case report highlights recurrent lower limb ulcers and cellulitis in a patient with type two diabetes mellitus, which was unresponsive to conventional antibiotic treatment. Histopathology revealed the diagnosis of cutaneous mucormycosis, and fungal cultures identified Rhizopus variabilis as the causative organism. Initial courses of oral azole antifungals yielded only partial response and he eventually required more aggressive treatment with i.v. amphotericin B and oral posaconazole. Good treatment outcomes for this condition require a high index of clinical suspicion, early histopathological and microbiological diagnosis, targeted systemic antifungal therapy, and surgical debridement if necessary.
Assuntos
Antifúngicos , Celulite (Flegmão) , Dermatomicoses , Diabetes Mellitus Tipo 2 , Úlcera da Perna , Mucormicose , Humanos , Mucormicose/diagnóstico , Mucormicose/complicações , Celulite (Flegmão)/microbiologia , Celulite (Flegmão)/tratamento farmacológico , Masculino , Diabetes Mellitus Tipo 2/complicações , Antifúngicos/uso terapêutico , Úlcera da Perna/microbiologia , Dermatomicoses/diagnóstico , Dermatomicoses/tratamento farmacológico , Dermatomicoses/patologia , Rhizomucor/isolamento & purificação , Anfotericina B/uso terapêutico , Recidiva , Pessoa de Meia-Idade , Triazóis/uso terapêutico , Rhizopus/isolamento & purificaçãoRESUMO
Fungal infections are generally observed in immunosuppressed patients only, with a diagnostic challenge due to non-specific symptoms. For this reason, appropriate management may be delayed. This case report concerns a 36-year-old man with history of pancreas and kidney transplantation. He had chemotherapy for post-transplant B-cell lymphoma and presented with left upper abdominal pain and fever. Multiple investigations led to a final diagnosis of disseminated abdominal mucormycosis with multiple Rhizomucor abscesses in the liver, spleen and kidney transplant. Treatment was antifungal therapy and laparotomy with splenectomy, wedge resection of two fungal abscesses in segments II and IVb, and segmental left colic resection.
Assuntos
Abscesso Abdominal/diagnóstico , Transplante de Rim , Mucormicose/diagnóstico , Transplante de Pâncreas , Complicações Pós-Operatórias/diagnóstico , Rhizomucor/isolamento & purificação , Abscesso Abdominal/etiologia , Abscesso Abdominal/cirurgia , Adulto , Hepatectomia , Humanos , Hepatopatias/diagnóstico , Hepatopatias/etiologia , Hepatopatias/cirurgia , Masculino , Mucormicose/etiologia , Mucormicose/cirurgia , Complicações Pós-Operatórias/cirurgia , Esplenectomia , Esplenopatias/diagnóstico , Esplenopatias/etiologia , Esplenopatias/cirurgiaRESUMO
γ-Linolenic acid (GLA) and carotenoids have attracted much interest due to their nutraceutical and pharmaceutical importance. Mucoromycota, typical oleaginous filamentous fungi, are known for their production of valuable essential fatty acids and carotenoids. In the present study, 81 fungal strains were isolated from different Egyptian localities, out of which 11 Mucoromycota were selected for further GLA and carotenoid investigation. Comparative analysis of total lipids by GC of selected isolates showed that GLA content was the highest in Rhizomucor pusillus AUMC 11616.A, Mucor circinelloides AUMC 6696.A, and M. hiemalis AUMC 6031 that represented 0.213, 0.211, and 0.20% of CDW, respectively. Carotenoid analysis of selected isolates by spectrophotometer demonstrated that the highest yield of total carotenoids (640 µg/g) was exhibited by M. hiemalis AUMC 6031 and M. hiemalis AUMC 6695, and these isolates were found to have a similar carotenoid profile with, ß-carotene (65%), zeaxanthin (34%), astaxanthin, and canthaxanthin (5%) of total carotenoids. The total fatty acids of all tested isolates showed moderate antimicrobial activity against Staphylococcus aureus and Salmonella Typhi, and Penicillium chrysogenum. To the best of our knowledge, this is the first report on the highest yield of total lipid accumulation (51.74% CDW) by a new oleaginous fungal isolate R. pusillus AUMC 11616.A. A new scope for a further study on this strain will be established to optimize and improve its total lipids with high GLA production. So, R. pusillus AUMC 11616.A might be a potential candidate for industrial application.
Assuntos
Carotenoides/metabolismo , Ácido Linoleico/biossíntese , Mucor/metabolismo , Rhizomucor/metabolismo , Ácido gama-Linolênico/metabolismo , Anti-Infecciosos/farmacologia , Egito , Ácidos Graxos/análise , Ácidos Graxos/metabolismo , Liofilização , Metabolismo dos Lipídeos , Testes de Sensibilidade Microbiana , Mucor/química , Mucor/genética , Mucor/isolamento & purificação , Filogenia , Rhizomucor/química , Rhizomucor/genética , Rhizomucor/isolamento & purificaçãoRESUMO
The order Mucorales is an ancient group of fungi classified in the subphylum Mucoromycotina. Mucorales are mainly fast-growing saprotrophs that belong to the first colonizers of diverse organic materials and represent a permanent part of the human environment. Several species are able to cause human infections (mucormycoses) predominantly in patients with impaired immune system, diabetes, or deep trauma. In this review, we compiled 32 reports on community- and hospital-acquired outbreaks caused by Mucorales. The most common source of mucoralean outbreaks was contaminated medical devices that are responsible for 40.7% of the outbreaks followed by contaminated air (31.3%), traumatic inoculation of soil or foreign bodies (9.4%), and the contact (6.2%) or the ingestion (6.2%) of contaminated plant material. The most prevalent species were Rhizopus arrhizus and R. microsporus causing 57% of the outbreaks. The genus Rhizomucor was dominating in outbreaks related to contaminated air while outbreaks of Lichtheimia species and Mucor circinelloides were transmitted by direct contact. Outbreaks with the involvement of several species are reported. Subtyping of strains revealed clonality in two outbreaks and no close relation in two other outbreaks. Based on the existing data, outbreaks of Mucorales can be caused by heterogeneous sources consisting of different strains or different species. Person-to-person transmission cannot be excluded because Mucorales can sporulate on wounds. For a better understanding and prevention of outbreaks, we need to increase our knowledge on the physiology, ecology, and population structure of outbreak causing species and more subtyping data.
Assuntos
Mucorales , Mucormicose , Infecção Hospitalar/microbiologia , Complicações do Diabetes/microbiologia , Surtos de Doenças , Microbiologia de Alimentos , Humanos , Hospedeiro Imunocomprometido , Tipagem Molecular/métodos , Mucor/crescimento & desenvolvimento , Mucor/isolamento & purificação , Mucor/patogenicidade , Mucorales/classificação , Mucorales/crescimento & desenvolvimento , Mucorales/isolamento & purificação , Mucorales/patogenicidade , Mucormicose/etiologia , Mucormicose/mortalidade , Mucormicose/transmissão , Técnicas de Tipagem Micológica/métodos , Infecções Oportunistas/microbiologia , Rhizomucor/crescimento & desenvolvimento , Rhizomucor/isolamento & purificação , Rhizomucor/patogenicidade , Rhizopus/crescimento & desenvolvimento , Rhizopus/isolamento & purificação , Rhizopus/patogenicidade , Rhizopus oryzae/crescimento & desenvolvimento , Rhizopus oryzae/isolamento & purificação , Rhizopus oryzae/patogenicidade , Ferimentos e Lesões/microbiologiaRESUMO
A 4-year-old captive ringed seal (Pusa hispida) was treated with subcutaneous antibacterial injections for pus exuding wounds in the skin and associated blubber following a bite attack. Three months after the incident, the animal presented nystagmus and died the following day. At necropsy, there was a 25 × 18 × 25 mm well-delineated, opaque nodular mass in the lung, besides the skin ulcers and localized areas of discoloration in the blubber correlating with the bite wound and injection sites. Histopathology of the pulmonary mass demonstrated severe eosinophilic inflammatory infiltration among numerous intralesional fungal hyphae. The hyphae were irregularly branched, broad and aseptate, consistent of zygomycosis. Magnetic resonance imaging was conducted on the head, which was initially frozen intact, revealing diffuse areas of hyperintensity in the cerebellum. Restricted histopathologic examination of the cerebellum showed severe granulomatous inflammation well spread within the neuroparenchyma, associated with abundant intralesional fungal hyphae similar to those appreciated in the pulmonary mass. Molecular analyses of the fungi in the pulmonary and cerebellar tissue identified the etiologic agent in both sites as Rhizomucor pusillus. The likely route of infection is through inhalation of R. pusillus spores or fragmented hyphae from the environment that developed into an initial pulmonary infection, becoming the source of hematogenous dissemination to the cerebellum. The skin and blubber lesions likely contributed to immunosuppression. Zygomycosis is uncommon in pinnipeds, and the present report emphasizes the importance of considering zygomycete dissemination even when the primary focus is highly confined.
Assuntos
Infecções Fúngicas do Sistema Nervoso Central/veterinária , Pneumopatias Fúngicas/veterinária , Mucormicose/veterinária , Rhizomucor/isolamento & purificação , Focas Verdadeiras , Infecção dos Ferimentos/veterinária , Animais , Infecções Fúngicas do Sistema Nervoso Central/microbiologia , Infecções Fúngicas do Sistema Nervoso Central/patologia , Evolução Fatal , Cabeça/diagnóstico por imagem , Histocitoquímica , Pneumopatias Fúngicas/microbiologia , Pneumopatias Fúngicas/patologia , Imageamento por Ressonância Magnética , Masculino , Mucormicose/microbiologia , Mucormicose/patologia , Rhizomucor/classificação , Rhizomucor/genética , Infecção dos Ferimentos/complicações , Infecção dos Ferimentos/patologiaRESUMO
A 61-year-old man with relapsing chronic lymphocytic leukaemia, status post allogeneic stem cell transplant and multiple chemotherapy regimens presented to the emergency room after suffering a grand mal seizure. His evaluation revealed a 1.5-2 cm ring-enhancing left temporal lobe brain lesion on the CT scan. This brain lesion was resected and the histopathology revealed an invasive fungal organism resembling mucormycosis. Amplification and sequencing of the 28S ribosomal RNA gene identified the organism as Rhizomucor pusillus The patient was treated with liposomal amphotericin B 5 mg/kg every 24 hours for 4 weeks, and then was transitioned to oral posaconazole. Serial brain imaging at 1 and 3 months, while on therapy, showed significant improvement.
Assuntos
Abscesso Encefálico/diagnóstico , Mucormicose/diagnóstico , Lobo Temporal , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Abscesso Encefálico/complicações , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/tratamento farmacológico , Diagnóstico Diferencial , Humanos , Hospedeiro Imunocomprometido , Leucemia Linfocítica Crônica de Células B , Masculino , Pessoa de Meia-Idade , Mucormicose/complicações , Mucormicose/diagnóstico por imagem , Mucormicose/tratamento farmacológico , Rhizomucor/isolamento & purificação , Convulsões/etiologia , Transplante de Células-Tronco , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Pulmonary mucormycosis is a rare opportunistic infection with high mortality that is caused by species of Mucorales. The most common species involved are Rhizopus, Mucor, Lichtheimia, and Rhizomucor. CASE REPORT: A 56 year-old woman presented with a clinical history of diabetes mellitus type 2 and chronic renal disease. She underwent a cadaveric kidney transplantation two years before her admission, for which immunomodulating therapy with thymoglobulin, tacrolimus, mofetil-microphenolate and prednisone was established. The patient suffered a pneumonic process with cough, expectoration, and dyspnoea. The computed tomography scan showed a cavitation in the right upper lobe. With all these findings an invasive broncopulmonary aspergillosis was suspected and the patient began an antifungal treatment with voriconazole without improvement. Rhizomucor pusillus was isolated from a clinical specimen obtained by fine needle aspiration, and its identification was confirmed by PCR. After this finding amphotericin B was administered, but the patient had an uncontrolled haemoptysis and died. CONCLUSIONS: Pulmonary mucormycosis is a rare infection, usually fatal in kidney transplant recipients with anti-rejection therapy. Mucorales species usually produce thrombotic phenomena, associated with necrosis and parenchymal destruction that caused a fatal uncontrolled haemoptysis in our patient. Early diagnosis is important in order to perform any surgical treatment and to administer amphotericin B.
Assuntos
Hemoptise/etiologia , Transplante de Rim , Pneumopatias Fúngicas/microbiologia , Mucormicose/microbiologia , Complicações Pós-Operatórias/microbiologia , Rhizomucor/isolamento & purificação , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Biópsia por Agulha Fina , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/cirurgia , Evolução Fatal , Feminino , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Falência Renal Crônica/cirurgia , Pulmão/microbiologia , Pulmão/patologia , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/tratamento farmacológico , Pessoa de Meia-Idade , Mucormicose/complicações , Mucormicose/tratamento farmacológico , Complicações Pós-Operatórias/tratamento farmacológicoRESUMO
No disponible
Assuntos
Humanos , Feminino , Adulto , Dermatopatias Infecciosas/microbiologia , Mucor/isolamento & purificação , Mucormicose/microbiologia , Rhizomucor/isolamento & purificação , Anfotericina B/uso terapêuticoRESUMO
We describe a severe pulmonary invasive zygomycosis sustained by Rhizomucor pusillus and concomitant bacterial endocarditis in a woman diagnosed with acute promyelocytic leukaemia.
Assuntos
Endocardite Bacteriana/complicações , Hospedeiro Imunocomprometido , Leucemia Promielocítica Aguda/complicações , Pneumopatias Fúngicas/microbiologia , Rhizomucor/isolamento & purificação , Zigomicose/complicações , Antifúngicos/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Pneumopatias Fúngicas/diagnóstico , Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/cirurgia , Pessoa de Meia-Idade , Pneumonectomia , Índice de Gravidade de Doença , Resultado do Tratamento , Zigomicose/diagnóstico , Zigomicose/tratamento farmacológicoRESUMO
We describe a case of primary cutaneous mucormycosis in a 44-year-old man with an 18-month history of infiltrative erythematous plaques and haemorrhagic crusting on the dorsum of his left hand. The isolate was identified as Mucor irregularis (formerly Rhizomucor variabilis) based on the fungus morphology and DNA sequencing results. Improvement was observed after a 6-month treatment course of itraconazole. No recrudescence was seen during a follow-up of 23 months after treatment.
Assuntos
Dermatomicoses/microbiologia , Dermatoses da Mão/microbiologia , Mucormicose/microbiologia , Rhizomucor/isolamento & purificação , Adulto , Antifúngicos/uso terapêutico , Dermatomicoses/tratamento farmacológico , Dermatoses da Mão/tratamento farmacológico , Humanos , Itraconazol/uso terapêutico , Masculino , Mucormicose/tratamento farmacológico , Resultado do TratamentoRESUMO
The natural microbiota involved in the fermentation influence the quality and taste of fully postfermented teas such as China's Pu-erh tea. Ten microbial isolates representing 6 species were recovered from a solid-state fermentation of a Pu-erh type tea. The isolates were Aspergillus tubingensis, Aspergillus marvanovae, Rhizomucor pusillus, Rhizomucor tauricus, Aspergillus fumigatus, and Candida mogii. With the exception of A. marvanovae and C. mogii, all these microorganisms have been previously reported in solid-state fermentations of native Pu-erh tea. The ability of the isolates for converting the tea polyphenols to bioactive theabrownins in infusions of sun-dried green tea leaves in a submerged fermentation process was subsequently investigated. All isolates except C. mogii TISTR 5938 effectively produced theabrownins in a 4-d fermentation in shake flasks at 40 °C, 250 rpm. A. tubingensis TISTR 3646, A. tubingensis TISTR 3647, A. marvanovae TISTR 3648, and A. fumigatus TISTR 3654 produced theabrownins at particularly high levels of 6.5, 12.4, 11.1, and 8.4 g/L, respectively.
Assuntos
Aspergillus/metabolismo , Camellia sinensis/microbiologia , Catequina/análogos & derivados , Fermentação , Polifenóis/metabolismo , Rhizomucor/metabolismo , Chá/microbiologia , Aspergillus/isolamento & purificação , Candida/isolamento & purificação , Catequina/metabolismo , China , Humanos , Folhas de Planta/microbiologia , Rhizomucor/isolamento & purificação , PaladarRESUMO
Antecedentes. Las mucormicosis son infecciones poco frecuentes en pacientes inmunocompetentes, y se han descrito muy pocos casos de mucormicosis asociadas a aspergilosis en pacientes no hematológicos. Caso clínico. Un varón de 17 años, inmunocompetente y sin factores de riesgo previamente conocidos, ingresó en el hospital tras presentar crisis convulsivas 11 días después de sufrir un accidente de moto. Presentó un curso clínico tórpido por infección fúngica invasiva mixta, con afectación pulmonar por Aspergillus niger y mucormicosis diseminada por Rhizomucor pusillus (diagnóstico histopatológico y microbiológico en varios lugares no contiguos). Fue tratado con anfotericina B liposomal durante 7 semanas (dosis total acumulada > 10 g) y precisó múltiples reintervenciones quirúrgicas. El paciente sobrevivió y fue dado de alta de UCI tras 5 meses de evolución y múltiples complicaciones. Conclusiones. El tratamiento con anfotericina B liposomal y el manejo quirúrgico agresivo consiguió la erradicación de la infección fúngica invasiva mixta, pero alertamos de la necesidad de mantener un mayor grado de sospecha clínica y de realizar técnicas de diagnóstico precoz de infecciones fúngicas invasivas en pacientes no inmunodeprimidos para evitar la diseminación de la enfermedad y el mal pronóstico asociado (AU)
Background. Mucormycosis infections are rare in immunocompetent patients, and very few cases of mucormycosis associated with aspergillosis in non-haematological patients have been reported. Case report. A 17-year-old male, immunocompetent and without any previously known risk factors, was admitted to hospital due to a seizure episode 11 days after a motorcycle accident. He had a complicated clinical course as he had a mixed invasive fungal infection with pulmonary involvement due to Aspergillus niger and disseminated mucormycosis due to Rhizomucor pusillus (histopathological and microbiological diagnosis in several non-contiguous sites). He was treated with liposomal amphotericin B for 7 weeks (total cumulative dose > 10 g) and required several surgical operations. The patient survived and was discharged from ICU after 5 months and multiple complications. Conclusions. Treatment with liposomal amphotericin B and aggressive surgical management achieved the eradication of a mixed invasive fungal infection. However, we emphasise the need to maintain a higher level of clinical suspicion and to perform microbiological techniques for early diagnosis of invasive fungal infections in non-immunocompromised patients, in order to prevent spread of the disease and the poor prognosis associated with it (AU)
Assuntos
Humanos , Masculino , Adulto Jovem , Rhizomucor/isolamento & purificação , Rhizomucor/patogenicidade , Aspergillus niger , Aspergillus niger/isolamento & purificação , Aspergillus niger/patogenicidade , Mucormicose/diagnóstico , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Anfotericina B/uso terapêutico , Infecções/cirurgia , Infecções/tratamento farmacológico , Rhizomucor , Biópsia/métodos , Controle de Infecções/métodos , Aspergilose Pulmonar/microbiologia , Fatores de Risco , Rinite/complicações , Rinite/microbiologia , Necrose/complicações , Técnicas MicrobiológicasRESUMO
BACKGROUND: Mucormycosis infections are rare in immunocompetent patients, and very few cases of mucormycosis associated with aspergillosis in non-haematological patients have been reported. CASE REPORT: A 17-year-old male, immunocompetent and without any previously known risk factors, was admitted to hospital due to a seizure episode 11 days after a motorcycle accident. He had a complicated clinical course as he had a mixed invasive fungal infection with pulmonary involvement due to Aspergillus niger and disseminated mucormycosis due to Rhizomucor pusillus (histopathological and microbiological diagnosis in several non-contiguous sites). He was treated with liposomal amphotericin B for 7 weeks (total cumulative dose >10 g) and required several surgical operations. The patient survived and was discharged from ICU after 5 months and multiple complications. CONCLUSIONS: Treatment with liposomal amphotericin B and aggressive surgical management achieved the eradication of a mixed invasive fungal infection. However, we emphasise the need to maintain a higher level of clinical suspicion and to perform microbiological techniques for early diagnosis of invasive fungal infections in non-immunocompromised patients, in order to prevent spread of the disease and the poor prognosis associated with it.
Assuntos
Aspergilose/complicações , Aspergillus niger/isolamento & purificação , Traumatismos Craniocerebrais/complicações , Imunocompetência , Mucormicose/complicações , Rhizomucor/isolamento & purificação , Infecção dos Ferimentos/microbiologia , Acidentes de Trânsito , Adolescente , Afasia Acinética/etiologia , Anfotericina B/uso terapêutico , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergilose/microbiologia , Coinfecção/tratamento farmacológico , Coinfecção/microbiologia , Terapia Combinada , Traumatismos Craniocerebrais/cirurgia , Cuidados Críticos/métodos , Gastroenteropatias/etiologia , Gastroenteropatias/cirurgia , Humanos , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/microbiologia , Pneumopatias Fúngicas/cirurgia , Masculino , Mucormicose/tratamento farmacológico , Mucormicose/microbiologia , Complicações Pós-Operatórias/microbiologia , Fraturas Cranianas/etiologia , Fraturas Cranianas/cirurgia , Úlcera/etiologia , Úlcera/cirurgiaRESUMO
The growing popularity of traditional Korean alcoholic beverages has led to a demand for quality enhancement of the traditional starter culture nuruk, which consists primarily of wheat. Therefore, this study focused on mycoflora characterization and the temporal variations in traditional wheat-based nuruks fermented at two representative traditional temperature conditions for 30 days. Nuruk A was fermented at a constant temperature of 36°C for 30 days and nuruk B was fermented at a high initial temperature of 45°C for 10 days followed by 35°C for 20 days. The average mycoflora load in the two different nuruk conditions did not vary significantly between the 0 and 30 day cultures, and a maximum load of 8.39 log CFU/g was observed for nuruk A on culture day 3 and 7.87 log CFU/g for nuruk B on culture day 30. Within two samples, pH was negatively correlated with temporal changes in mycoflora load. The pH of nuruk A was significantly lower than that of nuruk B at all of the time points evaluated. Culture-dependent characterization led to the identification of 55 fungal isolates belonging to 9 genera and 15 species, with the most prominent genera comprising Lichtheimia, Penicillium, Trametes, Aspergillus, Rhizomucor, and Mucor. A total of 25 yeast isolates were characterized belonging to 6 genera and 7 species, the most prominent among which were Rhodotorula, Pichia, Debaryomyces, Saccharomycopsis, and Torulospora. Mycofloral community dynamics analysis revealed that both samples A and B varied considerably with respect to the fungal communities over a span of 30 days.
Assuntos
Fermentação , Fungos/classificação , Fungos/isolamento & purificação , Triticum/microbiologia , Leveduras/classificação , Leveduras/isolamento & purificação , Bebidas Alcoólicas/microbiologia , Aspergillus/isolamento & purificação , Biodiversidade , Fungos/genética , Mucor/isolamento & purificação , Penicillium/isolamento & purificação , Rhizomucor/isolamento & purificação , Temperatura , Trametes/isolamento & purificação , Leveduras/genéticaRESUMO
Zygomycosis is a lethal and invasive mold infection that is often associated with hematological malignancies. The keys for successful treatment include making a rapid diagnosis and appropriately administering antifungal agents. We herein report the early diagnosis of a case of zygomycosis in a patient with acute myeloid leukemia using a deoxyribonucleic acid sequence analysis. We successfully performed allogeneic hematopoietic stem cell transplantation with the use of high-dose liposomal amphotericin B and granulocyte transfusion.
Assuntos
Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Leucemia Mieloide Aguda/complicações , Mucormicose/diagnóstico , Mucormicose/tratamento farmacológico , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/tratamento farmacológico , Rhizomucor/genética , Análise de Sequência de DNA , Humanos , Lipossomos , Masculino , Pessoa de Meia-Idade , Mucormicose/complicações , Infecções Oportunistas/complicações , Reação em Cadeia da Polimerase , Rhizomucor/isolamento & purificaçãoRESUMO
We report a patient with relapsed acute myelogenous leukemia after allogeneic stem cell transplantation who developed disseminated mucormycosis due to Rhizomucor pusillus/R. miehei involving lung, brain, and skin. After failing posaconazole and being intolerant to amphotericin, he was treated effectively with isavuconazole for over 6 months despite ongoing treatment for relapsed leukemia.
Assuntos
Antifúngicos/uso terapêutico , Mucormicose/diagnóstico , Mucormicose/tratamento farmacológico , Nitrilas/uso terapêutico , Piridinas/uso terapêutico , Rhizomucor/isolamento & purificação , Triazóis/uso terapêutico , Encéfalo/microbiologia , Encéfalo/patologia , Humanos , Hospedeiro Imunocomprometido , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/terapia , Pulmão/microbiologia , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Mucormicose/microbiologia , Pele/microbiologia , Pele/patologia , Transplante de Células-Tronco/efeitos adversos , Transplante Homólogo/efeitos adversos , Resultado do TratamentoRESUMO
Rhizomucor variabilis is a rare cause of human infections. We report a case of primary cutaneous zygomycosis in an immunocompetent host. Although microscopy reveals the fungal aetiology, the need for species identification is highlighted to better understand the species and establish an epidemiological pattern as it is reported from restricted geographical locations.
Assuntos
Dermatomicoses/diagnóstico , Dermatomicoses/patologia , Rhizomucor/isolamento & purificação , Zigomicose/diagnóstico , Zigomicose/patologia , DNA Fúngico/química , DNA Fúngico/genética , DNA Espaçador Ribossômico/química , DNA Espaçador Ribossômico/genética , Dermatomicoses/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Sequência de DNA , Zigomicose/microbiologiaAssuntos
Leucemia Mielomonocítica Aguda/microbiologia , Micoses/complicações , Antifúngicos/uso terapêutico , Candida glabrata/efeitos dos fármacos , Candida glabrata/isolamento & purificação , Farmacorresistência Fúngica , Equinocandinas/uso terapêutico , Evolução Fatal , Humanos , Leucemia Mielomonocítica Aguda/complicações , Leucemia Mielomonocítica Aguda/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Micoses/tratamento farmacológico , Micoses/patologia , Rhizomucor/efeitos dos fármacos , Rhizomucor/isolamento & purificação , Baço/irrigação sanguínea , Baço/microbiologia , Baço/patologiaRESUMO
The number of patients with haematopoietic malignancies receiving chemotherapy and stem-cell transplantation has increased the incidence of severe opportunistic infections. Systemic fungal infections are of major concern in immunocompromised patients, as these infections are often fatal. We report a case of a patient with acute myeloid leukaemia who developed multiple cutaneous plaques and necrotizing infiltrates in the lungs during chemotherapy. Using real-time PCR on a wax-embedded tissue sample, Rhizomucor pusillus was identified. We provide an overview of the literature on cutaneous mucormycosis and its diagnosis by PCR.
Assuntos
Dermatomicoses/microbiologia , Hospedeiro Imunocomprometido , Pneumopatias Fúngicas/microbiologia , Mucormicose/microbiologia , Rhizomucor/isolamento & purificação , Sinusite/microbiologia , Doença Aguda , Idoso , Humanos , Masculino , Reação em Cadeia da PolimeraseRESUMO
Zygomycoses are opportunistic infections caused by the Mucorales fungi. They are typically seen in immunosuppressed patients. The incidence of zygomycosis cases seems to be increasing. We report on zygomycosis in a pediatric, female stem-cell-transplant recipient. This case report underlines the difficulty of taking care of patients with zygomycosis. In fungal infections of immunosuppressive patients on broad-coverage antibiotics, foci of skin necrosis are unique and typical for zygomycoses, and may be helpful in this challenging diagnosis.